How to appeal a denial for an application of benefits

If we recently denied your Social Security benefits or Supplemental Security Income (SSI), you may request an appeal. Generally, you have 60 days after you receive the notice of our decision to ask for any type of appeal. There are four levels of appeal:

  • Reconsideration.
  • Hearing by an administrative law judge.
  • Review by the Appeals Council.
  • Federal Court review (please see the bottom of page for information on the Federal Court Review Process).

You can request an appeal online for a reconsideration, a hearing by an administrative law judge, and a review by the Appeals Council, even if you live outside of the United States. When we made the first determination on your claim, we sent you a letter explaining our determination. This letter contains guidance on what level of appeal you should select.

Request a Reconsideration Online for a Medical Determination

If we recently denied your disability claim for medical reasons, you can request an appeal online.

A reconsideration is a complete review of your claim by someone who did not take part in the first determination. We will look at all the evidence submitted used in the original determination, plus any new evidence.

Request a Reconsideration Online for a Non-Medical Determination

If you received a non-medical determination letter from us that you disagree with or we denied your application for a reason that is not disability related, you can request a non-medical appeal online. Non-medical reasons may include a denial due to income, resources, overpayments, or living arrangements.

Check the Status of Your Reconsideration

Whether you filed your appeal online, by mail, or in an office, you can check the status of your disability and SSI Reconsideration using your personal my Social Security account. A my Social Security account is an easy, convenient, and secure way to do business with us. If you don’t have one, you can create one today.

Request a Hearing Online

If you disagree with the determination we made at the reconsideration level, you may ask for a hearing. An administrative law judge who had no part in the original determination or the reconsideration of your case conducts the hearing. You may request a hearing online.

When we schedule your hearing, we consider what’s convenient and close for you. We usually schedule hearings within 75 miles of your home. In certain situations, your hearing may be held via video at one of our many available hearing sites, in person at one of our hearing offices, or from your preferred location.

After you submit your request for a hearing, you’ll receive a confirmation package that explains the hearing process. In that package, you’ll have the choice to opt-out of having your hearing by video. Video hearings have the same look and feel as in-person hearings. If you’re comfortable with having your hearing either in-person or via video, you don’t need to send in that form. We’ll find the first available day and time for your hearing, at a location that’s convenient to you. We’re committed to providing you quality customer service and the flexibility we offer with scheduling your hearing is just another way we’re able to meet your needs.

Check the Status of Your Hearing

Whether you filed your request for a hearing online, by mail, or in an office, you can check the status of your disability and SSI hearing using your personal my Social Security account. A my Social Security account is an easy, convenient, and secure way to do business with us. If you don’t have one, you can create one today.

Request an Appeals Council review of a decision or dismissal made by an administrative law judge

The Appeals Council looks at all requests for review, but it may deny a request if it finds the hearing decision is in accordance with social security law and regulations. If the Appeals Council decides to review your case, it will either decide your case itself or return it to an administrative law judge for further review. If you disagree with the hearing decision, you may request a review by Social Security’s Appeals Council online.

If you disagree with the Appeals Council’s decision, or if the Appeals Council decides not to review your case, you can file a civil suit in a federal district court. This is the last level of the appeals process. Currently, filing a Federal Court review is not available online. To learn more about this process, visit Federal Court Review Process.

How to appeal a denial for an application of benefits

Nothing stings worse than being denied unemployment benefits. Well, maybe losing that high-paying job in the first place ranks higher, but this is not an economic climate for moping.

If you are turned down for unemployment benefits, here are three potential courses of action:

1. Appeal the Decision.

When you applied for unemployment in the first place, your state unemployment agency made a determination of your eligibility.

Common reasons for denial include:

  • Voluntarily quitting your job,
  • Being fired from your last job for misconduct, or
  • Not earning enough money while you were employed.

You may disagree with the agency’s decision and reasoning with respect to your termination or salary, and that is why you must request a hearing.

2. Request and Attend a Hearing.

After receiving your unemployment denial letter, you may request a hearing with your state’s Department of Labor, typically within 30 days of the letter’s mailing date. (Check the agency’s website in your state for the specific deadline.)

