Appealing Denied SSDI Claims

Date Posted:

October 30, 2018

Post Author

Andres Beregovich

The Social Security Disability Insurance (SSDI) program exists to provide a safety net for workers who become unable to work. Workers pay into the program through their payroll taxes, but that doesn’t mean the funds will be automatically available to you when and if you ever need them. You’ll still have to apply for Social Security Disability benefits and, unfortunately, many more claims are denied by the Social Security Administration than are accepted.

Fortunately, applicants have recourse through the appeals process. Appealing denied SSDI claims is onerous, but the end result can be well worth it.

Steps In The SSDI Appeals Process

Applicants have 60 days from the time they receive their SSDI denial to file a written request for an appeal. Once the appeal has begun, it goes through four stages:

  1. Reconsideration. During this stage, denied applications are re-examined by a claims examiner who was not involved in the original decision. You are allowed to submit new or additional evidence to support your claim and your SSDI attorney can answer questions posed by the claims agent.  
  2. Hearing. If a claim is denied again or if you don’t agree with the results, you may request a Hearing in front of an administrative law judge. At this stage, you will appear in person before the judge to answer questions, witnesses may be called, experts may be brought in, and new evidence presented. Your attorney will play the important role in preparing you for questioning, securing witnesses, experts, and additional evidence, if available.
  3. Appeals Council. If you are dissatisfied with the judge’s ruling, the next step is to request a review by the Social Security Appeals Council for another examination or hearing. However, you are not guaranteed an examination or hearing. If you are granted a second hearing your attorney will repeat the actions taken at your first hearing.
  4. Federal Court. Your final option is to take the denial all the way to the federal district court. To do this, you’ll need to file a federal lawsuit.

Top Reasons Why SSDI Claims Are Denied

  • Lack of Medical Evidence. You must provide medical proof that you are unable to work due to your disability or injury. That means submitting records from your primary care physician and/or specialists that demonstrate your injury. Don’t expect the SSA to send you to a doctor to verify your disability, that’s not how it works. You must see a doctor first and he or she must document the injury and how it prevents you from working, then that documentation should be submitted with your initial application.
  • Previous Denials. Some people think they have a better chance of being approved if they simply apply again, but this is not the case. Appealing a denial is actually a better option than starting over from scratch.
  • Failure to Follow Treatment. If you fail to follow your doctor’s orders for treatment, you will be denied because the claims examiner won’t be able to determine if the actual injury/disability is preventing you from working or if it is your refusal to cooperate with treatment.
  • Failure to Cooperate. Speaking of a failure to cooperate with treatment, failing to cooperate with the SSA and its agents can lead to a denial too. If you don’t respond to requests for information or don’t show up for medical exams or meetings, you may be denied.
  • Fraud.  If you lied on your application or misrepresented yourself or your injury, the claim will likely be denied.

Appeal Denied SSDI Claims With Help From The Beregovich Law Firm

If your SSDI application has been denied, don’t despair! Initial denials are very common and can be successfully appealed with the right approach. Contact The Beregovich Law Firm for SSDI appeals assistance or even for help submitting your initial application.

Call (800) 631-9009 or email us to discuss your situation today.