Just got my Social Security denial. Now what?

For Disability claimants, there is no bigger disappointment than to receive a denial letter from the Social Security Administration.  How to handle this, depends on a number of factors, including where you are in the administrative appeal process.

First:  The easy part.  You have a 60 day deadline (upon receipt) at all appeal levels.

SSA says:

We assume that you got the hearing decision or order within 5 days of the date shown on the notice unless you can show us you did not get it within the 5-day period.

Denials at the Initial and Reconsideration Level

If you received a denial at these initial stages, you can appeal and complete the disability report (that must accompany

the appeal) online.  Just go to the Official Website for the Social Security Administration (www.ssa.gov) and select appeal a disability decision from the drop down menu.  The rest is fairly self-explanatory.

Make sure you have the denial letter with you when working online.  You will have to key in your name, SSN, DOB and the Date of the Decision or you will not be able to use this service.

For the disability report, you will need to have your names, addresses and phone numbers of current treating doctors and/or other health care providers.  Also, have your medications handy.  The more thorough you are in completing the report, the more likely Social Security will gather the appropriate information at the next level.  But remember, if you have been denied at the reconsideration level and now have to request a hearing, Social Security will do no more development on the case.  That is, they will forward the case to the Office of Hearings and Appeals only and not request updated medical records.

If you don’t have access to the internet (you wouldn’t be reading this, I know).  But if you can’t complete the online form for any reason, you need to complete a specific form that you can get at your local District Office.  You can find the Social Security Office closest to you from the Social Security Website.  See the last item on the list of Top Services.  Or you can call 1-800-772-1213.  If you have to call the SSA 1-800 number, be patient.  Sometimes there is a long wait!

Denial after a Social Security Hearing

You cannot use the SSA online services to appeal an Unfavorable decision after a hearing.  To seek review by the Appeals Council, you must complete Form HA520 and submit it to either your local office or the Appeals Council.

OK.  There are actually a lot of caveats to this.  It is not so simple.

There are only certain parts of that form you should complete.   Also, you may want to start a new application rather than appeal to the Appeals Council.  You may also want to do both.  What should you do?  There is no clear answer to this question because it will depend on very specific information about your case.  You may need to seek legal advice on this (if you haven’t already).  And don’t wait!  You are unlikely to get even an experienced Social Security attorney to help you at this point if you wait until day 59 of your deadline to start leaving your contact information on attorney websites.  I’m just saying….

Where is the Appeals Council?

Appeals Council, Office of Disability Adjudication and Review, 5107 Leesburg Pike, Falls Church, VA 22041-3255.

What about Federal Court?

Well, if you get a denial from the Appeals Council, your only option on this claim is to file a lawsuit.  Now you really need a lawyer unless you want to do so “pro se.”  You should begin your search right away because very few attorneys do this work and very few will be able to help you if you are again, too close to your deadline to file the lawsuit.

Should I go to Federal Court?

An Appeal to Federal District Court is not a lawsuit about whether you are disabled. It is a lawsuit about whether the Social Security Administrative Law Judge (ALJ) made mistakes in making his/her decision that you were not disabled.   The court generally does not decide whether you are disabled.

I do take some cases to Federal Court.  I must file the lawsuit within 60 days of the Appeals Council denial.  During that time, I review the ALJ decision, the AC decision and I often ask a lot of questions about what happened at the hearing and what type of statements are in the record from all the doctors (even those that did not treat you but provided opinions).  I also have to seek information about the claimant’s financial status and work with my potential client on waiving the fee to file the lawsuit.  There are other financial issues that may affect my decision.  (There is some important new law on how I get paid to represent a Social Security claimant in federal court).

Many attorneys and non-attorneys ask me to review their cases.  What do I look for?  Well, of course I am looking for those mistakes.  Sometimes ALJs don’t follow the law.  How can this happen?  Well, sometimes the ALJs don’t think the law should be applied to a claimant and want to make an exception.  Or sometimes the ALJs mis-interpret Social Security law.  There are a lot of different ways than an ALJ can make a mistake.

The representatives who send me cases may not always know if the ALJ made a mistake that the Federal Court will ask them to correct.  Instead, they will ask me to review cases that they feel strongly about.  Maybe they feel something about the case is very  important, the client is very sympathetic or the situation is otherwise unfair.  Each review I do is very specific to the case.

The federal courts defer to Social Security a great deal.  So it is very difficult to win at this level.  I’m very selective.

Of course, there is so much more to say on this subject.  This is only very basic information.  I would tell you, if we were sharing a cup of coffee right now, not to give up.  When your health conditions prohibit you from working, you should fight for your disability benefits.  Try to stay in treatment.  I know that many claimants struggle with this but maybe the new Health Care Law will eventually make this easier.  But continuing treatment not only improves your quality of life, it can improve your chances of winning your Social Security case.  Your medical records are the most important evidence in your Social Security claim.

Learn more about Wellness and Social Security Disability at my Wellness page.

If you need help with Social Security Disability Benefits complete the form at the Contact Us page and we will be in touch.  Or call us toll free at 1-800-481-0302.

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