Application Denied: What to Do Next

denied-imageAfter completing the rigorous application process and waiting several months for an answer, a Social Security disability (SSD) denial can be devastating. If your SSD benefits claim is denied, you may be afraid that you will be unable to get the money you need to support yourself and your family.

Fortunately, you are not alone and you are not out of luck – there is a four-step appeals process that you can pursue in order to convince the Social Security Administration (SSA) that you are entitled to benefits.

Disability benefits denials are a problem faced by the majority of applicants, yet many people go on to recover the benefits they deserve. Don’t give up hope if your claim is initially denied. Take action instead. Contact an experienced SSD lawyer at Land Parker & Welch, P.A., today for help.

Call (803) 435-8894 or use our online contact form for a free consultation. Our firm has more than 120 years of combined experience assisting disabled South Carolina residents obtain SSD benefits even after they received an initial denial.

It’s Likely Your SSD Application Will Be Initially Denied

The SSA has taken a tough stance to fight fraud in the disability benefits system. In order to ensure that benefits go only to the truly disabled, the SSA has a very narrow definition of “disability.” Your medical condition must last a year or be expected to last that long, and it must be listed in the SSA’s “Blue Book” listing of impairments. Not only that, but you also must exhibit the specific symptoms listed in the blue book for your condition. If your medical problems aren’t listed, you will probably face an uphill battle to prove medical equivalence.

Not only does the SSA have a narrow definition of “disabled,” but it is also strict in the medical documentation it requires, and it still denies many applications even when people claim to have a listed condition.

According to the SSA annual statistical report on the Social Security Disability Insurance program:

  • From 2001 to 2010, the percentage of applicants awarded benefits after their initial claim (as opposed to after appealing) was just 28 percent.
  • The highest approval level of initial applications from the period of 2001 to 2010 was just 37 percent.
  • The lowest approval rate during this same time period was 26 percent.
  • The percentage of applicants who were awarded disability benefits after making a request for reconsideration (the first stage of appeals) was 3 percent.
  • The percentage of applicants who were awarded disability benefits after a benefits hearing (the second stage of appeals) was 13 percent.
  • Overall, the average denial rate of disability benefits claims was almost 53 percent.

As these data show, more than half of all applicants had their SSD benefits claim denied. In South Carolina, estimates indicate that the denial rate may even be higher, with as much as 65 percent of first-time applications failing to get SSA approval.

As bad as these numbers are, things may only be getting worse in the future.  Most projections estimate that the Social Security Disability Fund is expected to go broke in 2016, and there have been numerous recent headlines, including an in-depth study, that suggests that the number of Americans who are on disability has risen to an unsustainable level in part because people are applying for benefits when they are unable to find work. This even prompted the House Oversight and Government Reform Committee to express concern about too many claims being approved.

With pressure on the SSD to keep costs (and approvals) down, many people with legitimate benefit claims may find themselves struggling to get the SSA to recognize that they are entitled to benefits.

What You Can Do If Your Social Security Disability Benefits Claim is Denied

If your claim is denied, the important thing is to realize that you have options. There are four different stages of appeal that you can pursue, including:

  • A request for reconsideration. This involves asking the SSA to have a disability claims examiner review your case again. The claim will be reviewed by a different examiner from the one who initially considered your application.
  • A disability benefits hearing. These hearings are presided over by administrative law judges (ALJ) who work for the SSA. You can present evidence as to why you deserve to receive benefits, and the SSA will make its own argument about why your claim should be denied. The ALJ then makes a decision about what should happen with your case.
  • An appeal to the appeals board. This involves having an internal SSA review conducted of the past decisions made on your case to determine if something went wrong or if you were treated unfairly.
  • Appeal to the federal court. This is the first stage at which you are appealing to a legal authority outside of the SSA’s administrative system. The court is deferential to the decisions already made in your case, but it can reverse them if there were clear problems with how your claim was handled.

At every step of the way, it is very important to be prepared for the appeal, to act quickly within the deadlines and to have solid medical evidence showing how badly you are disabled. You have only 60 days in which to file a request for reconsideration before you will be unable to appeal and need to start the claim over from the beginning.

As you consider appealing your SSD benefits denial, remember that the SSA has experts who specialize in denying claims and in fighting to have those denials stand. You need to find an advocate who can represent your interests and fight for you.

This means that as soon as you receive a disability denial, you should contact an experienced SSD denial lawyer who can fight for you. At Land Parker & Welch, P.A., our South Carolina disability attorneys have more than 120 years of combined experience helping disabled individuals to receive disability benefits.

Call us now at (803) 435-8894 or fill out our online form for a no-cost case evaluation.

Sources:

  • SSA – Final outcome of disabled-worker applications, 2001–2010
  • Washington Examiner – Social Security disability fund to go broke in 2016
  • NPR – Unfit for Work: The startling rise of disability in America
  • Fox News – Judges cite pressure to approve disability payments as program nears insolvency
  • U.S. House Committee on Oversight and Government Reform – Oversight of Rising Social Security Disability Claims and the Role of Administrative Law Judges