Denied Benefits

The Social Security Administration (SSA) has a multi-level approval process for Social Security Disability (SSD) claims.

Level 1: Application/Initial Claim

See applying for benefits for more information on how to apply. Once you apply for benefits your case will be reviewed to determine if you qualify for benefits under the SSA’s definition of disability. If you are approved then you will start receiving benefits in a matter of months. If you are not approved at level 1, then your case will move onto level 2.

Level 2: Reconsideration

If you are denied at level 1, you are not alone as the majority of SSD applications will be denied at the initial level. If you are denied at the initial level you will not receive SSD benefits but all is not lost. You have an opportunity to request that your case be reconsidered. You will need to file a request for reconsideration within 60 days after your initial claim is denied. If you fail to file your reconsideration properly within the prescribed time period, then your case may be closed and you may have to start the application process all over again if you wish to continue to pursue SSD benefits. Note: Not all states have a reconsideration step and in those states your case will move directly on to level 3, the Hearing.

Filing for reconsideration is often misconstrued as a “rubber stamp” of the initial denial and many applicants, and attorney’s, don’t take this step as seriously as they should and they miss out on an opportunity to be granted benefits at this level.

Hiring Allen Stewart, P.C. at this time, if you haven’t already, is a good idea as our experienced Social Security practitioners will know how to best present your case to avoid the “rubber stamp” denial. Our attorney’s will review your case for a thorough understanding of why your case was denied and provide SSA with updated information regarding your medical condition, you medical providers or any other pertinent information about your case. This will accomplish two things: (1) it will give you case a fighting chance of being granted at this tier, and (2) if your case is denied again, our attorney’s will be familiar with your case and know what evidence is needed to prevail at level 3, the Hearing.

Level 3: The Hearing

If you were denied at levels 1 and 2, or at level 1 and you live in a state without reconsideration, then you will proceed on to the hearings level. After you receive your reconsideration denial, or your initial denial in those states without reconsideration, you will have 60 days to file a request for hearing. If you fail to properly file your request for hearing within the prescribed time period, then you may forfeit your right to a hearing and you may have to start the application process over if you wish to continue to pursue SSD benefits.

By the time their case gets to this level, you may feel discouraged, tired of dealing with the process and just want to throw in the towel and quit. This is because you have likely been denied twice and it usually takes several months or longer to get to this step in the process. Once you actually get to this step, there’s even more bad news. It often takes up to a year or longer after you file your request for hearing for your case to actually get set before an Administrative Law Judge. During this time you will need to continue to update your file with new medical records and other pertinent information for your case.

Don’t let this discourage you, contact the attorney’s at Allen Stewart, P.C. and let us deal with hassle and headaches of getting your request for hearing filed properly and on time. We can also help you obtain and complete any necessary documents needed for the best chance to win your case once you get a hearing before a Judge. You certainly don’t want to get to a hearing and realize that you have an incomplete file. It is even possible, in some cases, for us to petition the Judge to grant you benefits without ever having to go to a hearing.

If you have to go to your hearing then you need competent and experienced representation on your side because the SSA may have experts give opinion testimony as to the nature of condition, the severity of your condition, your residual functional capacity, your past relevant work, and whether you retain the ability to perform any other work in the national or regional economy. Without an experienced advocate to question these experts on your behalf, you very well might have a solid winnable case that is denied benefits because the expert(s) didn’t paint the full and accurate picture of your condition and how it affects your ability to work.
If you are denied at this level then your case will move onto level 4.

Level 4: Appeals Council Review:

If your case is denied at hearing then you still have an opportunity to appeal your case to the Social Security Appeals Council Review Board. As in the initial and reconsideration levels, you have a limited amount of time to file your appeal. If you fail to properly file your appeal within the prescribed time period, then the denial of your case will stand and may prejudice you from obtaining benefits if you file a new application. Many applicants don’t provide additional information or statements of their case to the appeals council and they usually find that the denial of their case has been upheld. While most denials will be upheld, the attorney’s at Allen Stewart, P.C. can help you file your appeal in such a way so as to give you the best chance of having the denial overturned.