What To Do When Denied Disability

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If you have been denied disability, don’t panic yet. The facts are that nearly 70% of all initial disability claims are denied by the Social Security Administration (SSA) no matter what your social security disability claim info was. Fortunately you still have options after the initial denial. A good step at this point would be to get an experienced social security disability attorney Boston if you don’t already have one. They will be able to better navigate through the complex and often frustrating world of SSA disability benefit claims.

Below is some additional information that will help you if you’ve been denied disability.

Why Was the Disability Claim Denied

Obviously this is going to be the first question you ask, and it’s a good one. You should definitely try to understand why the claim was denied by SSA before you take any additional action. Be prepared though because you might feel that the decision was incorrect for a number of reasons. Still, you need to know SSA’s logic in denying your claim.  Sometimes the claim is denied, and the correct course of action is to get professional legal help.

When your disability application is denied you will receive a notice from SSA that gives the reasons behind the denial. In addition to the explanation for the denial this notice will also include all of the reviewed documents and a summary of the medical condition you are claiming disability under.

In general, claims are denied for medical reasons. While there are a small number that are denied regularly for technical reasons, this usually isn’t the case. It can often cause anger and frustration to have your claim denied for medical reasons and that’s perfectly understandable. While you might wonder why the SSA is questioning your physician’s opinion of your medical condition and ability to work, the Bureau of Disability Determination (BDD) at the SSA makes its evaluation based on the SSA guidelines. They do take your medical history and records into account, but in the end it is the official Listing of Impairments and the specific guidelines contained therein that is the final determinant of an approval or denial of a claim.

There are many reasons for a disability claim denial, but those below are some of the most common.

– You haven’t yet met the 12 month duration requirement for disability status.
– Your disability is the result of an injury sustained while in prison or while committing a felony. You can also be denied if you have previously been convicted of a felony.
– You failed to follow the treatment recommendations of your doctor. This rule does have some leeway, for example the treatment recommended by your doctor may have been too expensive for your financial situation.
– You cannot be reached by the Social Security Administration.
– Your disability is valid, but the severity isn’t great enough to keep you from working

Once you understand the reasons for the initial denial you will be less likely to repeat the same mistakes when you file your appeal. And if you hire a disability lawyer to work on your case they will be better informed when filing the appeal on your behalf.


Filing a Request for Reconsideration

Once you are denied disability benefits in PA you should immediately consider filing your appeal. Depending on the level of your claim when it was last filed you will have different routes of appeal, but for the initial disability application the appeal you will file is called a Request for Reconsideration.
It is important to understand that this reconsideration request will be reviewed at the same state level agency that denied your initial request, but by a different examiner that the initial request. This means the only difference in your request for reconsideration is that it is reviewed by a different examiner in the same office.

Because the reconsideration request process is exactly the same as the initial request most of these are also denied. In fact, the SSA admits that roughly 87% of reconsideration requests across the country are denied. This really shouldn’t surprise you because most of these reconsideration requests are reviewed just a few weeks after the initial application. Because there is rarely anything material that has changed in that time an approval at this stage would be the same as the SSA office admitting to making a mistake during the initial application review. Not surprisingly, this rarely happens.

Once the request for reconsideration has been denied the next step is to request a hearing with an administrative law judge. Filing this request is similar to filing the reconsideration request. The difference is in the way this request is handled. Rather than sending the request back to the same state office for further review, the case is now sent to a disability hearing office.

Be prepared to wait after filing this request for a hearing. It isn’t unusual for the backlog for these hearings to be several months long. Once the case is assigned to a federal administrative law judge their staff will prepare the case for a hearing, which could take several more weeks to months, depending on the complexity of the case.

This is where it becomes important to have legal representation for your disability claim. Those with legal representation can simply contact their lawyer when they receive the rejection notice and they will take care of filing the additional appeal. They will also follow up on the appeal process to ensure that the appeal doesn’t get stuck at the hearing office for an extended period of time.

Once the hearing date is set the attorney will be able to prepare all of your supporting documents, including any new medical records or changes in your condition. While you could certainly do all of this yourself, having an experienced attorney take care of the issue is far less stressful and time consuming for you.

Additionally, if you’ve hired an experienced SSDI attorney they are likely to have presented cases in the past to your administrative law judge. While this alone has little bearing on the outcome of your case, it can help your lawyer prepare because they will already know the predispositions of the judge sitting on your case. Judges are only human after all and some are more lenient or strict with certain disabilities. Your lawyer should know just how to argue your case to get the best response from a judge if they’ve been before that judge numerous times in the past.

Because Pennsylvania has a nearly 70% denial rate on initial SSDI claims it makes sense to have representation early in the application and appeal process. This will allow your lawyer to prepare your case more completely and present it in the best light when it comes time to stand before a judge in a review hearing.