What if My Application for Social Security Benefits Is Denied?

May 23,2016
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You’ve filed your application for Social Security disability benefits and are waiting anxiously for a decision.  While you should keep a positive frame of mind, it’s a good idea to prepare yourself for the possibility that your social security benefits is denied.  Why?  Because most claims are denied, including the claims of many deserving applicants. If your claim is denied, as an experienced Poughkeepsie Social Security attorney, I can assure you it is not the end of the road.  You have a right to appeal.  A majority of applicants who appeal after an initial denial are ultimately awarded benefits.

How Your Application Is Processed

The road that leads to receiving Social Security disability benefits begins with the filing of form SSA-16-BK (the application), and form SSA-3368-BK, (the adult disability Report).  These documents are initially filed and processed at a local Social Security Administration field office.  The field office reviews the paperwork to determine whether or not you have worked and contributed to Social Security long enough to allow you to participate in the system. If the field office determines that you do qualify to participate, your paperwork will be forwarded to Disability Determination Services (DDS.)

The DDS is a State agency funded by the federal government. DDS looks at your information and decides whether or not the evidence establishes that you are disabled.  Your file is then returned to a local field office for appropriate action and you are notified by mail of the decision.  If DDS decides that you are disabled you are done!  You will receive benefits as long as your disability continues.

Your Social Security Benefits is Denied — Should You Appeal?

What happens if the letter from the Social Security Administration informs you that DDS has determined that you are not disabled?   What can you do if you disagree with the decision?  The letter notifying you of the decision will tell you that you have a right to appeal the decision by requesting a reconsideration of your application.  You must submit your request within 60 days of your receipt of the decision letter.

Now the big question.  Should you request reconsideration of your claim?  The experienced representatives of the Social Security Administration have determined that you do not meet the SSA’s definition of disability.  How much chance is there the decision will be reversed?

The answer is that decisions made by the Disability Determination Services are frequently appealed and a significant number of those appeals are eventually successful.  You should not give up on your claim until you have talked to an attorney who has experience in handling Social Security Disability claims.  If you are already represented by an attorney who assisted you with the initial application process, call and make an appointment to go over the denial letter.  If your attorney tells you that there is no reason to file an appeal, call a different attorney and get a second opinion.  This is a very important decision.  You need to act quickly and you need to know that you are taking the best steps to protect your rights.

Our office often gets calls from people who have filed an application for disability on their own.  The person they met with at the field office helped them with the forms and assured them that they did not need to have an attorney represent them.  Now they have received a letter from the SSA denying their claim.  They still can’t work, and they do not know what to do.  We advise most clients to appeal the decision.  We prepare the paperwork and get it filed before the time for filing an appeal expires.

Levels of Appeal

There are actually 4 different levels of appeal.  If your initial application is denied, your first appeal is a request for reconsideration.   A request for reconsideration is a review of your claim by someone at the DDS who was not a part of the original decision.  The evidence in your file will be reviewed along with any additional evidence that you have submitted to DDS.  After the review, a decision is made to either grant your application for benefits or to confirm the original decision that you are not disabled.

If you are notified that, after reconsideration, you are still considered NOT disabled, you have a right to appeal that decision by requesting a hearing, (level 2.)  The appeal hearing will be conducted by an administrative law judge.  (Are you ready to hire an attorney now?)

An administrative law judge is not an elected official.  The judge is an attorney, hired by the Social Security Administration, and given the responsibility of conducting hearings to review decisions made by the DDS.  The judge will conduct a that you will attend if you are able.  Additional evidence may be presented at the hearing, you will have the opportunity to testify and you may call witnesses to offer testimony on your behalf.  After the hearing, the judge will make a decision and you will be notified by letter.

The decision letter finally arrives and you are still disabled!  But it says that you are still NOT disabled!  Now what!?  Don’t give up yet!   You are still unable to work.  Your doctor says you are not going to get better, so…Press on!  If you disagree with the decision of the administrative law judge, you can ask that your file be reviewed by the Social Security’s Appeals Council, (level 3)! The Appeals Council has the authority to deny a review if, after consideration, it believes that the decision of the administrative law judge was correct.  If the Council decides that your case warrants review, the Council may hear your case itself or it may order your file returned to an administrative law judge for further action.

If the Appeals Council denies your request for a review, or if after review the Council determines that you are not disabled, you still have the right to file a law suit in federal court (level 4), claiming that you are disabled and entitled to disability benefits.

Time to Get a Poughkeepsie Social Security Attorney Involved

If you decided to begin the process on your own and are now considering an appeal of a denial of your claim, it is time to think about retaining a Poughkeepsie Social Security attorney.  If you are worried about being able to pay for an attorney, you will be interested to know that attorney fees for representation in Social Security disability cases are contingent on a determination that you are entitled to benefits.  In addition, fees must be submitted to the Social Security Administration for approval.

The attorneys at the Herman Law Group have experience in handling Social Security disability claims throughout the New York metropolitan area.  We know the appeals process and can make sure that your right to a fair and honest evaluation of your impairment is protected. Call us at 877-773-3030 to schedule your free case evaluation.