You've been denied disability...Now what?

In 2010 nearly 3 million people applied for disability benefits.  That's nearly three million people claiming that they cannot work.  Only roughly a third of those were approved.  Those approvals came at all different levels of the application process.  So if you received a denial where does that leave you?  This article goes over the steps of the application process and describes what to expect next if you were denied.

If you have applied for benefits you can hire an experienced attorney at anytime to deal with the administration.

Initial


When you first apply for benefits, your application paper work is sent to a state agency who gathers some of your medical records and conducts a paper review of your application.   A doctor looks over you medical records and decides if you are disabled under social security's rules.  Sometimes applicants are successful at this step.

If have been denied at this step though, take heart, and make sure to appeal that decision within 60 days of the denial or you risk losing benefits.  An appeal at this stage, in most states, moves your application to the reconsideration stage.  In some states like Louisiana you move on to the hearing stage.

Reconsideration

At this stage, the state examiner gathers some more medical records.  You file some paper work describing any changes in your condition.  A different doctor looks over your medical records and again determines if you meet the Administration's definition of disabled.  A denial at this stage is very common.  So if you lose at this stage, again take heart, most people lose at recon.  Remember to appeal your case or request a hearing within sixty days to preserve your rights.

Administrative Law Judge (ALJ) hearing


This stage is where you finally get to talk with someone directly who can make a decision in your case--the ALJ.  You will be allowed a time to present your case.  There will also be others at your hearing, a hearing reporter and usually a vocational expert.  Sometimes there may even be a medical expert.  If you have not hired an experienced attorney yet, you should really consider doing so.  Your attorney would know how best to present your case, what evidence to highlight.  An experienced attorney knows how to cross-examine experts. Prior to the hearing the attorney can also gather your most up-to-date medical evidence saving you a lot of trouble and expense.

This step of the process is very important.  In the lawyer world, we say that this is where findings of fact are made.  Findings of fact are very hard to appeal.  The judge is acting as both judge and jury at this point so you want to absolutely put on your best case. I highly suggest hiring an attorney.

However, sometimes the most deserving people are denied at this point for various reasons.  Sometimes the judge did not see what he or she needed to see in a case.  The judge might not have found you credible.  For whatever reason though, all is not lost there are still more avenues of appeal.

Appeals Council or Refile


Just recently the Administration came down with a decision that a person either had to refile or appeal once a decision is made at the ALJ level.  It used to be that you could do both.  There are a lot of considerations in deciding which way to go.  Appeals can take a long time and can be harder to win than a new application, but at the same time by filing a new application you would be giving up any back benefits on your original application. So this decision is a big one.  Once again an experienced attorney can be a lot of help in advising you in what direction to go.

If you decide to appeal to the Appeals Council, your whole file is sent up to Virginia for review.  For my clients, I accompany the request for review with a brief detailing my theories as to why I believe the ALJ made the wrong decision.  I also send up any new evidence.  The Appeals Council examines the decision to see if the ALJ made any legal error.  You do not testify.  This is all done on paper. Then the Appeals Council can do one of three things, they can find you disabled, remand your case back to the Judge, or deny your request for review.  If you are denied at this point you have exhausted your administrative remedies, and you can now file in Federal Court.

Federal Court Appeals


Overturning an ALJ decision is even harder in Federal Court, but it can be done.  Here you would definitely need a lawyer to help you out.  Dealing with a Federal Court is even less forgiving than dealing with the Administration. In this step everything is on paper again.  You would not testify.  Some courts do allow for oral argument though.

So I hope this article has been helpful for anyone who is in the process of applying for benefits.  If you have any questions you may of course contact me.