How to Fight Your SSI or SSD Denial
Find out what you can do if Social Security turns down your application because they say you are not disabled. #7401EN
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The Basics
Yes, if the Social Security Administration (SSA, Social Security) turns down (denies) your application because they say you do not have a disability.
We wrote this fact sheet for people living in Washington state who have applied for SSI or SSD. Much but not all this information applies to people living in other states, too.
You can find all the fact sheets we link to here at WashingtonLawHelp.org.
Yes. You can ask Social Security to review (to reconsider) its initial decision. They often deny an SSI and Social Security Disability application at first but later approve it on appeal. If you ask for reconsideration, Social Security will review its decision and approve your claim or deny it again.
You must fill out a Request for Reconsideration form. Get one at your local Social Security office, by calling their toll-free phone number, or by going to their website at https://www.ssa.gov/forms/.
Social Security must get your form within 60 days (plus 5 days for mailing) of the date on the notice of denial.
You may still be able to file if you had a good reason for missing the deadline. This is a Request for Good Cause.
You must fill out a Statement of Claimant form, Form SSA-795 (or get the form at your local social security office) by 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. Return this form to your local Social Security office.
Social Security will decide if you had a good reason to file the appeal late. If so, they will process the appeal as if you filed it on time.
Social Security denies many SSI or Social Security Disability claims because it believes the person does not have a disability. In the denial notice, Social Security should explain why they denied your claim and list all places where they requested and got medical evidence.
If Social Security denied your claim because they decided you do not have a disability, make sure they had all the information they needed to make that decision. Ask to see the medical evidence in your file.
If your doctor did submit a report, ask the doctor to make another one explaining why they think you have a disability that makes you unable to work. Your own doctor's opinion can be very important in proving your disability.
Social Security may have sent you to see a doctor who you have never seen before instead of sending you to your own provider. If this happens, and your own doctor believes you have a disability and will do an evaluation, ask Social Security to order and pay for another evaluation from your own doctor.
Possibly.
Social Security must take into consideration information from other people about what you can and cannot do due to your disability (your level of functioning) when making its decision.
You can get letters from counselors, ARNPs, past employers, and friends and family if they describe your functional limitations and how those limitations affect your ability to work.
You can ask for a hearing before an Administrative Law Judge (ALJ). You must file a hearing request within 60 days plus 5 days mailing of the date of the notice of the denial.
You can 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. Social Security's toll-free phone number is 1-800-772-1213, 8:00 am - 7:00 pm; TTY 1-800-325-0778.
You can also get a hearing request form from SSA's website at https://www.ssa.gov/forms/.
Preparing for the hearing
The hearing will happen many months after you ask for it. The ALJ will tell you the hearing date at least 75 days beforehand.
If you have more evidence, such as new medical records showing you have a disability, you should submit it to the ALJ or tell the ALJ about it generally at least 5 business days before your hearing. If you do not do this in time, you must have a good reason for your lateness, such as a physical, mental, or educational limitation, or circumstances beyond your control.
You should let the ALJ know at least 10 business days before the hearing that you want the ALJ to issue a subpoena.
You can contact your local bar association or call the National Organization for Social Security Claimants Representatives referral line at 1-845-682-1881.
Your lawyer gets paid only if you win your case. Lawyers can only charge up to 25% of your back benefits, up to $7,200. You must pay any costs the lawyer incurs in working on your case, such as, for example, the cost of medical records.
Ask the lawyer to explain the fee arrangement, in writing, if possible, before you hire them.
It can take a long time for Social Security to schedule your hearing. Some people choose to apply again (to reapply) instead of appealing a reconsideration denial.
In some cases, if you do not appeal, you cannot get benefits later even if you reapply. If you believe you still have a disability and cannot work, you should ask for a hearing. You can also reapply while waiting for your hearing to be scheduled.
Yes. If you do, get a copy of your file on an encrypted CD from Social Security. The evidence on the CD is the exhibit file. This is the only information the judge has about you.
If you know about other medical proof 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, or send the judge a summary of them at least 5 business days before the hearing.
If you live in Washington state and you are appealing the denial of your Social Security disability or SSI application, you now can get a free copy of your medical record once every 2 years. You can read the state law about this at RCW 70.02.030(2)(b).
If you have trouble getting your medical records, read Reviewing and Getting Copies of Your Medical Records to learn more. If you believe your medical records are wrong, read My Medical Records Are Wrong to learn more.
Your hearing is the only time during the application process that you will meet the decision maker in person. You must tell the judge everything about your disability, its effects, and why it keeps you from being able to work.
Yes. 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.
Make a list of everything you want to tell the judge and everything you want your witnesses to tell the judge.
If you think there is incorrect information in your Social Security file, you must be ready to tell the judge at the hearing why it is wrong.
A vocational expert may be at your hearing. This expert gives their opinion about what jobs you can perform given your functional limitations. This is why you must explain at the hearing what you can and cannot do.
The judge will make a decision and notify you by mail within a few months of the decision.