Facing a denial of your Social Security Disability Insurance (SSDI) claim can be disheartening, but it’s essential to remember that the appeals process offers a path to pursue the benefits you deserve. In this comprehensive blog, we’ll walk you through each step of the SSDI appeals process, empowering you to navigate it with confidence and clarity.
Step 1: Understand the Initial Denial Letter
Upon receiving a denial of your SSDI claim, the first step is to carefully review the denial letter. This document will outline the reasons for the denial, state the sources of information used to make the determination, and provide crucial information about your next steps. Pay close attention to the deadlines for filing your appeal.
Step 2: Request Reconsideration
The first stage of the appeals process is requesting reconsideration. This involves submitting a request to have your claim reviewed again by the State agency designated by the Social Security Administration (SSA). You must file the appeal within 60 days from the date you receive your denial letter. It is (rebuttably) presumed that you received your denial letter five days after the date on the notice.
Step 3: Gather Additional Evidence
The SSA will continue to gather evidence during the reconsideration stage based on the information you provide in your appeal. If, however, you notice that any of your medical providers were not listed as sources on our denial, get that information yourself and take it to your local Social Security office.
Step 4: Reconsideration Denial Letter
The reconsideration determination denial letter is very similar to the initial denial letter. You should again carefully review it. This document will again outline the reasons for the denial, state the sources of information used to make the determination, and provide crucial information about your next steps. Pay close attention to the deadlines for filing your appeal.
Step 5: Consult with a Disability Attorney
If you have not already done so, you should consider seeking guidance from a disability attorney at this stage of the process. A knowledgeable attorney can offer valuable insights into your case, help you gather necessary evidence, and navigate the appeals process effectively.
Step 6: Request an Administrative Law Judge Hearing
If your claim is denied upon reconsideration, the next step is to request a hearing before an Administrative Law Judge (ALJ). This hearing provides an opportunity to present your case in person and testify about your disability and its impact on your ability to work. As before, and at each step of the appeal process, you must file the appeal within 60 days from the date you receive your denial letter. It is (rebuttably) presumed that you received your denial letter five days after the date on the notice.
Step 7: Presenting Your Case
At the ALJ hearing, you’ll have the opportunity to present evidence, provide testimony, and answer questions from the judge. Be prepared to discuss your medical history, symptoms, treatment, and how your disability affects your daily life and ability to work. A knowledgeable disability attorney can help you understand the legal aspects of our case, help you gather medical and medical opinion evidence, and generally prepare you for the hearing.
Step 8: Unfavorable ALJ Decision
If the ALJ issues an unfavorable decision, the next step is to request review of the decision by the Appeals Council. The decision will explain in much greater detail than in previous determinations how the ALJ decided your case. A disability attorney can help identify whether the decision contains appealable errors. Again, pay attention to the date of the decision and the time during which you can file an appeal.
Step 9: Request Appeals Council Review
The Appeals Council is a branch of the SSA that evaluates whether ALJ decisions comply with the law and are supported by “substantial” evidence. Their review is generally conducted completely based on the record of the case. It may affirm, reverse, or remand (send a case back to be redecided due to errors in the decision). If it affirms the ALJ decision, you have the standard 60 days to appeal (as discussed above). After the appeal time is past, the decision will become “final” (not changeable, except in rare circumstances) through the date of the ALJ decision.
Step 10: File in Federal Court
If your claim is denied by the Appeals Council, your final option is to file a lawsuit in federal court. At this level, you (generally through your attorney) makes arguments about errors made in the ALJ decision to a federal court judge, and Social Security will assign government attorneys to defend the ALJ decision. The judge reviews the entire record and determine whether the ALJ’s decision was lawful. Like the Appeals Council, the judge may affirm or remand the decision. It will rarely reverse it. There is a higher level federal court, called the circuit court. Few disability claims reach this court.
While navigating the SSDI appeals process can be complex and challenging, it’s essential to remember that you have the right to pursue the benefits you deserve. By understanding each step of the process and seeking guidance when needed, you can advocate effectively for your rights and secure the support you need. If you’re facing a denial of your SSDI claim, don’t hesitate to reach out to our team for assistance. We’re here to help you every step of the way.
The Roose & Ressler Team is located in Lorain, Toledo, and Wooster, Ohio. You can count on us as your local disability specialist to analyze your case thoroughly to determine what is necessary for you to receive benefits. We assess the best methods used to prove the crucial facts of your case and gather the necessary evidence. Having 40+ years of experience serving Northern Ohioans, we know the ins and outs of the local disability process.