Have you recently been denied benefits for a legitimate disability? Claimants who should be eligible for benefits through the Social Security Administration (SSA) but received a determination letter denying their claim may consider filing a disability reconsideration appeal. The SSA has a habit of denying claims, especially ones filed by applicants instead of attorneys. A denial doesn’t mean you don’t have other options.
Speak to an experienced Social Security Disability lawyer in Ohio immediately after receiving your determination letter to comply with deadlines. You’ll want to determine if you have a realistic shot at reversing their decision for denial through a disability reconsideration appeal.
What Is Reconsideration?
Reconsideration occurs when you apply for disability, and the SSA denies it. It’s the first step in the SSA disability claims appeal process. An adjudicative team—consisting of a disability claims examiner and a medical or psychological consultant will review your application and all case evidence. They and a disability hearing officer will decide whether your denial was correct or you have a valid claim to receive disability.
Should You File a Disability Reconsideration Appeal?
Whether you should file a disability reconsideration appeal relies primarily on the type of denial your claim receives. There are two denial types: medical and technical. The latter is considerably more challenging to appeal. If you receive a medical denial, the SSA doesn’t believe your medical condition qualifies as a disability.
Having an experienced disability lawyer help with medical appeals for claim denials can significantly strengthen your case. They can gather additional evidence, including medical expert testimony, to find ways to get your claim approved.
Technical appeals are considerably less common. These denials mean you don’t meet the non-medical qualifications, such as not having enough work credits or exceeding your substantial gainful activity (SGA).
Benefits of Hiring an Attorney for Your Disability Reconsideration Appeal
A study by the U.S. Government Accountability Office (GAO) determines that claimants who hire a Social Security attorney are three times more likely to be more successful in receiving disability benefits approval than those without legal representation. Knowing that should give a claimant a sense of security, as they allow a professional to fight for their benefit rights.
Additionally, a disability lawyer offers contingency arrangements, evaluates claim denials, handles paperwork and deadlines, submits additional evidence, represents you at hearings, and guides you through further appeals process.
Contingency Arrangements
A significant benefit to hiring a Social Security disability lawyer is their contingency arrangements. These arrangements allow anyone to receive legal counsel because they require no upfront fees. Your attorney will also not be paid unless you do, meaning their fees are contingent on winning your disability reconsideration appeal. Knowing that offers clients peace of mind by alleviating financial stress or experiencing hardship.
Paperwork and Deadlines
Your disability lawyer will ensure the proper completion, organization, and filing of all paperwork and meet all legal deadlines. They must submit a request for reconsideration within 60 days of the date you received notice of your initial determination. Do not delay scheduling a consultation.
Evaluating Claim Denial
The SSA will include the reason for your denial in your determination letter. However, many claimants need help understanding the convoluted administrative language or the issue with their initial application. An attorney will review your determination letter and identify the reason for your denial. Common reasons for denial are as follows:
- Clerical errors in filling out application forms
- Missing documentation (tax returns, birth certificate)
- Inadequate work history
- Missed filing deadlines
- Failure to follow SSA guidelines and instructions
- Lack of medical proof or evidence
- Too much gainful income or SGA
After your attorney identifies why your claim was denied, they can work diligently to remedy the situation for your disability reconsideration appeal. Sometimes, issues are resolved quickly, while others take more time.
Submission of Additional Evidence
After your disability lawyer identifies and understands the reason(s) for your denial, they can correct things, like locating additional evidence to strengthen your case. Additional evidence they gather may include:
- New Medical Information: Medical records documenting new info, including new diagnoses, recent treatments, or changes in your condition(s) since your initial application.
- Doctor Statements: Ask your physician to provide a detailed statement clarifying your limitations, functional restrictions, and how your condition affects or prohibits your ability to work.
- Work History Details: A detailed written explanation of your previous work attempts, outlining specific requirements and job duties you couldn’t perform due to disability.
Solid evidence can significantly strengthen the legitimacy of your claim and may result in benefits approval. If you have any new evidence since your initial filing, bring it to your free case evaluation with a disability attorney near you to better assess your chances of winning a disability reconsideration appeal.
Preparation for Your ALJ Meeting
Disability hearings are conducted before an administrative law judge (ALJ) and are called ALJ hearings. The ALJ questions you and other witnesses, reviews medical records and documentation, and then approves or denies your disability reconsideration appeal. Your attorney will prepare you for your appearance before the ALJ, informing you how to best answer questions.
Social Security lawyers are competent in ALJ proceedings, and many know some ADJs presiding over appeals. This helps your lawyer understand further evidence they must present at the ALJ hearing. You may submit new evidence, present witnesses, and challenge any inaccurate information in your file at your ALJ hearing.
Guidance Through the Appeals Process
Social Security disability denial rates demonstrate that 65 percent of initial disability applicants are denied, 87 percent of disability reconsideration appeals are denied, and 62 percent of second appeals are awarded to the applicant. About two percent of third appeals are favorable, and roughly 70 percent of appeals to federal court are denied. Having an experienced Social Security disability lawyer guide you through the appeals system is imperative for having any chance of success.
Schedule a Free Initial Consultation
To determine if you have a legitimate chance at a successful disability reconsideration appeal, schedule a free consultation with a disability lawyer immediately. You’ll want to ensure meeting the 60-day deadline for filing.
