What You Can Do When You Receive an SSDI or SSI Denial Letter

What You Can Do When You Receive an SSDI or SSI Denial Letter

Have you applied for Social Security disability insurance (SSDI)?

Did you wait months and months to hear back only to see an SSI denial letter in your mailbox?

Did you know that up to seventy percent of claims are denied after your first application?

Claimants often have to go through the appeal process, just to get the benefits they deserve.  

Things to Avoid on Your Initial Application

Some things to avoid while going through your SSDI or SSI disability application:

  • Applying for disability while currently working: There are no rules against this, but the social security administration will look to see if you are able to perform Substantial Gainful Activity (SGA).  It is exceedingly difficult to make a clear case that you are disabled to a point where you cannot earn an income when you are currently working and earning an income. 
  • Applying for disability with a condition that is temporary: Your debilitating condition should be expected to last for more than a year if you are looking to apply for benefits. Your case may be harder to prove that you have a long-term ailment if you are applying too soon.
  • Keeping it too simple: Some applicants do not provide enough evidence to prove your case fully. A consultative exam, provided by the social security administration is not enough. Doctors letters, RFC’s, and medical records help significantly.
  • Not following the doctor’s directions:  Social security examiners will look into your history of treatments when considering your application. It is very important to follow treatments your doctor has recommended, even if that means it will improve your condition and possibly hurt your chances of being approved.
  • Not checking in with the experts:  Even if it is premature to hire an attorney (is it ever?) you can reach out for consultations.  Read their blogs, sign up for newsletters.  Get to know the process and your place in it.  

What to do if You Receive an SSI Denial Letter

After receiving your SSI denial letter, it is important to apply for an appeal. You have sixty days, with five days for mailing, to send this application in. The four levels of appeal are:

  • Reconsideration: You will fill out a request for reconsideration for after you have received your denial.
  • Law judge hearing: This is optional for you. If you do however choose not to be seen by a judge in a live hearing, your appeal request will be determined by information strictly from your file.
  • Appeal council review: Next you can request the appeal council to review your case. During this time you can add any new evidence that may help out your case. The council can accept, deny or dismiss your request for review. If accepted you will then be sent back to a law judge hearing.
  • Federal court: Finally, if need be, you can file for a civil action. This is if the council denies your claim again. You will have sixty days to file for civil action which will then be taken to federal court. U.S district court will then be sent to review your case and make the final decision considering your claim.

Your final option, if you have gone through the previous steps and continue to be denied, is to simply reapply.

We Can Help You

Lilac City Law helps clients through Reconsideration and Appeal of their Social Security Disability Claims.  If your claim has been denied, is in reconsideration, or needs to be scheduled for an appeal hearing, we will help!

Contact a Lilac City Law Disability Attorney Today

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How to Appeal A Denial for Social Security Disability in Washington State

How to Appeal A Denial for Social Security Disability in Washington State

Applying for Social Security in Washington State can be an overwhelming process. 

If you are one of the greater than 70% of those who are initially denied your claim, it can be devastating, and your path to getting the benefits you have earned can be hard to see. 

What should you do?  Who can help you? This article was written to give you some clarity.

The first step is calm down, take a deep breath, and if needed contact a disability professional to help you. 

The first thing to know is that your denial letter should explain why you were denied and give you a list of the places social security requested and received medical evidence.  It is very common to read through these letters and be confused and frustrated.  Clearly the Social Security Administration missed the mark somewhere; otherwise, you would not even be reading this article.  Nevertheless – you should familiarize yourself with their statements and prepare yourself for your appeal options.  

Here are your four appeal levels for Social Security in Washington State.

Request for Reconsideration

With your denial letter in hand, you now have 60 days (plus five days for mailing) from the date you received your denial notice to complete a request for reconsideration form and return it to the Social Security address listed in your letter.  You can do this either by mail or by dropping it off at your local Social Security office.   Here is a handy tool to locate Social Security offices in Washington State.

If you were denied because the Social Security Administration did not determine you to be disabled, ask to see what medical evidence they have in your file. When filing your request for reconsideration, you should seek to include as much of the following as possible with your request for reconsideration form:

  • Letter from your doctor stating why he believes you are disabled
  • Letter from friends or family stating how your disability has affected your day to day activities
  • Additional medical evidence that was not originally included in your claim

You do not need to be present for the reconsideration.

And remember, if you are denied because Social Security believes you no longer have a disability, you do have the option to meet with a Washington State Social Security representative to explain you still have a disability.

Talk About Your Social Security Denial With A Disability Lawyer Today

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Disability Hearing

If your request for reconsideration is denied, then you can request a hearing before an administrative law judge.

Typically, the time between your request and the hearing is 1-2 years, though this timeline can vary widely depending on where you live.  In Spokane, WA – the timeline for disability hearings was 487 days as of the date this article was written.  It is important for you to attend the hearing and bring your representative (if you have one).

Other witnesses, such as medical or vocational experts will likely testify for Social Security.  You or your attorney representative will be able to ask them questions during the hearing and make a strong case for your disability is a barrier to employability.

After the hearing, the judge will make a decision, and you will receive a letter and copy of the decision.

Review by the Appeals Council

If you disagree with the decision made by the judge on your appeal, you can ask for the decision on your claim to be reviewed by the Appeals Council.  At this point, if you have not used a Social Security Disability attorney, it is necessary to start consulting with one.

In short, the Appeals Council will look at your request and decide if they agree with the hearing decision – the decision of the judge based on the evidence provided.

If they believe the ALJ (administrative law judge) decision was correct, then the judge’s decision will be upheld.

If the appeals council believes there was an error in the ALJ’s decision, they may remand your claim back to another administrative law judge for another appeals hearing.

And, rarely, but it does happen – the Appeals Council will overturn a denied claim if they believe the judge’s decision was completely in error. This action would result in an approved disability claim.

Here is data on the Appeals Council Requests for Review so you can get an idea of their backlog.

Federal Court Review

If you do not agree with the Appeals Council, you can file a lawsuit in the Federal District Court.  In the letter sent to you about the Appeals Council decision, you will find information on how to file with the federal court.  You will need an attorney at this point, in any case.  They should be aware of the process of filing a federal district court lawsuit.