Preparing for the hearing means taking the following steps:

  • Gathering paperwork. You need to collect and organize all of your pay stubs, job evaluations, employee guidelines and warning letters.
  • Line up witnesses. You may need someone to testify on your behalf from any of your past jobs.
  • Think about your arguments. Condense your frustrations and complaints into a handful of strong, salient points to present at the hearing.
  • Consult an attorney. Speaking at least once with an experienced unemployment attorney can give you a good idea about your arguments and whether you need representation.

On the day of your hearing, arrive early, be well-dressed, be polite, and refer to the judge as “Your Honor.”

3. I Lost My Appeal. What Now?

While you can always appeal your appeal, unemployment insurance shouldn’t be your sole focus.

Here are some tips for minimizing your costs until you find your next full-time job:

How to appeal a denial for an application of benefits

Social Security Disability Insurance (SSDI) benefits are awarded by the Social Security Administration (SSA) to individuals who are unable to work due to a disabling condition. On the other hand, Supplemental Security Income (SSI) is awarded to blind or disabled individuals who have not earned enough work credits to be eligible for SSDI and meet certain income and resource criteria.

It is an applicant’s responsibility to prove their eligibility for disability compensation from the SSA, and this process is often quite confusing and drawn out and can often take over a year to complete. For this reason, it is beneficial to contact a disability lawyer to help you speed up the appeals process after being denied Social Security disability benefits.

What Causes Delays in the SSD Appeals Process?

There is a lot of paperwork that goes into filing for disability benefits, including employment and medical records. One wrong step in the filing process could result in a denial of benefits, potentially delaying your application for months.

The longest delay typically lies in waiting for a hearing with an administrative law judge (ALJ). A hearing with an ALJ will be necessary if you are denied benefits again after filing an initial appeal. Waiting for this hearing could delay your claim for Social Security benefits for up to two years in some instances, depending on your county and region.

How to Speed up the Social Security Disability Appellate Process

If your SSD claim is denied, you have 60 days to appeal the decision in writing. There are several ways to avoid waiting for a hearing with an administrative law judge. The first is to seek an On-The-Record (OTR) decision, which is a ruling that can be made by an administrative law judge before having a formal hearing. OTR decisions require extensive medical information to prove your disability. If your Social Security disability claim receives approval at this stage, that would conclude the appeals process.

Other options are available for specific medical conditions or extreme financial need. For instance, if you are diagnosed with a terminal illness or one of the serious illnesses listed in the SSA’s compassionate allowances list, you may be eligible to receive Social Security disability benefits much sooner. Furthermore, proving that you are in financial “dire need” circumstances will also help speed up the approval process after a denial.

Don’t Wait to Contact an Attorney

The process of obtaining Social Security disability benefits can be long and complicated, especially in the event of one or more denials. Don’t risk delaying your claim by making a mistake in the appeal process. Instead, let an experienced disability attorney help you speed up the appeals process after being denied Social Security disability benefits.

Whether you have applied for Social Security Disability Insurance or Supplemental Security Income benefits, there is the chance that the Social Security Administration (SSA) will deny your claim for benefits. Fortunately, there is a simple process that you can follow in order to appeal, or ask for another review, of the denial of your application for Social Security benefits.

Three Step Process for Appealing a Denial of Benefits

There is a three-step process that you must follow in order to request an appeal of the denial of benefits.

  1. First, you must complete an Appeal Request form, which asks the SSA to review your case again.
  2. Second, you need to complete an Appeal Disability Report, which gives the SSA more information about your medical condition.
  3. Third and finally, you should complete an Authorization to Disclose Information to SSA form, which gives your medical providers permission to give information to the SSA about your medical condition.

You can appeal the denial of your benefits by calling the SSA at 1-800-772-1213, or by visiting your local SSA office, and advising SSA that you want to appeal the denial of your claim for benefits.

After Your Appeal Forms are Received

Once the SSA receives the forms listed above, they will forward your application to the office that makes decisions about people’s disability claims. They will review your forms and request any new medical records from your doctors, and then make a decision about your claim. You also have the right to request an in-person appointment for the review of your claim. Once a decision has been made on your case, you will receive that decision in writing.

