How to Get Help for Your Social Security Disability Claim or Appeal

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1Filing Your Claim

2Appealing a Denied Claim

3Understanding the Appeals Process

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Tips and Warnings

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Are you among the estimated 75 per cent of Americans who have been denied Social Security Disability benefits upon initial filing of a claim? If so, you need to know why this may have happened and what you can do from this point onward. That may mean filing an appeal for your denied claim -- an appeal which can proceed via several avenues, including a hearing before an administrative law judge. Whatever you do, you want to avoid making the same mistakes or omissions which led to your initial claim being denied -- and that's not always easy. The Social Security Administration has a complex and elaborate system of rules and procedures. That's why it may be beneficial to consider getting help for your Social Security Disability claim or appeal.

Steps

Part 1

Part 1 of 3:

Filing Your Claim

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   Know if you are eligible. Before you even consider making a claim for social security disability, you need to know the standard guidelines for who can apply. In order to file a successful social security disability claim, you must meet the following criteria:

   • Are 18 years of age or older
   • Are not already receiving benefits on your own social security record
   • Are unable to work because of a medical condition that will persist for at least 12 months or will, ultimately, result in death
   • You must not have had a disability claim denied in the last 60 day
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   Document your disability. The first step in making a claim for social security disability is to get a well-documented diagnosis from your doctor regarding your disability. You will need to see a fully-licensed medical doctor or, depending on your disability, a specialist in a subfield of health care (like an orthopedic surgeon, gastroenterologist, etc.).

   • To have your claim taken seriously, avoid going to doctors who have questionable histories or records, especially if their offenses are related to social security or insurance fraud.
   • You will need the contact information for any and all doctors who have provided you with or contributed to the diagnosis of your current condition that is preventing you from working. You will need phone numbers, addresses, dates of visits, and your patient ID numbers for these doctors.
   • You will also need to provide information on all prescribed medications and medical tests ordered by doctors. Here you will need the names of the doctors, addresses, phone numbers and any other contact information for anyone who prescribed you medication or evaluated your test results.
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   Collect personal information. There are a number of documents you will need to make your claim in addition to your medical history and disability diagnosis. You will need the following documents to file with the SSA:

   • Social Security Card/Number
   • Date and place of birth
   • Name, date and place of birth, social security number, marriage/divorce dates, and date of death for any current or past spouses.
   • Names, dates and places of birth for all minor children in your care.
   • Your bank or financial institution’s routing numbers, if you would like to deposit disability payments electronically.
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   Collect work information. The SSA will need to contact your past employer(s) to determine the validity of your claim and decide on a dollar amount to allot to you. You will need to acquire:

   • Income statements, names, dates of employment, and addresses for any employers you have had this year or the last.
   • A copy of your social security statements
   • A list of up to 5 jobs, and your dates of employment, that you have worked over the last 15 years before you were struck with your disability
   • Any and all information about workers compensation claims you have filed with your employers in the past.
   • If applicable, you will need to provide dates for any military service accrued before 1968.
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   Prepare for SSA requests. There are a number of supplemental documents that the SSA may determine it needs from you after you have applied. You should have these documents ready in case the SSA asks for them. The documents you will want to have ready are:

   • Your birth certificate or proof of U.S. citizenship
   • W-2 forms and/or other tax forms for the last year
   • Military discharge papers (if you served before 1968)
   • Your medical records in your possession, like doctor’s reports, test results, etc.
   • Pay stubs, award letters or settlement agreements for any workers’ compensation payments you have secured in the past.
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   Apply. You can apply for social security disability benefits online, by phone or in person. The vast majority of people apply online and, as a general rule, these electronic applications are processed more quickly. However, you can:

   • Call 1-800-772-1213 from 7 a.m. to 7 p.m. Mondays through Fridays to apply by phone. If you are deaf or hard of hearing, you can call the SSA at TTY 1-800-325-0778.
   • Apply in person by making an appointment and visiting your local social security office.
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   Wait for a decision. You will be notified of the SSA’s decision by mail. There is no set time frame for this process, so be patient. Also, make sure you are available to the SSA if they contact you with requests for further documentation while vetting your application.
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Part 2

Part 2 of 3:

Appealing a Denied Claim

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   Determine why you were denied. The SSA may deny your claim for any number of reasons, ranging from a small inaccuracy on your application to an outright challenge of your claimed disability. Before deciding to appeal the decision, you will need to know why the SSA denied your claim in the first place.

