Your claim was denied, not closed.
In fact, as many as 65% of applications are denied initially, even with a solid case.
The Social Security Disability Insurance application process has a set number of levels of appeal, any of which can overturn the initial decision & give you the benefits you deserve. If you’re here, you’ve been denied twice & are ready to appeal again, requesting a hearing before a judge.
More people are applying for Social Security Disability and Supplemental Security Income than ever before. The increase of applicants, combine with the Social Security Administration reducing staff and hours of operation has caused a severe backlog driving time from application to approval as high as three years. Unfortunately, this forces many disabled people into severe financial distress, bankruptcy or worse.
We know the stress this situation is causing, and we are here to help.
We will get to work immediately to build your case with the strategy and evidence needed to win. We will prepare you for your hearing. Nobody will work harder to win your case.
Please click through these tabs to learn more about the hearing process.
The Social Security disability hearing, conducted before a U.S. administrative law judge, is a critical step of Social Security’s administrative review of disability claims. It can take over a year to get a hearing date, but the hearing level offers many applicants the best chance to have their disability claim granted.
Preparing for the hearing is critical to the success of your claim. Social Security Law Group will guide you through each of these steps and more.
Step 1. Determine why your claim was denied.
The denial letter from Social Security usually gives reasons why the claim was not granted. Also, the letter should provide a list of the medical records used to make the determination. Review the list to ensure that all of your medical records have been obtained and reviewed by Social Security.
The denial letter should also express a rationale for the determination. Does the letter say you can return to a past job? Does the denial letter say that, given your age, education, impairments and vocational background, that there is other work you could perform? This rationale helps to identify the type of evidence that needs to be developed to achieve a favorable decision at the hearing level.
Step 2. Continue with your regular medical treatment.
Ongoing medical treatment is important both for the management of your health conditions and for your disability claim. Over time, the medical record of your impairments will become stronger, and will provide a better basis for a favorable disability determination. By the time your claim gets to a hearing by an administrative law judge, well over a year will have passed since your initial denial, and the medical picture is often much clearer by that time.
One reason more claims are won at the hearing level is that there is often more complete medical evidence, including medical opinion evidence, by the time a hearing is held.
Be sure to tell your doctor about your symptoms, and how they affect your daily activities. Your doctor should enter these limitations into your treatment notes, so that it will be apparent to the judge reviewing your medical records that you are experiencing significant functional limitations.
Step 3. Obtain a medical source statement.
Identify which of your doctors is the most knowledgeable of your medical condition, and the most supportive of your claim for disability benefits, and get a medical source statement form into the hands of that doctor.
Obtain your doctor’s opinion regarding your physical and/or mental limitations, and how those limitations affect your ability to work.
Social Security is not concerned with whether or not your doctor believes you are disabled; that is an issue reserved to Social Security to decide. What is important is your doctor’s opinion regarding your work-related functional limitations. And that doctor’s opinion is missing from almost every Social Security claim file that gets denied.
A medical source statement from your doctor setting forth your limitations due to your impairments is usually the most powerful medical evidence in support of your disability claim. You can greatly improve your chances of an award of disability benefits by obtaining these opinions prior to your disability hearing. Social Security uses medical source statement forms for this purpose.
Step 4. Consider obtaining an additional statement in support of a disability claim.
Social Security will consider evidence from non-medical sources (for example, spouses, parents and other caregivers, siblings, other relatives, friends, neighbors, and clergy).
A key person who can give witness to you and your condition can be powerful evidence. A non-medical, or “lay” statement is powerful evidence because it puts a disability case in a human context.
The statement is usually a 2 or 3 page typed document. It will usually tell the story of how the claimant used to be, what changed medically, and what life is like now.
Ideally, the statement should be in the record when the judge reviews the claim prior to the hearing. In a typical case, prior to the hearing the judge can only review the medical records and various Social Security forms that are in the claim file. The human element is often missing until the judge meets the applicant at the hearing. The statement adds the human element to the disability claim file in advance of the hearing.Tab content 1
It can take over a year to get a hearing date in most parts of the country. There are two exceptions to this rule:
1. Critical case
A critical case request asks Social Security to expedite a claim at the hearing level. Critical cases are governed by HALLEX I-2-1-40. Critical cases get priority because they are the most serious claims. There are three situations that constitute critical cases:
- The claimant’s illness is terminal.
- There is an indication that the claimant is suicidal or homicidal
- Dire need. Dire need is the most frequent basis for a critical claim request. Dire need is when the claimant is without – and is unable to obtain – food, medicine or shelter. Mere hardship is not enough. The situation must be dire. An imminent eviction, with no financial resources to find new shelter, can qualify.
