Very few Social Security disability applications are approved immediately. Most claimants either give up or are forced to appeal. With the help of a Georgia Social Security disability representative, you will have a better chance at being approved. Call today to find out how we can help you.
An application for disability can be complicated. You must gather a lot of information, including medical documentation, educational records, and work history. The more details you can provide to the Social Security Administration (SSA), the better. However, despite your best efforts, you may still be denied. If your claim is denied, do not give up hope. You may still be approved through the appeals process.
The Appeals Process
Many people are confused about the application process. It can be complex, and there are several levels through which you must progress if you are repeatedly denied. Disability applications may go through five levels of review:
- Initial Determination
- Reconsideration
- Administrative Hearing
- Appeals Council Review
- Federal Court Review
Each of these levels gives the claimant an additional opportunity to submit evidence to the SSA. Each level also requires a new review of your information and an in-depth look at your conditions.
Initial Determination
During the initial determination of your application, a claims examiner will be assigned to review your entire claim for disability benefits. They will review all of the forms and evidence that you submit.
After verification of your non-medical eligibility, such as your age, employment, marital status, and other coverage information, your medical evidence will then be reviewed by a trained staff member. The initial determination will consider the following:
- Whether you have an impairment or combination of impairments; and,
- Whether your impairments are expected to last at least 12 months or result in death; and,
- Whether you can complete substantial gainful activity.
You must have verifiable medical proof that you have a severe impairment that is expected to last the specified amount of time and that it prevents you from working. If you do not provide enough evidence, your application may be denied.
Requesting For Reconsideration
If your initial application is denied, you may request for reconsideration of your application and evidence within 60 days of that denial. You may also take this opportunity to submit additional evidence in any areas of your application that were weak.
If your application was denied because the medical evidence did not show that your condition was expected to last at least 12 months or result in death, you may obtain further medical documentation that will prove that fact. Similarly, if the SSA did not feel you were unable to complete substantial gainful activity, you may undergo additional medical tests and examinations that further describe your limitations. The more evidence you provide, the better chance you have at being approved upon reconsideration.
Very few applications are approved upon reconsideration. However, you have further options.
Administrative Hearing
If your application is denied upon initial review and reconsideration, as are many applications, then you may appeal to an administrative law judge (ALJ) within 60 days of the reconsideration denial. Less than one-quarter of the people who are denied at the initial and reconsideration levels appeal their claims to the ALJ; however, doing so allows you an opportunity to speak with someone about your claim.
During an administrative hearing, you will appear in front of an ALJ, who will review your application and any evidence you have submitted. You may also submit additional evidence. The ALJ will hear your testimony and that of any person you wish to bring to the hearing. This is an important step in proving your abilities to complete activities of daily living.
The ALJ will then take your claim under advisement and make a decision concerning your eligibility for disability benefits.
Appeals Council
If the ALJ denies your claim, you may appeal to an appeals council within 60 days of that denial. However, the appeals council does not have to review the ALJ’s decision. You must show that the ALJ made a specific error in his or her consideration. If the appeals council does consider your claim, the council will decide to reverse, change, or uphold the previous decisions of your claim.
If the appeals council reverses the decisions of the ALJ and lower levels, your claim will return to the ALJ for reconsideration with instructions. The appeals council will inform the ALJ of the error that was made, or provide him or her with additional evidence, and the ALJ will again consider your claim.
The appeals council may also change the ALJ’s decision. They may change the onset date of your condition, a decision regarding specific evidence, or some other aspect of your claim. However, this does not constitute a complete approval or disapproval of the ALJ’s decision. This is simply a small change to the decision made by the ALJ.
If the appeals council upholds the ALJ and lower level evaluators’ opinions, you may appeal the denial of your claim to the federal court level within 60 days of their decision. Also, if the appeals council refused to consider your appeal, you may skip to the federal court level.
Federal Court Review
While many applications are denied through the appeals council level, people who seek review by a federal court are often approved. By this time, you have had the opportunity to continue treatment and improve your evidence. Your claim may have been reviewed by an independent medical examiner or by a Social Security medical advisor. You are able to state in a brief exactly why your claim qualifies you for benefits. The federal court will carefully consider every piece of evidence, and will make a new decision that is not based on those already made by examiners.
Seeking Claim Approval
The process of applying for disability benefits can be daunting. You may face several difficult decisions as you appeal your claim. However, you should not give up. At each level you have an additional opportunity to submit evidence and make statements regarding the severity of your impairment and your abilities. You will gain clarity at each level regarding what the SSA needs in order to approve your claim.
If your claim for Social Security disability insurance benefits were denied, or if you are seeking to file an initial claim, consult an experienced and knowledgeable Georgia Social Security disability representative to assist you through the appeals process. Contact Adams & Associates Disability Inc. at 1-888-551-1190.