Four Different Levels of Appeal

There are four different levels of appeals from the denial of a disability claim. You have the right to have an attorney represent you at each level, or you can represent yourself in at least three of the four levels of appeals. When you have applied for disability benefits and the SSA denies your application, you begin with the first level of appeal, or reconsideration. This sends your case to the State Disability Determination Office, which reconsiders your case. If SSA still denies your claim after reconsideration, the next level of appeal requires a hearing before an administrative law judge. It can take several months before this hearing is scheduled, and you can meet in person with the judge if you choose. Once the judge makes a decision, he or she will send you a decision in writing.

If the administrative law judge still denies your claim for disability benefits, you can then ask that your case be sent for an appeals council review. You cannot complete this stage of the appeals process online, but must do so by contacting your local SSA office. Once you request this type of appeal, SSA will send your case to the Office of Disability Adjudication and Review, which, again, may take several months to review your case. The final stage of appeal involves filing a lawsuit against SSA in the federal district court system, and you are well-advised to seek the assistance of an attorney at this level of appeal.

Speak to an Experienced Social Security Disability Attorney Today

This article is intended to be helpful and informative. But even common legal matters can become complex and stressful. A qualified social security disability lawyer can address your particular legal needs, explain the law, and represent you in court. Take the first step now and contact a local social security disability attorney to discuss your specific legal situation.

You’ve gathered all your medical records and filled out all the forms that were required. But after carefully preparing your application and sending it in on time, you were still denied. What do you do now?

The truth is, more than half the people who apply for benefits are denied the first time they apply. You have the right to an appeal within 60 days, so use it. Don’t assume that a denial is the end of everything, or worse, re-apply without legal help from a disability lawyer.

How to appeal a denial for an application of benefits

The Process Of Appeals

Many people assume that a denial is the end of their application and either give up entirely or re-apply. Both are incorrect, and you will lose valuable time and your appeal rights in both scenarios.

There are four steps to the appeals process in Texas, and they have to be done in order.

  • Request for Reconsideration—this involves turning in your same paperwork to another SSA representative for review. You can also include additional information that was omitted from your original application. About one out of six people who request reconsideration are approved at this stage.
  • The Disability Hearing—you’ll go in front of an administrative law judge who will hear your case and decide if you are qualified for disability. Expert witnesses, such as a medical expert to discuss your condition and a vocational expert that can advise on what kind of work you may be qualified to perform. However, you are allowed to bring witnesses as well as present any new evidence that has come to light since your application or last denial.
  • ·The Appeals Council—if the judge denies your request, you can bring your case to the next level. This council consists of administrative law judges that were not involved with your case previously. These judges won’t consider any new evidence, however, they will make sure that the previous judge followed proper laws and procedure in deciding your case.

These judges can either agree with the original judge’s findings or overturn the decision and award your disability benefits. They can also send the case back to the prior administrative law judge with comments about any mistakes made in the case.

  • Federal Court Review—this is where you’ll file a lawsuit if you disagree with the decisions of the previous courts.

Why You Need A Disability Attorney

Just applying for disability is complicated and confusing. Going through the process of appeals is even more complicated as well as challenging. Finding an attorney who understands the process and knows what to do will make the process much easier, and increase your chances of winning on appeal.

Call Us For Help With Your Disability Appeal

If you didn’t have legal help with your disability application, don’t leave things to chance. The process can take many months, and in some cases, years. Don’t give up. Let us help you with your appeal and increase your chances of winning.

We’re experienced in handling all types of disability claims and have helped more than 4,000 Houstonians get the disability benefits they need. Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and we’ll take your case on a contingency fee basis, with no up-front charges.

If the SSA denies your disability claim and you don’t agree with their decision, you have the right to file an appeal. The tricky part is how to write an effective appeal letter that will convince them to give your case a second chance.

The SSA’s decision notice usually contains the reason why your claim got denied and the sources they used to evaluate your claim. It will also include instructions on how to make an appeal as well as a guide on what level of appeal you should choose.

The appeals process has four levels:

  • reconsideration
  • hearing by an administrative law judge
  • review by the appeals council
  • federal court review

Your appeal request will depend on the level of appeal you are going for. But most of the time, a disability appeal letter is submitted to request for reconsideration.

