If you've been denied for an initial claim of social security benefits owed due to an injury or impairment, you shouldn't feel alone. According to polls conducted both privately and by the Social Security Administration itself nearly 65% of initial claims are denied. That's a staggering number and can be a disheartening statistic to those unable to provide for themselves or their family.
While many applicants may give up at this point, it's important to understand that an initial denial is not the end of the road for your SSDI benefits claim. In Florida there is a well-developed system for appealing a denial of disability benefits. While the appeals process has many technical requirements and can be difficult to navigate, applicants are entitled to retain legal counsel to help guide them through the various forms and hearings that may be required in order to obtain their temporary or permanent Social Security benefits. Whether represented by an attorney or going at it on your own, here is an overview of the various stages of the SSDI appeals process.
Denial of Initial Claim for Benefits
While many applicants feel that an initial denial of a disability benefits application is a judgement on the validity of their claim, this couldn't be further from the truth. The social security claims process has many formalized and stringent requirements. Applications can be denied for completeness, failure to submit supporting documents or any other number of reasons that don't affect the worthiness of your underlying application.
Reconsideration of Your Initial Claim
After an initial denial of a claim for benefits, applicants can request a reconsideration of denial. This stage is not a formal appeal, but a request for a review of the decision of the initial disability examiner. A new medial expert and examiner will review the contents of the original claim. At this stage, no new evidence can be submitted. Given that the original application is re-reviewed, as is, only 5-10% of claims are granted benefits based on reconsideration.
Request an ALJ Hearing
Applicants who are denied with both their initial applications and their reconsideration efforts shouldn't lose hope. The next stage in the social security benefits appeal process is requesting a hearing from an Administrative Law Judge, or ALJ. The term “judge” is a bit deceiving in this instance. ALJ's are attorneys who work for the Social Security Administration's office of Hearings Operations. The ALJ's are tasked with holding hearings on denials of benefit claims, either at the application stage or denial of ongoing benefits, and upholding or overturning the initial decision.
After a denial of benefits, applicants have 60 days to formally request a hearing by an ALJ. During the hearing claimants for benefits can call witnesses, submit new supporting evidence and affidavits and can testify on their own behalf. Applicants may have an attorney represent them at the hearing who may help with properly phrasing answers to questions, questioning witnesses and making the case for approval to the ALJ. While hearings can take place at the SSA physical office space, they are often performed via video conference to accommodate travel limitations.
Nearly 50% of appeals that come before an ALJ are granted benefits. This makes the ALJ hearing many applicants' best chance of overcoming any initial deficiencies in their application and receiving a positive outcome to their benefits claim.
If your claim is denied after reaching the ALJ hearing, all hope is not lost. Claimants still can file an appeal with the Appeals Council. The Appeals Council selection process for cases to review is random. New evidence is generally not allowed to be presented to the council, instead they review for any flaws in the ALJ's opinion. At this stage only 2-3% of appeals are granted.
Finally, applicants that have been denied at all previous levels can appeal for a Federal Court Review. This involves filing a lawsuit, essentially suing the Social Security Administration. This process can be costly to applicants and has a low chance of success with under 1% of applicants winning their benefits claim at this stage.
The Bottom Line on Appeals
While applicants who have been denied their initial claim shouldn't lose hope, filing a thorough, well-documented and complete application from the outset gives claimants the best chance at having their disability benefits approved. An experienced Social Security Benefits attorney, such as those with the Law Offices of Justin McMurray, P.A., can help ensure your benefits application is complete and thoroughly documents your injury or disability. If you're in need of legal representation for an appeal of a denial of benefits, call today for a free consultation of your claim and find out the difference legal representation can make towards getting you and your family the benefits you deserve.