Denied Social Security Disability Benefits? Here are your options.

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Being denied disability benefits is frustrating, especially during the pandemic. Where to start? How long will it take? You have 3 options moving forward.

If you are denied social security disability benefits, it’s important to understand it might not be your fault. At this point it may be beneficial to enlist the help of a social security disability lawyer to help you navigate your next step. As stated, you have 3 options moving forward. They are:

  1. Appeal the disability determination
  2. Reapply for benefits
  3. Do nothing

Preserving your rights to benefits.

If you choose to reapply for SSDI benefits or let the determination stand, it’s important to understand that you will not be entitled to seek disability benefits for any period of time prior to the date of the disability determination. The only way to preserve your right to receive disability benefits for the period of time before the initial date of denial is to file an appeal.

The importance of preserving your right to the benefits before the denial is two-fold:

  1. you may lose retroactive disability payments. For example, you stopped working on January 1, 2019, due to your disability. You waited until you had been out of work for 12-months and then applied for benefits on January 1, 2020, and you were denied on June 1, 2020. If you had been awarded benefits you would have been entitled to monthly benefit payments starting on June 1, 2019. If you do not appeal the denial, you can never obtain that year of retroactive benefits.
  2. if you do not appeal the denial, you will lose the year of time that passed that would have counted toward your entitlement to Medicare benefits.

How does the appeals process work?

After you receive your initial denial, you have 60 days to file a Request for Reconsideration. The Reconsideration involves having another medical examiner with Social Security review your file. During the reconsideration phase, if you have additional medical records to submit, they will be accepted.

Social Security may also obtain additional records on your behalf if you’ve undergone additional treatment since the last time records were received by Social Security.

What are your chances of getting approved?

Unless you’ve undergone significant treatment, like a surgery, a hospitalization, significant changes in your medication or treatment regimen, etc. you will likely be denied for second time at the Reconsideration level.

Do I need an SSDI Attorney to file a request for Reconsideration?

You do not need an attorney to file a Request for Reconsideration, however due to the likelihood of a second denial, you may want to consider engaging an attorney at this point. The next step if you are denied is to request a hearing before an Administrative Law Judge. It is advisable to have an attorney present when you request the hearing. It is not required, however if you come to a hearing without an attorney, the Judge will likely suggest you obtain an attorney prior to proceeding.

How long will it take to get a hearing?

Prior to the pandemic, a request for a hearing was taking approximately 12 to 16 months to get a date. Since in-person hearings andhave not been held since March of 2020, that time frame may lengthen.

I am scheduled for a telephone hearing on my SSDI appeal. How does that process work?

In order to move forward with hearings before Administrative Law Judges during the pandemic, hearing offices have been scheduling telephone hearings. On the day of the hearing, the court reporter assigned to the case will call you, your attorney, the judge and possibly a vocational expert and join you in a conference call. Each party must be in a separate location therefore your attorney will not be with you other than by phone during the hearing. There will be no video, so the judge will not see you when making determinations about your credibility and you will not see the judge.

I really don’t want a telephone or video conference hearing. Do I have options?

Under the law, you are entitled to a face-to-face hearing and you may object to participating in a telephone or video hearing.

What are the pros and cons of an in-person hearing?

There are pros to an in-person hearing especially if you have a visible physical manifestation of your disabling condition. For example, if you have rheumatoid arthritis with severe joint swelling in your hands that has not been sufficiently documented by your treatment providers, having the judge see the swelling and how it limits the use of your hands and causes you pain is more compelling than you verbally describing it over the phone. Other examples of visual evidence of the severity of a condition may include tremors, gait abnormalities, dramatic weight loss or gain, etc.

The con of not accepting the telephone hearing is that it will prolong getting a hearing and decision on your claim. An SSDI attorney would discuss the pros and cons in your specific case and assist you in making the best decision about how your hearing should be held.

Navigating a claim through the SSDI process can be daunting especially if you are dealing with physical or psychological impairments and a loss of income. There are attorneys and non-attorney advocates that can assist you in presenting the best initial case possible to Social Security through your application and support you if you are denied benefits and want to appeal the determination.

The questions addressed here are only a very small portion of those that will likely arise during this process. Obtaining an experienced and compassionate attorney that also has a strong medical background will be able to answer these questions for you and provide the assistance you need moving through the process.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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