Denied Social Security Disability Claims

If you have a disease or injury that is so serious that you cannot work, not only are you worried about your health, but also about your finances. Fortunately, the federal government offers a disability program that may be able to provide you with financial benefits while you cannot work due to your medical condition.

The Social Security Disability Insurance program (SSDI) provides benefits to those who are disabled and who have a record of working and paying FICA taxes. If you do not have a sufficient work record, you still may be able to qualify for disability benefits under the Supplemental Security Income disability program (SSI) which offers benefits to those who do not have adequate work records and have a low incomes.

Facing Social Security Disability Denial in Rhode Island

However, being approved for disability benefits under either program is challenging. The applications of the vast majority of people are initially denied. The best way to ensure that your claim is handled correctly, especially after it has been denied, is to have a Social Security Disability attorney on your side. The Social Security Disability lawyers of Gemma Law Associates are well-equipped to help you with this process. Please feel free to contact one of our Providence Social Security Disability attorneys by calling us or by filling out this form.

Qualifying for Social Security Disability Benefits

There are several factors that the SSA reviews in order to determine whether or you qualify for Social Security Disability benefits, including meeting financial conditions and meeting the SSA’s very strict definition of “disabled.” It is not enough to say you are disabled; the SSA requires very specific types of proof that vary depending on the type of condition you have. If you do not meet any of the requirements for qualification for Social Security Disability benefits, your application will be denied.

When you submit your claim for SSDI benefits, it is first reviewed by the Disability Determination Services (DDS).  On average, this process takes 3-5 months. Common reasons for denial include lack of sufficient work history, inadequate medical documentation, or other errors in completing the claim application. Because of the complexity of the SSA application for disability benefits, nearly 70% of claims are denied at the DDS level. However, there is an appeals process.

The Appeals Process

If your initial claim is denied, you should not be discouraged. There is an appeals process. Often, the reason for denial is something that can easily be fixed. However, the success of your appeal depends on understanding why your application was denied. There are four stages of appeal for a disability claim, including:

• Reconsideration. If your claim was denied after the initial application, you have 60 days to file a “Request for Reconsideration.” Your application will then be reviewed by a different reviewer in the Disability Determination Services office. Essentially, your application is reviewed as if it was submitted for the first time but by a different person.
• Administrative hearing. If your claim is again denied, you have another 60 days to request an administrative hearing. Administrative Law Judges (ALJs) preside over the administrative hearings at the Offices of Disability Adjudication and Review. At your administrative hearing, the ALJ will interview you and the experts. This appeals step can take time as your hearing date may not be held until a year later. After the hearing, it typically takes the ALJ two months to render his or her decision. About 65% of cases are approved at this level.
• Appeals Council review. If your claim is denied at the administrative hearing stage, you have another 60 days to request that the Appeals Council review your case. The Appeals Council has the discretion to refuse to review your case. If the Appeals Council does agree to review your case, it examines the ALJ’s decision for errors. Appeals are rarely granted at the Appeals Council level.
• Lawsuit in federal court. If your claim is again denied or the Appeals Council declines to review your case, your last option is to file a claim in federal court. A federal judge reviews the cases without a jury. The judge looks at the cases for legal errors. About 30% of cases that reach this stage are approved.

Whether or not your disability claim is ultimately approved on appeal depends on many factors. However, your chances of receiving approval are greatly improved if an experienced attorney represents you. If you have questions about applying for Social Security Disability, or if you feel that your application has been unfairly denied, you should seek legal counsel.

The Providence, Rhode Island law firm of Gemma Law Associates can help you. Please get in touch with us by calling toll-free or by filling out our online contact form.

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