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What is the appeals process for a denied SSDI application?

On Behalf of | Oct 10, 2024 | Social Security Disability

Working professionals in Connecticut make regular contributions toward Social Security. The funds sent to the Social Security Administration (SSA) help support several important benefit programs. There are retirement benefits available to professionals who have ceased working full-time after years of gainful employment. There are also disability benefit programs including Social Security Disability Insurance (SSDI) benefits. Professionals who have a lengthy work history and who can no longer work because of medical challenges may qualify for benefits.

Even those who believe they have obviously debilitating medical conditions may have a hard time qualifying for SSDI benefits. The SSA looks at medical information very carefully. Small mistakes in paperwork and inadequate medical evidence can lead to a claim denial. Many applicants have to appeal to get the benefits they deserve.

What does the SSDI appeals process entail?

Appeals begin within the SSA

An applicant dissatisfied with their denial of benefits can request an appeal. Typically, the letter they received rejecting their application should contain information about why the SSA ruled against them. They then have an opportunity to correct their application if there were problems with the paperwork. They can also obtain more medical evidence if the SSA does not believe their condition meets the necessary standards.

During a reconsideration, an SSA employee looks at the updated application and new medical evidence to determine if the original decision was incorrect. According to data reported by the SSA, approximately 2% of applications get approved during reconsideration on average each year.

If reconsideration is not successful, then the case may go to an administrative law judge. During an SSDI appeals hearing, the applicant or their lawyer may present information about their condition. Medical reports and even expert testimony can help applicants convince a judge that the SSA made a mistake by denying them benefits.

Roughly 8% of applicants obtain their benefits during an appeal hearing in front of a judge. Occasionally, applicants may pursue their appeal if the hearing is unfavorable. They may have an opportunity to present their case to the Appeals Council or to pursue litigation in federal court.

Knowing what happens during SSDI appeals can help people prepare for the process ahead. Applicants who have the right support have a better chance of getting the benefits they need and deserve.

 

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