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How to Fight Your SSI or Social Security Disability Denial

Authored By: Northwest Justice Project LSC Funded
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7401EN - Read this to find out what you can do if the Social Security Administration (SSA) denies your application because they say you are not disabled. If you have been receiving benefits and are notified that they will stop, see How to Fight a Termination of SSI or SSD.

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Should I read this?

Yes, if the Social Security Administration (SSA, Social Security) denies your application because they say you are not disabled.

I have been getting benefits. What if Social Security is now saying they will end them?

Read How to Fight a Termination of Supplemental Security Income (SSI) or Social Security Disability When SSA Decides You are No Longer Disabled.

Social Security denied my initial application. Can I appeal?

You have the right to ask Social Security to reconsider its decision. They deny many SSI and Social Security Disability applications but later approve them on appeal. If you ask for reconsideration, Social Security will review its decision and approve or deny your claim.

How do I appeal?

You must fill out a Request for Reconsideration form. You can get one at your local Social Security office or by calling their toll-free phone number or going to their website at https://www.ssa.gov/forms/ssa-561.html.

How much time do I have to appeal?

Social Security must receive your form within 60 days (plus five days for mailing) of the date on the denial notice of denial.

What if I did not file my appeal in time?

You may still be able to file if you had a good reason for why you missed the deadline. This is a Request for Good Cause. You must fill out a Statement of Claimant form (http://www.ssa.gov/online/ssa-795.pdf or get the form at your local social security office) asking for good cause (example: "I request good cause for late filing of my appeal") and explaining why you could not file the appeal on time. Either bring it or mail it to your local Social Security office. Social Security will decide if you had a good reason to file the appeal late. If you did, they will process the appeal as if you filed it on time.

How do I prove that I am disabled?

Social Security denies many SSI or Social Security Disability claims because it believes the person is not disabled. In the denial notice, they should

  • explain generally why they denied your claim.
  • list all the places where they requested and got medical evidence.

If Social Security denied your claim because they determined you are not disabled, make sure they had all the info they needed to make that decision. You may ask to see the medical evidence in your file.

Would a letter from my doctor help my case?

If you have a regular doctor who has not sent Social Security a letter or report, ask him/her to do so. If your doctor did submit a report, ask her/him to make another one explaining why your doctor thinks you are disabled and unable to work. Your own doctor's opinion is very important in proving your disability.

Social Security may have sent you to see a doctor who has never seen you before. If this happened to you, ask them to order and pay for another evaluation from your own doctor if s/he believes you are disabled and is will do an evaluation. If you can get a second evaluation showing you are disabled, Social Security may change its decision in your case.

Would letters from other people help?

Social Security must take into consideration info from other people about your level of functioning (example: what you can/cannot do due to your disabling impairment) when making their decision.  You can get letters from counselors, ARNPs, past employers, and friends and family if both of these are true:

  • They describe your functional limitations.
  • Those limitations have an effect on your ability to work.

They denied my reconsideration. Now what?

You may ask for a hearing before an Administrative Law Judge (ALJ). You must file a hearing request within 60 days plus five days mailing of the date of the notice of the denial. You may file the hearing request at your local Social Security office OR call Social Security and have them mail you the request for hearing form, then fill it out and mail it back. Their toll-free phone number is 1-800-772-1213 from 7:00 am to 7:00 pm; TTY 1-800-325-0778. You can also get a hearing request form from the SSA website at http://www.ssa.gov/forms/ha-501.html.

Your hearing will probably be many months after the date of your request. The ALJ will notify you at least 20 days before your hearing. If you have more evidence, such as new medical records which show you are disabled, give them to the ALJ as soon as they are available. You may have a lawyer or an experienced paralegal represent you at the hearing, or you may represent yourself. Generally, represented people do better.

How can I get a lawyer?

Contact your local bar association or call the National Organization for Social Security Claimants Representatives referral line at 1-800-431-2804.

How do I pay for a lawyer?

The Social Security Administration regulates fees. Your representative gets paid only if you win your case. Representatives may not charge more than 25% of your back benefits (up to a maximum of $6,000). You will also have to pay any costs the representative incurs in preparing your case (example:  the cost of medical records). Be sure you get an explanation of the fee arrangement from the lawyer before hiring her/him.

Should I reapply or appeal and wait for my hearing?

It can take a long time to get to your hearing. Some people choose to file a new application instead of appealing a reconsideration denial.
In some cases involving Social Security Disability benefits, not appealing can result in your inability to get benefits even if you reapply. If you believe you are still disabled and unable to work, you should request a hearing.

Can I represent myself at the hearing?

Yes. If you do this, you should get a copy of your file on an encrypted CD. The evidence on the CD is called the "exhibit file." It has the only info the judge has about you. If you know about other medical info that is not in your file, such as hospital or doctor's records, therapist's notes, or x-ray reports, get copies of them to the judge before the hearing if possible.

Your hearing is the only time during the application process that you will meet the decision maker in person. You must present your whole case: everything about your disability, its effects, and why it keeps you from being able to work. Tell the judge all this. You can bring someone such as your spouse or a friend to testify about how your disability affects you in your day-to-day activities.

When getting ready for your hearing, make a list of

  • What you want to tell the judge
  • What you want your witnesses to tell the judge

If you think there is incorrect info in the file, tell the judge at the hearing why you think that info is incorrect.

What is a vocational expert?

A vocational expert may be at your hearing. S/he will give his/her opinion about what jobs you can perform given your functional limitations. This is why you must explain at the hearing what you can/cannot do.

When does the judge decide?

The judge will make a decision and notify you by mail within a few months of his/her decision.

 

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This publication provides general information concerning your rights and responsibilities.  It is not intended as a substitute for specific legal advice. 
This information is current as of February 2017.
© 2017 Northwest Justice Project — 1-888-201-1014.

(Permission for copying and distribution granted to the Alliance for Equal Justice and to individuals for non-commercial use only.)

Last Review and Update: Mar 27, 2017