The unfortunate reality is that applying for disability is a challenging process that often initially leads to a rejection notice from the Social Security Administration (SSA). Statistics vary by source, but most estimates place the average approval rate for Arkansas claimants no higher than approximately 30%, and others report numbers closer to 25%. In either case, the result is that well over half of all Arkansas disability benefits applications are denied after the initial submission and review.
However, a denial isn’t necessarily the end of the story; there are additional steps you can take toward an approval. If you are initially denied by the SSA, you have another chance in the form of reconsideration. Then, even if reconsideration fails, you can still request a hearing before an ALJ (Administrative Law Judge). Fayetteville Social Security Disability denial attorney Ken Kieklak explains how to file for reconsideration and what you can expect as the process unfolds.
Basic Tips for the Disability Appeals Process in Arkansas
Before we discuss the timeline following a denial, an important point to always remember as you go through the appeals process is that time is of the essence. If you miss a deadline, instead of appealing your original claim, you will have to create a new application and begin again from scratch. Consistently sticking to deadlines will help to keep the process as smooth, rapid, and cost-efficient as possible.
When the SSA sends you a rejection notice, you should also receive a detailed explanation of the rationale behind the decision. This can help you address any flaws, weaknesses, or errors which may have undermined your application the first time so that your future efforts are stronger. In many cases, disability is not denied because the SSA believes you truly are not disabled and do not deserve disability benefits, but instead because they do not have enough information to confirm your disability. Many denials can be resolved by providing additional information to show the SSA that your disability exists, helping people to move forward with the benefits they deserve.
Requesting Reconsideration After an Initial Denial for Social Security Disability Claims
When the SSA denies your case, the first way to appeal your case is through reconsideration. Essentially, if you disagree with the SSA’s conclusion, you can request reconsideration. This type of appeal is usually used for disagreements based on medical reasons, such as a denial that says your condition isn’t severe enough or that it doesn’t meet the SSA’s strict medical definitions.
You can make this request by submitting an electronic or paper version of Form SSA-561 (Request for Reconsideration) to the SSA, along with these two additional forms:
- Form SSA-3441 (Disability Report – Appeal)
- Form SSA-827 (Authorization to Disclose Information to the SSA)
The request form (561) is about four pages long and asks for basic information such as your address, SSN, and reasoning for disagreeing with the rejection. Form 3441 is actually far more involved and asks the claimant detailed medical questions, all of which must be answered. If you don’t know how to answer a question, state as much: do not leave a field empty.
Here are a few examples of what you can expect to see on the form:
- “Has there been any change (for better or worse) in your illnesses, injuries, or conditions
- since you last completed a disability report?”
- “Are you currently taking any medications for your illnesses, injuries or conditions?”
- “How do your illnesses, injuries, or conditions affect your ability to care for your personal needs?”
It is extremely important that you file your request and associated documents within 60 days of the date of the denial. While the SSA adds a five-day grace period as a cushion for mailing time, it is simply safer to either submit the form electronically or, if submitting via post, to send the form well before the deadline nears.
Outcomes of Reconsideration for Denied Social Security Disability Cases in Arkansas
After you submit your request, you will be granted reconsideration appeal. This appeal is a fairly rapid and straightforward process. An examiner with a local DDS (Disability Determination Services) bureau will review your claim. After this review is completed, you will be sent written notification informing you of the outcome and the reasoning behind the decision, usually within about five months.
The bad news is that the reconsideration stage traditionally has a terrible prognosis; the average success rate for Arkansas claimants is only about 8.7%, meaning over 90% of all appealed rejections are rejected yet again. (On a national level, the average approval at reconsideration is not much better: just 13.8%.)
The good news, however, is that the next stage (the ALJ hearing) actually has an excellent prognosis: 49.6%. That’s a robust fifty-fifty chance. Some sources even report numbers as high as approximately 62%.
Interestingly, the hearing office (ODAR, or Office of Disability Adjudication and Review) which arranges your ALJ hearing may have a slight impact on your chances. Of the two hearing offices which currently exist in Arkansas, the ODAR located in Fort Smith has a 47.1% award rate, while the ODAR in Little Rock has a slightly higher average rate of 50.6%.
Nonetheless, you cannot simply skip ahead to the ALJ hearing. Even though the likelihood of approval is low, you must complete reconsideration before advancing through the tiers of the appeals process.
Administrative Law Hearings for Denied Disability Claims in Arkansas
There is a high chance your reconsideration will not yield an award, meaning you will probably advance to a hearing before an administrative law judge. Fortunately, many applicants fare much better at this stage.
