Appealing a Social Security Disability Decision

by Editorial Board on October 25, 2010 · 0 comments

in Appealing a SS Decision,Legal Concepts in SSD,Why People Are Denied

If you receive a letter denying your disability benefits the letter should also include instructions on how to appeal.  You must appeal within 60 days from the date of the decision.  It’s best to appeal as soon as possible rather than waiting for the deadline to approach.

Failing to appeal a denial of your benefits is a common and often critical mistake.  Appealing preserves your eligibility for past due benefits, also called the back award.  Appealing also increases the chances of winning your case.

If you don’t meet the appeal deadline then the denial may become permanent under the legal doctrine of res judicata, Latin for “a matter judged”. Social Security may hold that you were not disabled up to the date of the decision.  In this event if you are awarded disability benefits on a later application you will only be able to collect benefits for the time period running after the date of the denial.

Appealing when you are denied on Reconsideration greatly increases the chances of winning your case.  Most cases heard by a disability judge are awarded.  This is a crucial fact.  To understand why, we have to look at the steps of Social Security disability adjudication before the disability judge hearing level.

The first decision on a disability claim is made by a Disability Examiner.  The Disability Examiner reviews the medical records and other paperwork in your application before making a decision.  This first decision is usually a denial.  If the case is appealed it is sent to another Disability Examiner for a second decision, which is also usually a denial.

If the case is appealed again it is sent to an Office of Disability Adjudication and Review (ODAR) hearing office for a hearing with a disability judge.  The judge assigned to the case schedules a live hearing.  At the hearing you provide testimony to the judge.  Your disability attorney (if you have one) appears with you to present your case and make legal arguments.

Disability judges are independent.  They are not pressured to award or deny a certain percentage of cases.  They are usually better trained than a Disability Examiner.  Also, being able to speak to the judge live with the assistance of an attorney can help your case tremendously.  Sometimes the medical records and paperwork aren’t enough.  To really understand a disability claim it’s necessary to talk to the person who is suffering through the disability.   Unfortunately, you don’t get the opportunity to speak to a judge unless you appeal the first two denials on your claim.

If the judge denies your case then the next step is an appeal to the Appeals Council.  Some attorneys won’t appeal to the Appeals Council since it is a difficult process.  Before hiring an attorney ask them if they appeal hearing denials to the Appeals Council level.

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