Social Security Disability Insurance application and appeal lawsuit investigation

Filing a Social Security Disability claim?

• Social Security Disability applicants who get legal help with their applications or appeals are almost twice as likely to have success, according to a Nolo survey.
• The ideal applicants are at least 50 years old and have worked for at least five of the last 10 years.

Social Security Disability benefits are meant to provide a safety net for Americans suffering from a medical condition that makes it difficult or impossible for them to work.

Unfortunately, the application process for obtaining Social Security Disability benefits can be daunting because it is time-consuming and difficult to understand. To further complicate the application process, there are strict deadlines that must be met once an application is submitted.

The denial rate of first-time Social Security applications for disability benefits is a whopping 70%. Applicants can appeal a denial, but the appeals process is complex and can take up to two years before the first hearing even occurs. While some applicants start the process on their own, an experienced Social Security attorney can help navigate the process from beginning to end. An attorney’s role is to help file the best claim possible, advocate for their client, keep their client informed about the status of their claim, and ensure important deadlines are met.

Overview: Social Security Disability application

Workers may qualify for Social Security Disability Insurance (SSDI) if they suffer from medical conditions that leave them unable to work for over a year. SSDI may also benefit workers who are expected to pass away from their medical condition.

An application for SSDI can be completed online, at a local Social Security office, or by phone. Applicants will need to answer questions about their work history and fill out an Activities of Daily Living Questionnaire.

On a Social Security disability application, applicants must be able to show that their medical condition will last more than a year. They will also need to provide medical records and other personal information such as their Social Security number, birth certificate, physician contact information and information about medications. Applicants should be prepared to provide a description of their current work as well their work history, along with a recent W-2 form. And they may also be required to undergo another exam as a result of their initial contact with the Social Security office.

After an SSDI application is submitted to Social Security, the office will evaluate the claim by considering the applicant’s work history and current employment status. Either of these factors could disqualify an applicant. For example, if there is not a sufficient work history or if the applicant’s current job status disqualifies them from benefits, the office may reject an application.

If the applicant passes the initial evaluation, the Social Security office will send the information to an examiner at the Disability Determination Services (DDS) office. The examiner will ultimately approve or deny the application for SSDI based on the medical information and work history provided, or the DDS office may require the applicant to be examined further.

In addition to medical history and employment information, another factor the DDS considers is whether the applicant’s disability is included in the Social Security Listing of Impairments (those impairments that have been determined to impact someone’s ability to work). The DDS office will evaluate whether the applicant’s disability, as reported by their medical records, will impair their ability to work based on their work history.

The applicant will receive a letter notifying them that they have either been approved or denied Social Security Disability benefits. It generally takes Social Security between three and six months to issue a determination. Unfortunately, a mere 37% of applicants are approved at this point in the process.

Read More: How to apply for Social Security disability benefits

Appealing a denial of Social Security Disability benefits

Applicants who are denied SSDI can appeal that decision. The first step is to request a reconsideration within 60 days of receiving a denial of disability benefits from Social Security. Those who fail to request reconsideration will need to submit a new application.

It is important to ensure that all vital information has been included in the request for reconsideration—simply returning the same information will likely result in another denial and, in fact, more than 80% of such requests are denied.

The reconsideration request goes back to the Disability Determination office but will be handled by a different examiner. The process can take up to five months.

If an applicant’s request for reconsideration is denied, that decision can be appealed to an administrative law judge. A hearing is held in which the judge reviews the evidence and asks the applicant questions about their medical condition. The applicant can bring witnesses to testify about their medical condition and the administrative law judge can also request witnesses. The appeals hearing can take more than a year to schedule; however, the chances of success are much greater at this point.

If an SSDI claim is denied as a result of the appeals process, the applicant can appeal again, this time to the Social Security Disability Appeals Council. The Council reviews the decision by the administrative law judge to ensure it was legal, but the Council will not review the actual claim or any medical evidence. This type of appeal can take up to two years.

The Council can approve the denial of the SSDI claim, remand the claim back to another administrative law judge for a hearing, or can approve the claim. Appeals to SSDI claims that are denied by the Social Security Disability Appeal Council must be made to a Federal District Court. An appeal to a Federal District Court requires the payment of a filing fee or proof of financial hardship. The process will require an opening and reply brief, as well as oral arguments in front of a federal judge. These appeals can take up to a year.

A Federal District Court can either uphold the denial of the SSDI claim, send it back for review, or approve the claim. If the SSDI claim is denied, applicants can appeal to the Federal Circuit Court.

Read More: How do you appeal a Social Security disability denial?

Seeking help from a Social Security Disability attorney

After an initial denial, consulting with an experienced attorney can help applicants through the complicated appeals process and improve the chance of a successful outcome.

According to Nolo, around 60% of surveyed applicants who sought help from an attorney were approved. In contrast, only 31% of those without help from an attorney were approved for Social Security benefits.

Join a Social Security Disability claim review

If you plan to apply for Social Security Disability benefits or your application was denied, you may be eligible for a free consultation with an attorney if you meet certain qualifications, including the following:

• You are at least 50 years old; and
• You have worked at least five of the last 10 years.

Please fill out the form on this page to see if you qualify for a free case evaluation.