The fact is that a majority of those who apply for Social Security disability benefits will be initially denied. However, that doesn’t mean you should give up on your claim. Rather, like many others, you must go through the process of appealing the decision.
About half of all claim denials are overturned during an appeal hearing before an Administrative Law Judge (ALJ).
Since other stages of appeal allow a much lower chance of winning benefits, your best chance is typically during this hearing.
It’s of course ideal for you as the claimant to be approved and receive your benefits quickly. And there are some instances where a disability is easily provable, and you’ll be approved.
However, if you’re not approved, your claim can take additional months or years to resolve. It’s vital to understand how to maximize your chances of winning benefits during appeals, as well as how to avoid mistakes and missed deadlines that can delay a favorable outcome.
If you haven’t filed for Social Security disability in the past, you may have questions, such as:
How do I avoid common mistakes that would force me to appeal a denial? What exactly are all the stages of appeal for a claim denial?
What do I need to do to file for appeal? How do I prepare?
Here’s a closer look at the appeals process and how consulting a lawyer as early in your claim as possible can help.
Stages of Appeal for Social Security Disability Claims
Claim denials happen for various reasons. Some possible reasons for a denial include:
- A perceived lack of medical evidence
- You are able to work, or are currently working and earning above a certain income.
- Missed deadlines or appointments
- Missing or incomplete paperwork
- An error by the person reviewing your claim
Regardless of the reason, the proper thing to do after being denied isn’t to resubmit the same claim again. Rather, you must go through the appeals process so a Judge can properly examine all the evidence. Appeals ensure your case is considered as thoroughly as is possible.
The stages of appeal include:
Reconsideration
Someone other than the person who reviewed your claim the first time will reconsider the evidence regarding your disability. This stage of appeal will most likely not be successful unless you can demonstrate that the first reviewer made a mistake. You can submit an appeal either based on a medical denial or a non-medical denial (based on income, resources, living arrangements etc.).
Hearing by an Administrative Law Judge (ALJ)
This is the stage of appeal when you’re most likely to reverse a denial and win your benefits. It’s also the stage of appeal where consulting a disability attorney can greatly increase your chances of winning. This is because you’ll be given the opportunity to present your case during a legal hearing.
Review by the Appeals Council
The Appeals Council will probably deny a review if they feel the ALJ’s decision is backed by Social Security laws and regulations. You may request a review by the Appeals Council, or in some instances they may initiate a review on their own.
After this stage, your final recourse is to appeal in federal court.
Hiring a Social Security Disability Lawyer for Your Appeal: A Timeline
It’s important to consider at what stage of your case you’d like to consult a lawyer. Some attorneys may not take on your case unless you’ve already been denied—however, there are also lawyers who are completely willing to represent you from beginning to end.
When you hire a lawyer depends on your needs. However, a lawyer can help at each stage leading up to and including appeals. You typically don’t pay an upfront attorney’s fee for Social Security cases—but rather your lawyer is paid a federally regulated percentage of your initial back pay only if you win. This means there’s no financial disincentive to hire a lawyer early in the process.
Here’s how they can help throughout the timeline of your claim.
Your Initial Social Security Disability Application
An attorney can help you gather the right kinds of medical evidence to prove your claim as well as file all the proper paperwork.
While the Social Security Administration (SSA) offers instruction and guidance on your application and review, an attorney may have insight into the kinds of evidence, and how that evidence is presented, that will maximize your chances of being approved.
After You’ve Been Initially Denied
Hopefully if you must appeal an initial denial, your attorney would have prepared you for this next stage of your claim and the possible outcomes.
In most cases, you have 6 months after a denial to apply for whatever is the next stage in your appeal process.
You’ll be sent a letter detailing the reason for the denial. This will allow you and your attorney to decide how best to prepare for your appeal.
A qualified lawyer can advocate on your behalf, help you prepare for the hearing and gather the right kinds of evidence to overturn a denial, present evidence to the judge, and even question you and others present at the hearing, such as medical and vocational experts.
Additionally, lawyer’s working relationships and familiarity with local court personel’s expectations can help increase your chances of a positive outcome.
While an attorney can never offer a “sure thing” or a quick approval, your chances of winning your benefits are much higher when you have a legal expert to inform and advocate for you and your family.
If you are filing for Social Security Disability Insurance or Supplemental Security Income, Affleck and Gordon can help. We’ve been helping people in Georgia just like you for over 45 years. Sign up for a free case evaluation, or call us (404) 990-3945.