The laws surrounding applying and getting approved for Social Security can be confusing and frustrating, which is why it’s helpful to find an expert Social Security disability attorney in St Charles you trust. The emotions start when you receive that denial letter in the mail. You applied for Social Security disability (SSDI) or Supplemental Security Income (SSI) benefits with the hope your benefits would be approved and that would be the end of your worry. Instead, a denial notice arrives from the Social Security Administration (SSA), and you do not understand what it means. Let’s break down the process after denial:
Step 1: Request for Reconsideration
In most states, the first step to take after receiving your initial letter of denial or termination of disability benefits after continuing disability review is to request the Social Security Administration take another look at your case through a Request for Reconsideration. A few states skip this step though, and so you would proceed to the hearing stage if you wanted to continue pursuing your benefits denial case. Many folks, however, have no choice but to continue as working in pain is just not an option. (Go to Step 2 if your state skips the Request for Reconsideration step.)
Reconsideration of Initial Claims
If you received a denial notice after filing your first application of benefits, then request reconsideration. The denial notice you received in the mail will outline information about your rights to appeal and include a paragraph detailing the findings regarding your medical condition. Go to your local Social Security Administration to file the request for reconsideration appeal or visit the SSA website (www.ssa.gov) and click “Find a Social Security Office” to locate one nearest you. So what will a request for reconsideration do? The SSA office will assign an examiner or medical consultant from Disability Determination Services who has never reviewed your case to perform a review. None of the original consultants or examiners who reviewed your initial claim will be allowed to decide your reconsideration request. Approximately 5 to 10% of reconsiderations filed are approved for benefits at this level. For the other 90 to 95% who are denied again, you will receive another denial letter. Your next step is to file a request for a hearing before an administration law judge. (Go to Step 2).
Reconsideration after Termination of Benefits
You may not be “in the clear” forever after you begin receiving disability benefits, as your case will be re-visited from time-to-time to determine whether continuing benefits is necessary. This is called a continuing disability review (CDR), and the SSA may rule to discontinue your benefits for any number of reasons including:
- if your condition has improved to the point you can return to some form of work
- if you fail to cooperate with the continuing disability review
To appeal termination of your benefits, you have to request a reconsideration of the decision before a disability hearing officer at a hearing. But before your claim is taken to the hearing officer, it will receive a second review from yet another examiner and medical consultant who may reverse the prior decision to terminate benefits. Disability hearing officers are not medically-trained physicians or psychologists, but are allowed to review your medical evidence and provide a medical opinion concerning the severity of your physical and/or mental condition. When preparing for the hearing with the disability hearing officer, remember that the SSA must show sound evidence that your medical condition has improved significantly and to the point of being able to return to work. Your treating physician’s opinion and medical records will be an important part of that evidence. Your benefits will continue if you win your appeal. If your claim is denied on this level, you may continue the appeals process by requesting a hearing before an administrative law judge. (Go to Step 2.)
Step 2: Administrative Law Judge Hearing
When your request for reconsideration of your initial claim for disability or termination based on a continuing disability review has been denied, you have 60 days from the date you receive your denial notice in which to request a hearing before an administrative law judge (ALJ). An ALJ is actually an attorney who works for the Social Security Administration. Their primary function is to either uphold or overturn a denial for disability benefits. Taking the time to reach this step in your appeal is important, because ALJs approve over 65% of the claims before them. There are even a few ALJs who approve a higher number of claims than the average.
Step 3: The Appeals Council
If you are once again denied benefits at your hearing with the ALJ, you may request a review by the Appeals Council. The Appeals Council randomly selects cases, so wait times can be lengthy. They may deny, grant or dismiss your request. Success at the Appeals Council level is far rarer than at the ALJ stage. The Appeals Council may even dismiss your case without review if you die or file late unless they find any of the following:
- discretion abuse or an ALJ made an error of law
- there is not substantial evidence supporting the ALJ’s decision
- the case raises a broad procedural or policy issues
Step 4: Federal Court Review
The final step in the appeals process necessitates hiring an attorney like a Social Security disability attorney in St Charles. It would be exceedingly difficult for someone who is not an attorney to file a lawsuit in U.S. district court and successfully sue the Social Security Administration. These disability cases are heard by federal judges without juries, and reverse about a third of them. although the chance of winning an appeal on this level is fairly good, the process is expensive, time-consuming, and may take years to reach end.
Contact a St. Charles Social Security Disability Attorney
When it comes to your livelihood and quality of life, you want an attorney who understands every aspect of the Social Security disability claims and appeals process. St. Charles Social Security disability attorney David M. Hicks has the experience required to make your best case. Call (314) 812-4885 to set up a consultation. Hire a Social Security disability attorney in St Charles who will stick with you through your appeals.