Your attorney will request this hearing for you by filing a formal request.) The medical details and documents supporting your application will be reexamined by the judge, who will then make a determination as to whether your disability meets the SSA’s standards or not. For this reason, it is of the utmost importance that you are supported by a skilled and experienced attorney who can advocate on your behalf. At the hearing, your lawyer can submit evidence to the judge and answer the judge’s questions, make arguments, and push for your appeal to be accepted.
If the judge finds that your condition does meet the medical definitions and that your case is severe enough to qualify for SSDI benefits, then your case should be accepted and payments can proceed. If the ALJ denies your case, you still have a couple of levels of review left to appeal to.
Filing a Request for Review for an SSDI Denial with the Appeals Council in Arkansas
If your claim is still denied at the ALJ hearing, then you can send the case up the chain to the SSA’s “Appeals Council.” The appeals council will look at every appeal that comes up from the ALJ level, which consists of most cases that lose at the ALJ level. This means that there is probably a backlog of cases, and this level of appeal takes some time.
With an Appeals Council review, there are three potential outcomes. First, Social Security’s Appeals Council could accept your claim and overturn the denial. This is the best outcome because it means you can start receiving your benefits. The Council can alternatively send the case back to an administrative law judge for additional fact-finding and information. If the ALJ missed something and the Appeals Council realizes that, this could mean repeating the previous step and getting a new ruling from an administrative law judge.
Lastly, if the Appeals Council agrees with the ALJ and denies your claim, they can stop the case there. However, there is one final level of appeal you can go through.
Filing a Federal Lawsuit to Appeal Disability Denials in Arkansas
If your initial application is denied, reconsideration is denied, the ALJ denies your claim, and the Appeals Council confirms the ALJ’s denial, you might still have options. Many cases that get to this level are valid claims that are denied for unjust reasons. If that is the case with your application, you can take your case to the courts for a final review.
Federal judges deal with many kinds of cases, including lawsuits against the government. Generally speaking, you have to exhaust other remedies before taking a case against the government to court, which is why this option is only available after you go through the SSA’s appeals process.
In a federal lawsuit against the SSA, you might be able to have denials overturned if they were based on discrimination or other serious problems. You can also get the help of a neutral judge who can review your claim fresh and decide whether or not the Social Security Administration’s process was correct.
If the judge rules that mistakes were made or there was discrimination involved in your case, the judge might be able to order the SSA to proceed with payments, or the judge might send the case back for additional review. If your claim is denied, you might be able to appeal it to the Federal Circuit Court and eventually the Supreme Court, but it is quite rare that a case progresses to this court stage, let alone to the Supreme Court.
What Happens After a Denied Disability Application is Overturned in Arkansas?
If any of these stages are successful in overturning your appeal, the SSA should begin paying your benefits as soon as the process allows. Once your application is accepted, it may take a while for the SSA to process payments, but you should be able to receive all payments you are owed, potentially dating back to the application date.
The SSA offers two different disability programs: SSI (Supplemental Security Income) is a need-based program and SSDI (Social Security Disability Insurance) is a program for injured and ill workers and their families to get benefits on their work record. If you applied for SSI, you may be able to get back payments dating back to when you first applied. This back pay can make up for the lengthy appeals process, getting you the benefits you missed out on while the SSA considered your application. With SSDI, you can get retroactive benefits dating back even further. If you applied for disability benefits within a year of the onset of your disability, then retroactive payments can be made to cover you all the way back to the date your disability started. These payments usually cannot go back further than a year before your application date.
The SSDI program usually has a 5-month waiting period during which you will not receive benefits until the 6th month. However, applications often take longer than that, so you might still receive back benefits. Additionally, many disability applicants can file for SSI to cover them during the waiting period, potentially allowing you to claim back payments for the full period.
Talk to a lawyer about what to expect after your denial is overturned. In some cases, it may take additional appeals to get the gears of the SSA to turn and get the proper back payments paid. Some exceptions and special rules might affect these general rules, so it is always best to talk to a lawyer about your specific case so you know what to expect.
Call Our Disability Denial Lawyer in Arkansas for Help with Your Application
Ken Kieklak represents disabled Arkansans in their fight to get disability benefits covered by the Social Security Administration. If your case was denied and your application was thrown out because it did not have enough information, because you had trouble proving your disability met the medical definition, or because of other issues with the way the SSA processed your application, our attorney may be able to fight to appeal your case and have the denial overturned. To schedule your private legal consultation with a Fayetteville, AR disability lawyer, call us at (479) 316-0438.