Last updated on November 14th, 2023
You waited months and finally got your Social Security Disability determination letter in the mail. But instead of an approval, you’re reading a denial. After working your whole life, you’re now stuck without an income – even though you’re impaired and are finding it difficult to work.
Don’t throw in the towel just yet. Getting denied after an initial application is common. That’s why it’s important to notify an SSDI lawyer about your case. This is true whether you need to fill out an application or you’re making an appeal. You can get denied for medical and/or non-medical reasons.
To determine if someone is eligible for disability benefits, the Social Security Administration (SSA) follows a process, using the criteria below as a guide.
1. Work Credits Evaluation. The SSA initially reviews the applicant’s work history and the worker’s contributions to Social Security taxes to assess if they have the needed or earned work credits required for making a claim.
2. Severity Assessment. Next, the SSA considers the severity of the applicant’s condition. They determine whether it significantly limits their ability to perform work activities like walking, sitting, and remembering. The impairment should affect daily work activities for a period of at least 12 months.
3. Impairment List Analysis. The SSA maintains a list of impairments known as the “Blue Book,” which includes conditions that automatically qualify as disabilities. If an individual’s condition is not on the list, the SSA evaluates whether it is equal in severity to one of the listed impairments.
4. Evaluation of Work Ability. In cases where the condition is severe but not on par with a listed medical condition, the SSA examines whether the condition prevents the applicant from performing their previous job.
5. Assessment of Alternative Work Options. If an individual cannot continue with their job due to impairment, the SSA assesses whether they are capable of adjusting to other types of work.
The Social Security Administration (SSA) takes other factors into account as well when assessing an individual’s eligibility for SSDI benefits. These factors include the person’s overall health, age, level of education, prior work experience, and any skills that can be transferred to other jobs.
To get approved at the reconsideration level, providing additional medical evidence about your condition is key. Work closely with your doctor(s) to obtain updated medical records, test results, and evaluations.
Obtain a statement from your healthcare provider about how your condition prevents you from working. Submit this new evidence along with a letter you’ve written that explains how your condition has changed or worsened since the denial of your claim.
The reconsideration process typically takes 3 to 6 months. During this time, the SSA will review your medical records and any new evidence submitted to determine if their initial denial was premature or incorrect. Here’s what you can expect:
With the help of your attorney, you’ll start gathering updated medical records and statements from your doctors regarding your condition and limitations. Expect to schedule new evaluations from any new treating physicians as well.
When filing the request for reconsideration, you’ll have 60 days to take action following receipt of the denial letter. The letter is sent to the SSA office that rendered the initial decision.
A different disability examiner and medical consultant, not involved in your first claim, will review your file. They will evaluate all medical records and evidence to determine if you meet the Blue Book listing or have an impairment that is equal to the severity of a listed condition. If needed, they may request additional medical exams or evaluations.
After the review is complete, you will receive a written decision in the mail, either approving or denying your claim. If approved, you’ll start receiving your benefits. If denied again, you have the option to file an appeal for a hearing before an administrative law judge.
An attorney who handles SSDI claims can help support your case for reconsideration, even if you’re denied again. They know the ins and outs of the system and what the SSA is looking for to approve a claim.
Hiring an attorney for your SSDI reconsideration, therefore, can increase your chances of finally getting approved. Going it alone rarely works out in your favor, especially on reconsideration. Here are a few reasons why legal counsel is so important at this stage.
Disability attorneys have experience representing people just like you. They know the ins and outs of the SSDI system and what medical evidence the judges and examiners find the most persuasive. With their resources, they can build a strong case to show how your condition prevents you from working.
An attorney and their staff will handle collecting all the necessary paperwork so you can focus on your health.
If your claim is denied after an administrative hearing, an attorney can also help you appeal to federal court. Again, don’t despair – get legal help. With the right attorney advocating for you, you’ll get the SSDI benefits you deserve.
Attorneys who handle SSDI claims do this day in and day out. They stay up-to-date with the latest laws and regulations. More importantly, they understand what medical evidence and explanations the SSA finds most convincing. An experienced attorney will know how to present your case in the best possible light to increase the odds of approval.
Your attorney can help obtain additional medical records and statements from your doctors to further support your claim. They know what specific details and language the SSA prefers to see in medical evidence.
The attorney may also send you to doctors for independent medical evaluations. All of this additional evidence significantly impacts a reconsideration request or an appeal.
The paperwork required for an SSDI claim can be extensive and exhausting. An attorney has a dedicated staff who will help collect medical records, fill out forms, write statements, and draft a reconsideration request or appeal.
They’ll ensure that all the information is complete, consistent, and presented in the proper format by the proper date. This lifts the burden from you and avoids unnecessary delays in your case.
Again, if your claim is denied after an administrative hearing, an attorney can file an appeal to take your case before a federal judge. In this forum, the judge will review all the evidence and may question you about your condition. Having an attorney to represent you at this fourth and final stage is critical.
With an attorney at your side, you can gain further support through the cross-examination of medical experts as well.
An attorney can gather powerful information and will stay committed to fighting for the fair outcome of a claim, no matter how long it takes. With their knowledge and advocacy, you can get approval on reconsideration or, after a second appeals denial, get approved by a federal judge.
It’s important to stay proactive during the SSDI reconsideration process. Keep your medical information current and gather as much evidence as you can to show the seriousness of your impairment.
Work with your healthcare providers to obtain updated medical records, test results, evaluations, and statements about your condition and limitations since your initial denial or a denied reconsideration. New evidence is key. Provide specifics on symptoms, diagnoses, treatments, side effects, and how your condition still prevents you from working.
Again, our SSDI lawyer can review your claim, gather the necessary medical records, and submit a comprehensive appeal on your behalf.
Many SSDI attorneys don’t charge upfront fees and only collect payment if you are awarded benefits. Therefore, you can receive legal help at an economical cost to you. So, it can pay–literally–to appeal.
You must submit your request for reconsideration within 60 days of receiving your denial letter. Include a cover letter summarizing why you disagree with the decision and a list of additional evidence that you wish to include. Your attorney can help draft the letter and submit it for you electronically via the SSA website.
The key, again, is not to give up if you get denied. Keep providing updated medical evidence, work with an SSDI lawyer, and pursue every appeal option available to you.
While the road to SSDI benefits can be long and rocky, you still have a good chance of being approved. You just need to stay determined and patient through each stage.
An attorney who handles disability cases possesses the experience needed to present the strongest case possible. Don’t ever go it alone when you’re dealing with this type of claim. An attorney can pick up the pieces that may be ignored or overlooked along the way.
Do you need to file an SSDI claim, or do you need help with an SSDI reconsideration with an attorney? If so, contact Dyer, Garofalo, Mann & Schultz today. Get the help you need now to ensure you receive the benefits you need and deserve for you and your family.
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