Did you know that each year, millions of workers apply for SSDI and SSI benefits, but up to 70% are denied the first time they apply? Did you know that SSDI is not an entitlement program and that you are not guaranteed benefits?
Most workers have paid into the social security disability system for many years and are surprised to find that if they become disabled and cannot work, it could take months or years to receive benefits. Other applicants may never be approved. Unfortunately, many disability applicants are also unaware that if they are denied disability benefits, they may be able to fight their denial by filing an appeal.
When do I appeal my SSDI denial?
If you receive an SSDI denial, you may have the right to file an appeal within 60 days from the date of receipt of the denial letter. First, however, you need to determine why you were denied benefits and whether you meet the non-medical requirements for SSDI:
- Is your condition expected to last 12 continuous months?
- Do you have sufficient work credits to qualify for SSDI?
- Are you currently working too much or making too much money to qualify for SSDI?
If you do not meet the non-medical requirements for SSDI benefits, there is no reason to file an appeal. You will be denied a second time. If, however, the SSA denied your claim because they believe that you can retrain for new work, or you did not provide sufficient evidence to prove your condition is severe and will last 12 continuous months, you may be able to provide more information and win your claim on appeal.
Requesting a Reconsideration
Assuming that you meet the non-medical requirements for SSDI benefits, the first step in the SSA appeals process is to file a reconsideration (some states skip this step and allow you to immediately request a hearing). The reconsideration allows another disability examiner to review your case and determine if you are disabled. Unfortunately, the denial rate at the reconsideration level can be as high as 80%.
Requesting a Hearing
If your case is denied a second time at the reconsideration level, you will receive a second denial letter. You will have 60 days from the date of the denial letter to file your next SSDI appeal and request a SSDI hearing before an administrative law judge. It can take one to two years to have your hearing scheduled, although some states have been working to streamline the hearing request process.
If you have requested a hearing, however, there are several steps that you need to take while you wait. For example, you may want to talk to a disability lawyer, find out exactly why you were denied, and identify what steps to take to make your case stronger. Winning benefits could be as simple as going to the right doctors and having them provide strong medical evidence about your physical and mental limitations that preclude you from working.
Do not wait until right before your hearing to get legal help. A disability lawyer could need several months to review your claim and prepare your case for court.
What if I missed an appeal deadline?
The SSA allows claimants 60 days from each denial letter to request an appeal. The SSA should send information about the appeal process with your denial letter. If you do not file your appeal within the specified time frame, you will have to begin the process again by filing another claim. There are, however, exceptions to this rule (i.e. you were in the hospital or too injured to file an appeal).
Appealing a denial instead of filing another SSDI application
It’s not unusual for disability applicants to file a new application after receiving a SSDI denial rather than filing an appeal. Although this may seem easier, this seldom produces different results and you can risk losing retroactive benefit payments.
Filing an appeal and getting to the hearing level may also give claimants their best chance to win SSDI benefits. Not only can you present information directly to a judge, the judge also has the authority to grant SSDI benefits.
How long will the appeals process take?
One of the most common questions claimants ask is, “How long will I have to wait to receive disability benefits?” Unfortunately, the amount of time varies by claimant. On average, a claimant may wait 90 days or more for an answer at the initial application level. The reconsideration may take another 60 days, and it could take up to two years to have a hearing scheduled.
All of these time frames, however, could be longer if the disability examiner has too many cases, the SSA has to wait for medical records to be sent, or if there are other special circumstances.
Should I hire a disability lawyer to fight my appeal?
Although some SSDI claimants have the fortitude to face the challenges of the SSDI appeal without legal help, many SSDI claimants may need a lawyer to do the work for them. The disability process can be challenging, and wading through the bureaucratic chaos of the SSA can be daunting, even for the most able-bodied worker. Note that disability lawyers are paid on a contingency fee basis and are only paid if you win your case.