Social Security Benefit Claim DenialWhen you are disabled and unable to work, you may need financial support and want to apply for Social Security disability benefits. This process can be complex, frustrating, and overwhelming, as most people don’t know the right approach to take or where to begin. Additionally, it’s important to know that nearly 70 percent of all initial claims filed with the Social Security Administration (SSA) are denied. The following information will explain the general claims process and what you’ll need to have a better chance of getting an approval.

The Initial Application

When you begin the claims process for disability benefits, you start by filing an application. Before you do this, it’s important to talk to your treating physician and explain your intent to file because your doctor is critical in helping you receive an approved claim. Not only will the SSA contact your doctor for information about your medical condition and how it interferes with your ability to work, you will need the right kind of medical evidence with your application. This evidence can be the key in whether or not your claim gets approved. So, before you begin filling out the application, make sure you have a complete copy of your medical records to help you prepare your claim.

Filling Out the Form

When you fill out the disability application, don’t just answer the questions. Make sure you provide detailed and exhaustive answers. The adjudicator reviewing your file knows nothing about your medical condition, so basic yes and no answers won’t help him understand why your illness is disabling. Without complete, in-depth information, your claim will likely be denied. Thus, give as many specific facts as you can about your condition, and explain how each fact affects your medical situation.

It may take up to six months for you to receive a decision on your application. If you’re denied, there are steps you can take to appeal. To request an appeal, you’ll need to send a written request to the SSA within 60 days of your denial. While you should have an attorney to help you through the initial application step, it’s especially important to hire one at this point.

The 4 Levels of Appeal

In general, there are four levels to the appeals process: Reconsideration; Hearing by an Administrative Law Judge; Review by the Appeals Council; and Federal Court Review. If you’re moving on to appeal your claims decision, it’s important to understand each of these levels:

1. Reconsideration

This is the first level of the appeals process where your entire claim will be reviewed at the SSA by someone who did not take part in the first determination. The SSA looks at your complete file and all the evidence again, as well as at any new evidence you may have sent them in the interim. Thus, if you have additional medical reports, lab test results, or other critical information, you can submit them for the review. You do not have to be present for this file review.

2. Hearing by an Administrative Law Judge

If your appeal is denied again at the reconsideration stage, you can ask for a hearing. This hearing is handled by an administrative law judge not involved in the initial denial of your claim or in the reconsideration. The SSA will notify you of the location of the hearing and the date and time. You may also be asked to send additional, clarifying evidence about your medical condition. At the hearing, you’ll be asked questions by the judge, and you can bring witnesses and experts about your disability. The judge’s decision is sent to you in a letter.

3. Review by the Appeals Council

You can request a review by the Social Security’s Appeals Council if you disagree with the judge’s decision. The Council can either make a decision in your case or send it back to the judge to be reviewed again. If the Council believes the decision made at the hearing was correct, it can also deny your request for a review.

4. Federal Court

If the Council refuses to review your case or you disagree with the findings, you are allowed to file a lawsuit in a federal district court. When you receive the letter about the Council’s decision, it will include information about how to make this request for a court case.

Smith Klein Law Can Help

If you need help with the Social Security disability claims process, Smith Klein Law can help. We’ve assisted clients with their paperwork and managed them through every level of the appeals process. Contact us for a free consultation, and we will evaluate your case and discuss how we might be able to increase your chances of receiving an approval on your claim.