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Scales of Justice

How To Appeal A Denied SSD Claim

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Did you know that the average number of denied Social Security Disability claims is around 62 percent?

This high rate of initial denial can be discouraging for individuals struggling with a disability.

The Social Security Administration (SSA) may deny claims for a number of reasons, including income limits, medical conditions, incorrect or incomplete filing, and more.

However, you can appeal your denied Social Security Disability claim by filing an appeal. Filing an appeal can be a confusing and time-consuming process. There are various levels of appeal that require supporting evidence to make your claim, which we’re sharing here.

If you need help appealing your denied claim or completing an initial application, an experienced disability attorney at Carr & Carr can help. Call Carr & Carr at (888) 823-9525 for a free consultation.  

Why Your SSD Claim Was Denied

Social Security Disability claims are denied for a variety of reasons. Some of these factors may be beyond your control, and some may not. It’s important to understand why a claim may be denied so you are informed when appealing your claim.

Income

To be eligible for disability benefits, you must be unable to engage in “substantial gainful activity,” or SGA. If you earn less than a specified monthly income, you may qualify for SSD benefits. However, if you earn more than the specified amount, you may be denied.

In 2020, the monthly SGA amount for non-blind individuals is $1,260. For blind individuals, the SGA is $2,110.

Medical Condition

To be considered a disability by the SSA, your medical condition must “significantly limit your ability to do basic work such as lifting, standing, walking, sitting, and remembering – for at least 12 months.”

Social Security will only cover total disability. The SSA does not pay benefits for partial disability or short-term disability. If your medical condition is expected to improve or it doesn’t significantly limit your work abilities, your claim may be denied.

Refusal to Cooperate

The SSA grants disability by evaluating your medical records. If you refuse to release those records, or if you refuse the SSA’s request to be examined by an SSA doctor, your claim may be denied.

Similarly, if you fail to or refuse to follow a doctor’s prescribed treatment or therapy, the SSA may deny your claim. There are legitimate reasons you may not follow doctor’s orders, such as religious beliefs or conflicting doctor’s opinions, but other reasons may negatively affect your SSD claim.

Drug Addiction or Alcoholism

If there is medical evidence of drug addiction or alcoholism that contributes to your disability, your claim may be denied. The SSA will investigate and determine whether you would still be disabled if you stopped using drugs or alcohol.

Crime or Fraud

The SSA suspends benefits to an otherwise eligible person who is convicted and confined for more than 30 continuous days. Furthermore, the SSA does not pay benefits in certain cases related to crime or fraud.

For example, if you were injured while committing a crime, or you were injured while incarcerated, your condition can’t be used to show that you qualify for disability benefits.

How to Appeal a Denied SSD Claim

If you’re unlucky enough to receive a denial letter from the SSA, you will want to consider an appeal instead of accepting the first ruling.

To get started, you must first identify the reason you think you were denied, and then file the request for appeal in writing within 60 days from the date of your notice of denial.

Reconsideration

Filing a Request for Reconsideration is the first step in the appeals process. It’s similar to the initial disability decision-making process: an SSA employee evaluates your application and, if they decide you meet the requirements, sends your application to the Disability Determination Services (DDS) office where you reside for the final decision.

During reconsideration, your case is assigned to a different disability examiner and the medical team at the DDS office. You can present additional evidence for consideration to support your claim.

Hearing by an Administrative Law Judge

If your claim is denied again, you may request a hearing before an administrative law judge (ALJ) who had no part in the previous process of your claim.

The ALJ will make a decision based on evidence, the testimony of witnesses, and your argument. The hearing may be via video or in person at a hearing office.

Review by the Appeals Council

If you’re unsatisfied with the decision made by the ALJ at your hearing, you may request a review by the Appeals Council. The Appeals Council is made up of administrative appeals judges. They consider your initial evidence and additional evidence submitted, as well as the ALJ’s findings.

The Appeals Council may agree to review your case and make a decision, or they may return it to the ALJ for a new hearing and decision. They may also deny your request if they agree with the hearing decision.

Review by Federal Court

Your final option in appealing a claim is a review by a federal court. If you’re unhappy with the outcome of the Appeals Council’s review, you may file a lawsuit in a federal district court within 60 days of receiving the Appeals Council’s decision.

Filing a civil lawsuit in federal court is not easy or quick. You’re not required to have an attorney for federal court review, but a disability attorney can help you navigate the process more quickly and comprehensively. Because they’re experienced in appealing denied Social Security Disability claims, you also have a better chance of receiving a decision in your favor. 

A Disability Attorney at Carr & Carr Can Help

Most people do not realize they have the right to question the SSA’s decision on their claim. If you’re not satisfied with their decision on your claim and you believe you’re eligible for a certain amount of Social Security Disability benefits, you can appeal their decision. You can request an appeal by yourself, but a Social Security Disability lawyer can help make the process more effective and less stressful.

The experienced disability attorneys at Carr & Carr will fight for the SSD benefits you seek. At Carr & Carr, we do more than fight for the outcome that you want in an appeal. We take the time to listen to you, help you understand your legal options, and give you the support that you need.

If you need assistance appealing a denied SSD claim, call Carr & Carr at (888) 823-9525 for a free consultation. Be sure to follow the Carr & Carr Facebook page for more news and resources on Social Security Disability benefits.  

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