2. On the Record Decision
An “on the record” (OTR) request asks Social Security to grant your case on the record without a hearing. This request is for claims pending at the hearing level at the Office of Disability Adjudication and Review (ODAR). On the record decisions can only be fully favorable. You cannot lose your case “on the record”. Rather, if the OTR request is denied, your claim simply goes back in line for an eventual hearing.
Although there is nothing to lose by filing an OTR request, they should only be filed when a favorable result is mandated by the evidence and by Social Security’s disability evaluation process. Also, the medical
evidence in the record should be up to date before an on the record request is filed.
If neither of the above exceptions applies to you, you will have to wait for your hearing. The good news is the time waiting for a hearing can be spent making your claim stronger.
In most instances, the third level of appeal in the SSDI process is a Request for Appeals Council Review.
When the hearing decision is appealed, the Appeals Council will:
- Review the decision to determine if your claim was adjudicated properly by the Administrative Law Judge (ALJ).
- Reverse or confirm the decision of the ALJ, or remand your case back to the Office of Disability Adjudication and Review (ODAR) for further review.
Please review these tabs for a refresher on the Social Security Disability Insurance process.
Initial level: Four to six months
We will work with you to gather all the information necessary to complete the required forms that enable us to represent you throughout the SSDI process.
Your personal case advocate will help you prepare and file your initial application for benefits. After it is filed, your claim will be reviewed and processed on its technical merit by your local Social Security Administration (SSA) office to ensure you meet initial eligibility requirements.
If your claim meets the initial requirements (sufficient work credits, citizenship requirements) a medical determination will be made by your state Disability Determination Services (DDS) agency. In order to verify your eligibility, the DDS office may provide additional questionnaires or request that you attend a Consultative Exam performed by a doctor of SSA’s choosing and paid for by SSA. Your case advocate will contact you with continuous updates as we monitor the progress of your application.
The Social Security Administration denies 65% of all claims at this level. In contrast, because we focus on getting early awards for our clients, most of the people we represent receive their award during this phase.
If your claim is denied, your case advocate will immediately begin the appeals process—we make sure you don’t miss the 60-day deadline that SSA gives you to complete your appeal.
Depending on the state that you live in, you may move on to the Request for Reconsideration or Request for Hearing phase.
Reconsideration level: Four to six months
In most instances, the first level of appeal in the SSDI process is the Request for Reconsideration. Depending on which state you live in, if your initial SSDI claim is denied, we have 60 days from the date of the notice to file a Request for Reconsideration with SSA.
During this step your claim will be:
- Technically processed by your local SSA office.
- Medically determined by your state’s Disability Determination Services (DDS) agency.
When your case reaches DDS:
- It will be reviewed by a different examiner who will assess your updated medical records and any changes to your health.
Because of this, you may:
- Receive additional sets of questionnaires.
- Be required to attend another Consultative Exam (CE).
The following states skip the Reconsideration level and go directly to a Request for Hearing:
Alabama, Alaska, California (some locations), Colorado, Louisiana, Michigan, Missouri, New Hampshire, New York, Pennsylvania
Hearing level: 12 to 18 months
In most instances, the second level of appeal in the SSDI process is the Request for Hearing. If your Reconsideration request is denied, we have 60 days from the date of the notice to file a Request for Hearing.
During this step your claim will be:
- Technically processed by your local SSA office.
- Medically determined by your local Office of Disability Adjudication and Review.
At the Office of Disability Adjudication and Review your claim will be reviewed and assigned to an Administrative Law Judge prior to setting a hearing date.
Because of the heavy volume of requests at the SSA, the average processing time at this level is 12 to 18 months. During this time, your case advocate will:
- Contact you to prepare for the hearing.
- Conduct scheduled status checks and keep you updated on your claim.
At the hearing, your SSAD hearing advocate will offer compelling evidence before the Administrative Law Judge as to how your disability impacts your ability to work.
It will take additional time for Office of Disability Adjudication and Review to process and mail your decision to you.
Receiving Your Benefits
When you are awarded Social Security Disability Insurance benefits, we will help you receive payment and ensure that you are prepared for your Medicare entitlement.
Click here for additional information on our benefits coordination services.
Let us get to work for you.
Hiring us means you’ll be have the best attorneys in the country laser focused on preparing your case for the hearing. And you will not pay fees unless and until your benefits are awarded.
Call us at 800-909-7754. Or, complete the contact form here. We will contact you within one business day.