If the Social Security Administration (SSA) denies your claim for Social Security Disability Insurance (SSDI) benefits, you can appeal their decision if you disagree with it. You would start that appeal by submitting a Reconsideration (Form SSA-561). A reconsideration is a complete review of your claim by someone who did not take part in the first determination. That new SSA official will look at all the evidence used in the first determination, plus any new evidence that you submit.
You can request an appeal online for most levels of appeal. Visit the SSA appeal page to get your appeal started.
If you’re requesting a reconsideration of a determination about whether you have a qualifying disability, the SSA will send your request to the Washington State Disability Determination Services (DDS) for review. You may receive letters from the Washington DDS while they are handling your reconsideration.
Potential Reasons for Denial of Your SSDI Application
Some potential reasons for the denial of your claim are listed below, but there are potentially other factors. Getting help from an experienced SSDI attorney could help you improve your chances of an approved appeal of your denial.
- Lack of medical evidence. You need substantial medical evidence that documents your disability and how it prevents you from working. This is the most typical reason for SSDI claim denials.
- Prior denials. If you make the mistake of just filing a new application if your initial one is denied rather than filing an appeal, your second application will likely not be approved.
- Too much earnings. If you continue to work and earn too much money as an SSDI applicant, you will be ineligible for benefits. You can only earn a limited amount of wages when receiving these benefits.
- Failure to follow treatment advice. If you don’t follow your doctor’s advice on treatments for your disability or there are gaps in medical care, your application will most likely be denied. If you’re not receiving needed treatment, it’s difficult to determine whether you qualify for benefits.
- Failure to cooperate. If you ignore requests for additional information or otherwise fail to cooperate during the application process, your claim for SSDI won’t be successful.
The Value of Medical Evidence in Your SSDI Appeal
Medical evidence is the cornerstone of your disability determination. When you provide SSA with timely, accurate, and complete information and evidence, you can enable a smooth processing of your claim. But if you submit insufficient or inaccurate medical evidence, or if you submit it after the deadline, you risk both an initial denial of your claim and a rejection of your appeal.
For your SSDI appeal, essential medical documents may include:
- Detailed treatment records, including date types, frequencies, and effectiveness
- Lab tests and imaging results, including X-rays, MRIs, and/or blood test results
- Reports from specialists, such as neurologists or orthopedists
- A statement from your treating physician that describes how your condition limits your ability to work
How to Get By Financially While You Await the Outcome of Your Appeal
You have options when you’re in dire financial need as the SSA decides on your approval. Public financial assistance programs in Washington state include:
Temporary Assistance for Needy Families (TANF): You can apply for this Federal temporary cash program if you’re responsible for the care of children or are pregnant. There are specific requirements you must meet regarding income, resources, and citizenship status.
Aged, Blind, or Disabled (ABD) Cash Assistance: If you’re not eligible for TANF, this Washington state program provides cash assistance to you if you’re likely to meet Supplemental Security Income disability criteria based on an impairment(s) expected to last at least 12 consecutive months.
How an Attorney Can Help
An attorney with expertise in SSDI law can help you work through your appeal and compile and present your medical evidence thoroughly for the Social Security Administration. Their familiarity with administrative law judges and understanding of common pitfalls in SSDI claims can be invaluable.
Working With Schott Law
If you need help dealing with your SSDI appeal process, Schott Law is here for you. Maggie Schott is an SSDI & SSI lawyer serving Washington and Idaho. Contact us now at (509) 328-5789 to start your application.