Also enclosed in the decision notice are appeal forms which you can also download online. You need to complete and submit these forms to the SSA if you want to file an appeal. Please note that there is only a small portion on the form where you can write your appeal statement. But you can always add the phrase “see attached page” and write your appeal letter in a separate sheet of paper.

If you can convince them to reconsider your claim, then there might not be a need for you to go through all four levels of the appeals process. But, of course, this depends on how convincing your appeal is.

Here’s a quick guide to writing an effective disability appeal letter.

Before Writing the Letter

1. Understand Why Your Claim Was Denied

As mentioned, the reasons why the SSA denied your claim will be detailed in their decision notice. As such, you need to carefully read their decision and understand why you were not approved for disability benefits. It will help you come up with a convincing argument for your case.

The SSA usually denies a disability claim due to either medical or non-medical reasons. But it can also be because of both. The notice will usually explain this in a clear and easy-to-understand manner.

2. Determine Which Impairments the SSA Evaluated

If you have several impairments, the SSA may not be able to evaluate them all. The notice will also list the impairments the SSA has evaluated. If there are impairments that they missed out on, you need to point it out in your appeal letter.

3. Examine the Sources Used to Evaluate Your Claim

The SSA will also list down their sources for evaluating your claim. If you disagree with them or have better sources, you can also include them in your letter.

Writing the Disability Appeal Letter

1. Indicate Your Name and Claim Number at the Top

Yes, the SSA appeal form will already bear your name and other details. But it’s not uncommon for the attached letter to get separated from the forms. Writing your name and claim number in the upper part of the letter will help the SSA staff determine which letter goes with which form.

2. Point Out Any Mistakes or Oversights

If you see any mistakes or any information the SSA has missed, you need to point it out in your letter. Be specific and if possible, state the paragraph and line on the notice where the error can be found.

3. Supply Missing Medical Information

If your claim was denied due to medical reasons, you need to include medical information that the SSA has missed (if any). Just make sure you have proper evidence to back it up.

Medicare is a medical insurance program administered nationally by the Centers for Medicaid and Medicare Services, a part of the U.S federal government working under the Social Security Administration. The program is divided into part A to D, and one has to be a permanent U.S citizen for at least five years to be eligible for either. For part A and B, the criteria are that you have to be aged 65 years and above and qualify for Social Security support. You can also enter the program if you are below 65 years but be permanently disabled and have been receiving disability benefits for at least two years or be suffering from the end-stage renal disease.

Part C, also known as Medicare advantage is procured from private insurers, but to qualify, one has to be already enlisted in part A or B. Part D also available from private insurers caters for prescriptions drugs and is also available to people subscribed to part A or B.

How to appeal a denial for an application of benefits

Steps and Procedures for Appealing a Denied Application

Determine if an Appeal is Appropriate

  • It denies your request for a health care service, supply, or drug that you feel you should be able to access.
  • A change of the amount you should pay for health care services; prescription drugs, supplies or items is denied, OR,
  • A request for payment of a health care service, item, supply or prescription medication that you already have is rejected.

Evaluate your Medical Summary Notice

Appealing starts by evaluating the Medical Summary Notice (MSN) sent to your mail every three months. It indicates all the services and supplies that providers billed to Medicare in a quarter. From the MSN, you can determine the amount paid by Medicare and what is denied. It is usually an initial determination made by the company that handles bills for Medicare.

Appealing the Decision

  • Filling out a Redetermination Request Form and sending it to the contractor handling your case indicated on the MSN
  • Adhere to the instructions for appealing as shown on the MSN. You may need to consult your doctor or healthcare provider on information that may be helpful to your case.
  • Making a written request to the organization that handles the claims of Medicare (the information can be seen on the MSN at the Appeals Information section. The petition has to explain as to why you do not agree with the initial determination and the specifics for which you require to be predetermined.

Your name, address, phone number and Medicare number have to be provided on a signed form. All the documents submitted for the appeal request have to have the Medicare number indicated on them. Additional information or supporting evidence can be provided after the initial redetermination request has been filed.

How to appeal a denial for an application of benefits

What to Expect After Filing an Appeal?

