If you are suffering from long-term illness or injury, you may receive social security disability insurance benefits (SSDI) or supplemental security income (SSI) if you match the eligibility criteria and filed an insurance claim. However, if your disability claim has been denied, it can be financially devastating, especially if your medical condition renders you unable to work. This is why knowing how to appeal can be an important resource for people with disabilities.
The following sections will provide relevant information about state disability programs: who are eligible for benefits, disability insurance application process, and appeals for reconsideration.
Information about Disability Insurance Benefits and Eligibility
Under the SSA’s policy, a disabled person is someone with a long-term disability, either a physical or medical condition, that renders him unable to engage in the substantial gainful activity or to work in any capacity.
After the SSA evaluates your eligibility, your application shall be reviewed by the Disability Determination Services (DDS). The DDS shall check whether or not:
- Your average earnings exceed the allowable amount
- There is proof that the condition is severe or lasted more than a year
- The disability is on the SSA’s list of impairments
- Your inability to perform your previous work or any type of work after the onset of the disability
When a claim is approved, total disability benefits shall be covered. Take note that social security does not cover benefits for partial and short-term disabilities.
Reasons for Denial of Disability Benefit Claims
When a claim for SSI and SSDI benefits has been denied, this usually occurs at the beginning of the application process. A claimant’s request to receive disability benefits may be turned down by the Social Security Administration (SSA) for any of the following reasons:
- The severity of the condition is low, or will not last for more than 12 months
- The claimant can still perform normal work tasks even with the medical condition
- The disability resulted from use and abuse of alcohol or drugs
- No sufficient medical records to support the existence of a disabling condition
- Failure to adhere to the prescribed treatment for medical conditions
- Claimant returned to work before the long term or short term disability was proven
Appealing for Denied Disability Claims
If your request has been denied, but you believe that you meet the conditions for receiving disability benefits, then you may still appeal to the council for reconsideration. This should be done within 60 days after the disability claim decision has been released by the SSA.
Step 1: Gather New Evidence to Support Your Appeal
Rather than submitting a new claim to the SSA, it is more efficient to file an appeal and include additional evidence to support how you may qualify for the requested benefits. A good example is a detailed doctor’s medical report which will include information about your medical history, laboratory test results, medical prognosis, response to treatment, and how the disability can affect your ability to perform routine work tasks. If the impairment is due to a mental disability, then the report should also include the doctor’s evaluation of how you perform in cognitive tasks such as recall, following instructions, or handling social pressure.
Step 2: File Your Request for Reconsideration
To file your request for appeal, you will need to fill out three forms:
- Request for Reconsideration (Form SSA-561)
- Disability Report – Appeal (Form SSA-3441)
- Authorization to Disclose Information to the Social Security Administration (Form SSA-827)
These forms, together with your new evidence, should be mailed to the SSA office. For appeals denied due to medical reasons, requests for reconsideration may also be filed online through SSA’s disability appeal tool.
Step 3: Wait for the Reconsideration Decision
Upon receiving your request, the appeals council shall deliberate on whether or not you qualify for disability benefits, which takes between three to five months. After this period, the final reconsideration decision shall be issued to you by the SSA. In cases where appeals have been turned down, you still have a chance of getting disability benefits through a hearing before an Administrative Law Judge.
Filing a disability claim appeal is a rigorous process that involves procuring differing documents alongside adhering to state processes and deadlines. It will be in your best interest to consult with a disability lawyer before submitting your reconsideration claim.
Have you been suffering from a long term disability caused by serious injuries or illness that affected your ability to do work? It is best to get in touch with a disability attorney.
Our experienced disability attorneys at Farmer & Wright, PLLC will guide you throughout the process of applying for social security disability claims, or appealing a denied decision. Contact our law firm now for a free consultation with a Kentucky disability lawyer and waste no time in submitting your application or appeal.