   • Often times, the SSA just needs further or better documentation of your medical condition. If this is the reason you were denied, you can streamline your appeal process by appealing online and uploading or providing more comprehensive medical records.
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   Acquire comprehensive documentation. The most important part of the appeal process is, usually, the acquisition of better documentation. You will likely need to contact your health care providers, doctors, and last place of employment to acquire the necessary documentation. The SSA should tell you in the denial letter what they need. Let this letter be your guide in seeking out better documentation.
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   Appeal by yourself. It is your right to appeal the SSA’s decision to deny your claim. You do not necessarily need to enlist the help of a lawyer to appeal your denial of SSA disability benefits. Where your appeal is at in the appeals process (see below) will likely determine whether or not you want to secure outside help. You will want to pay very close attention to the SSA’s reasoning for denying your claims and prepare to defend your claim accordingly.

   • When appealing by yourself, you can streamline the process by asking for a reconsideration online. All steps beyond the reconsideration phases will be dealt with by mail, in-person, or over the phone.
   • If more medical records are called for, seek such records from your physician and provide copies to the SSA along with your appeal of your claim.
   • If more work history records are called for, seek such records from an employer or former employer which indicate the duration of your work and the reasons why you became unable to work.
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   Determine if you need help. You can consider finding help from a source online or elsewhere designed to assist with social security disability claims. Such sources are likely to charge a fee based on a capped amount set by the Social Security Administration, but they may enhance your chances for getting your denied claim approved.

   • When choosing an outside service to help you with your disability claim, you can consider engaging a service not affiliated with a law firm and not part of the legal profession. Legal experience is not required in order to offer assistance with Social Security Disability claims. Although legal experience is not required, many community service agencies offer pro bono Social Security Advocates who have been trained to handle disability claims.
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   Consider engaging a disability lawyer.This might prove helpful if your appeal is heard before an administrative law judge or makes it to a federal court hearing. Once your appeal goes in front of a judge, it is no longer a simple consideration of your work and medical history, but draws upon legal concepts that may be well beyond your grasp. If this is the case, it may be wise to seek the help of a disability lawyer to represent you.

   • When seeking help from a disability attorney, look for respected, courteous and effective lawyers in your area. Never seek out lawyers who will “guarantee” success.
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   Reapply. If the outcome your appeal of the SSA's decision is not favorable, or you simply don't want to go through an appeals process, you can wait 60 days and reapply. However, understand that simply putting in the same application will likely result in a second denial. You will need to pay close attention to the SSA's reasons for denying you in the first place and make the necessary adjustments to your second application.
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Part 3

Part 3 of 3:

Understanding the Appeals Process

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   Understand the appeals process. Appeals are divided into four levels by the SSA. The SSA will explain why you were denied in their letter. From there, your case will move from one appeals process to another until it is accepted or denied in federal court.
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   Ask for a reconsideration. These are the simplest types of appeals and the first step in the appeals process. Essentially, you will provide any further documentation the SSA needs and a person who did not engage in the initial decision will re-examine your claim. You will not need to attend any reconsideration appeal hearings.
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   Ask for a hearing by an administrative law judge. If your claim has been reconsidered, but still denied, you can take your claim in front of a judge. The appeal hearing will usually be located within 75 miles (121 km) of your home and you will need to attend this hearing. You will have the opportunity to present your case and any witnesses to support your claims. On a side note, this process may be held remotely by video conference.
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   Ask for a review by the appeals council. If a judge overrules your appeal, you have the right to pass that decision on to an appeals council. The SSA will arrange a review council at your request. The council will review your initial application, the denial, the appeal, and the judge’s decision before making a ruling of their own or passing it back to a judge.
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   Demand a hearing in a federal court. This is the final level of appeal, saved for when all other options have been exhausted. If the appeals council denies a review of your case, or passes it back to a judge who determines that the SSA was right to deny your claim, you can file a lawsuit in a federal court. This process is very drawn out, and will cost you money in the form of legal fees and penalties. If you lose the case, you will have to pay back any money issued to you throughout the court case.
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   Be patient. Be aware that as a general rule, two appeals via mail are denied before an appeal before an administrative law judge is required. So be patient and follow the proper procedures before rushing to bring your case in front of a judge.
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Tips

• If your disability was caused during the commission of a felony or if an addiction to drugs or alcohol is a material factor, congress has ruled that disability is not eligible for Social Security Disability benefits. In the case of drug and alcohol addiction however, a medical evaluation may determine whether or not the addiction is causing the disability or simply adding to it.
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• If you choose to engage a disability lawyer or attorney with help for your claims appeal, keep in mind that some lawyers and attorneys are members of the National Organization of Social Security Claimants’ Representatives, or N.O.S.S.C.R, while others are not. An attorney or lawyer who has this accreditation may be preferable to one who does not.
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