What Should I Expect During my SSDI Appeal in Northwest Arkansas?

Statistically speaking, it is a somewhat rare event for a benefits award on an initial Social Security Disability Insurance (SSDI) application. However, receiving approval at the initial stages is far from impossible since roughly 35 percent of initial applications receive benefits awards. These early approvals are likely due to extremely serious conditions or impairments where a compassionate allowance or other expedited relief may be available. But, for the vast majority – the 65 percent who are rejected at the initial consideration – an SSD appeal is necessary to obtain an SSDI benefits award.

However working with an experienced SSDI and Supplemental Security Income (SSI) attorney, can improve your chances of a benefits award. An experienced Fayetteville AR disability lawyer understands the Social Security Administration’s decision-making process. An experienced lawyer can also play a central role in finding and obtaining medical, educational, and occupational evidence that can bolster the credibility of your claim. The Law Practice of Ken Kieklak has helped injured and disabled Arkansans with Social Security and related questions for more than 20 years. To schedule a free consultation, call us at (479) 316-0438.

Common Reasons for SSD Denials

There are two main grounds for a denial of benefits. First, the applicant was unable to meet either SSI’s or SSD’s non-medical program requirements. Additionally or alternatively, the applicant may have failed to show that he or she has a qualifying medical condition. Because many denials are due to the insufficient medical evidence or the claims examiner misunderstanding or misinterpreting the record, a thorough understanding of the decisional process is essential.

As for non-medial denials, they can include reasons such as you are still working, you do not have the work credits required to qualify for SSD, excessive substantial gainful activity, and many other reasons. In some cases, you can show that the technical is in error. However, in some cases waiting several months to allow time to pass so that your recent work becomes more remote can solve some of the reasons for a non-medical denial.

Medical denials can be issued for a broad array of reasons, but reasons can include:

  • The SSA does not consider your condition or impairment to be severe.
  • Your condition is not expected to persist for at least one year or result in death
  • The SSA does not consider the cumulative effects of all of your conditions or impairments to be severe.
  • Your impairment or condition is controlled by medication or through supportive structures.
  • There is alternate work available that you can perform despite your disability.

Sometimes the denial is based on a misunderstanding of the true extent of challenges and limitations you face on a daily basis. In other cases, you may not have presented sufficient clinical tests, medical signs, and other objective evidence that shows the severity of your condition.

How Do I Appeal My SSD Benefits Denial?

Now that you understand the reasons for your denial, you can begin the process of preparing an appeal that shows the initial decision was an error. You have a right to administrative appeal and can also appeal to the federal courts, but your initial appeal is due within 65 days of the denial letter. Failure to meet this filing deadline will usually mean that you will have to start the process over.

To request an appeal at the initial reconsideration level, the applicant must obtain, complete and submit a Request for Reconsideration. A form to make this request can be obtained from the Social Security Administration’s website. You must state the reasons why the decision was wrong. Potential issues to raise in the appeal can include mistakes of law, mistakes of fact, and newly submitted evidence. Typically, those filing an appeal should submit additional medical, occupational, educational, or other evidence that shows the severity of your condition or conditions and the limitations you cope with. SSA Form 3441 “Disability Report – Appeal” should also be completed and submitted.

If your request is rejected at the Reconsideration level, it is not particularly surprising.  Most requests for reconsideration are rejected. However, at the next level of appeal you have a much greater chance of a benefits award. This is because at the next level an administrative law judge will, for the first time, hear your matter. Those who appeal to this level are entitled to a court hearing regarding their SSD application. In most circumstances the individual should request a disability hearing and appear before the judge.

Even if your claim is rejected at this level, you will receive a written decision. This written decision can be used to guide your appeal at the next level where an Appeals Council will hear the matter. If you have reached this stage, it is generally prudent to at least speak to an experienced SSD attorney because the Appeals Council can review not only your impairments and conditions, but it can also address errors in procedure or mistakes of law. The experienced team at the Law Practice of Ken Kieklak can help you through each step of this process. To schedule your free and confidential Social Security benefits consultation call us at (479) 316-0438 or contact us online.