UnitedHealthcare reviews all submitted appeals before elapsing of 60 calendar days from the date of receiving the MSN. It takes roughly 30 days to process claims. However, if additional information is submitted after the initial appeal, it can take an extra 14 days. One can file for an expedited decision in situations that are time sensitive. The expedited process is used when the standard timeframe for making decisions might seriously jeopardize your health. Such decisions are made within a maximum of 72 hours.

Elliot Marks

Author & Social Security Advisor

Elliot Marks has spent over 10 years providing clear and concise information to help Americans navigate the complex nuances of social security and many other government services in the United States. Elliot has a passion for helping those in need of these services to be able to find timely access to news and information that is relevant and helpful to their daily lives.

Have you been denied Social Security disability Insurance (SSDI) benefits recently? If so, your frustration and disappointment is understandable and common. According to the latest annual report on Social Security Disability benefits, about 70 percent of applicants are denied during their initial application. The appeal process can be lengthy and arduous, but it’s worth the financial security in the absence of employment. here’s everything you need to know about the appeal process for Social Security Disability benefits.

How to appeal a denial for an application of benefits

An Overview of Eligibility

  • The Social Security Administration (SSA) must deem you totally disabled as per its own definition.
  • This disability can be mental or physical, although physical disabilities are easier to prove and are less often rejected.
  • You cannot perform your previous job due to your current disability.
  • You cannot perform any job due to the effects of your disability.
  • Your claim must be supported by independent professional medical opinions.
  • You must demonstrate financial difficulty, which often means living below the poverty line.

Even though most applicants do meet the eligibility requirements for Social Security disability benefits, they can be overlooked and therefore denied.

Step 1: Request For Reconsideration

If you’ve been denied by the SSA, you will receive a letter informing you of the decision. This can take place within a month to six months of submitting your application. Your letter will contain directions on how to appeal. It may also include the form you’ll need to use, known as the “Request for Reconsideration” form.

If you’d rather fill the form out online, You can do so. Then, you can submit it or print it out. You have 60 days to submit your appeal. The appeal will be reviewed by a different SSA official.

Step 2: Administrative Law Judge Hearing

If your request for reconsideration is denied, the next step is requesting a hearing before an administrative Law Judge. Again, you must make this request within 60 days of your reconsideration denial notice.

An Administrative Law Judge is an attorney who works for the SSA. His main job is to conduct these hearings and make a decision about appeals.

  • Any medical documents that support the extent of your disability.
  • Any witnesses who can testify that you cannot work.
  • Any documentation of financial hardship, such as tax records and rent receipts.
  • A legal representative.

About 50 percent of cases reviewed by an ALJ are overturned. You may have to wait several months for your hearing.

Step 3: Appeal To The Council

If the ALJ denies your claim too, you can request that your case be reviewed by a council of Administrative Law Judges. In this step, you cannot introduce any new information to your case. You may only be able to note if there were any significant changes to your disability status from the time when you first appealed.

The ALJ council’s job is to check if the initial ALJ conducted your hearing fairly. They examine whether all of your documentation was considered and whether your representative was allowed to conduct a cross examination.

The process of a council review can take more than a year from the time you request it.

Step 4: Federal Court Lawsuit

Although most cases don’t get to this level of the appeal process, you can file a lawsuit against the Social Security Administration with the Federal Court. Since the SSA is governed by federal law, this court can make the ultimate decision about your appeal.

This process can get expensive and takes up to several years to conclude.

How to appeal a denial for an application of benefits

Benefits of Legal Representation

At any point during the appeal, you can seek legal representation for your Social Security disability case. Your lawyer can specialize in disability law, but it is not a legal requirement.

A lawyer is most beneficial at the ALJ hearing stage. this is where you and your witnesses can advocate for your needs as a disabled individual. Since the appeal is face-to-face and direct, your lawyer can present the case in a more compelling way.

If you’ve been denied your rightful claims, start your appeal process by filling out the “Request For Consideration” form today.

Elliot Marks

Author & Social Security Advisor

Elliot Marks has spent over 10 years providing clear and concise information to help Americans navigate the complex nuances of social security and many other government services in the United States. Elliot has a passion for helping those in need of these services to be able to find timely access to news and information that is relevant and helpful to their daily lives.