My SSI was Denied. What now?
Work. Home. School. Every aspect of your life is impacted by disability. The hope of a supplemental security income benefit relieves the pressure. And, somehow between doctor’s appointments and therapy you managed to complete the application for SSI benefits. However, the response you hoped for failed to arrive.
Instead, you are found ineligible — denied. A denial letter strikes at the heart of applicants. Without SSI benefits and no work due to a disability, how will you make ends meet? Unfortunately, many fall to the temptation to simply give up. Before you lose heart, we want you to know that you have options. A denial is not the end of all hope.
So, now what?
Hope is Not Lost
First, you need to know that you are not alone. Many initial SSI applications are denied. While you retain the right to file on your own, applying without an attorney often contributes to a denial. Going forward, an attorney proves to be an asset. He or she helps gather documentation, hit deadlines and get you the benefits you deserve.
Second, requesting a reconsideration and a hearing before an administrative law judge (ALJ) lie within your tool box. You can appeal to the Appeals Council and even the Federal court. Hope rises again knowing you have several opportunities to get your case reviewed. Check out your options below.
You Can File for a Reconsideration
Appealing the decision of the Social Security Administration (SSA) falls well within your rights. The SSA system works to get you SSI benefits (honestly). However, their job is to also ensure you deserve those benefits. The appeals process protects you in case you fall through a gap and allows you to present further evidence.
Filing for reconsideration allows an SSA representative to review previous and see new evidence which supports your case. Perhaps you failed to submit the documentation needed to prove your claim. Or, perhaps new information on your diagnosis, medical treatments and work limits came to light since you first filed.
You must request a reconsideration within 60 days of a denial. Staying within the deadline is vital. The SSA offers only a few rare extensions beyond this two-month time frame i.e. increased illness. Missing this important deadline does not mean all hope is lost. It means you start the process over.
Is your case closed if the reconsideration is denied? No! The next step is filing for a hearing before an administrative law judge (ALJ).
You Can Plead Your Case Before an ALJ
Do not let a second denial letter defeat you. Let it bolster your fight. Applying for a hearing with an ALJ must occur 60 days from your denial letter. Again, these deadlines are strict. Missing the deadline wastes your valuable time and delays your benefits. Plus, a second application may get denied for the same reason as the first.
This hearing is a face-to-face meeting with an ALJ. You provide evidence and answer questions about your disability and its impact on your work and daily living. Vocational or medical experts may also be present to help the ALJ understand your claim more fully. The nuances of your case are better understood in-person rather than on paper alone.
The ALJ often approves claims at this level. A slight flexibility lies with this judge that is not present in other parts of the system. Many of these hearings result in a supplemental security income benefit. However, if you again face denial, the Appeals Council hears your claim.
You Can Take it to the Appeals Council
At this point, your file alone goes to the Appeals Council. Made up of several ALJs, the Council reviews your case. They look for an impartial ruling by the ALJ and judgments which fall within the SSA’s policies and regulations.
This group of reviewers either upholds the ALJ’s decision, reverses it or sends the file back to the ALJ with notes for a second review. If you receive yet another denial, one more option awaits you — a Federal court appeal.
You Can Appeal to the Federal Court
The SSA’s system stops at the Appeals Council. However, a Social Security lawyer can file your claim with the Federal Court. The road to get to this point is long and wearying. However, if you believe you have been wrongly denied, this is the next step. But, keep in mind that a Federal court review proves challenging.
Your case must be filed with the Federal Court within 60 days of the Appeals Council decision. Fees, documentation such as a complaint, brief and reply brief, and an oral argument (by an attorney) are required at this stage.
It Proves Wise to Hire an Attorney
Most disability claims are denied due to a lack of medical evidence. A Social Security disability insurance (SSDI) attorney knows the proof the SSA looks for to support a claim. He or she ensures you submit the proper documentation to win your case. Hiring an experienced SSDI attorney to appeal a denial proves wise and beneficial.