SSI How to Appeal a Denial

If you have received a letter of denial regarding your Supplemental Security Income (SSI) Disability claim, you are not alone. The system is somewhat slanted towards denying disability claims, as the burden of proof is on you regarding your disability and your financial status. In order to qualify for SSI, you must prove both that you are completely disabled by the SSA’s standards and that you are in financial need.

Disability, for the sake of receiving SSI, means that you are unable to do any work. This includes not only the kinds of work you have done up until now, but also any kind of work for which the SSA figures you could reasonably be trained and expected to perform. It takes a significant amount of the right kinds of medical or psychological evidence to back up your claim that you cannot function on the job because of your disability.

Additionally, you must prove that you are in financial need. This means that any income you have must fall within tight guidelines, and that you cannot have more than $2,000 in assets ($3,000 for married couples), not including your car and your home.

If you are denied SSI on your initial claim, you may file a request for reconsideration. While you can do this yourself, it is highly recommended that you employ a Social Security lawyer to help you with it. Not only will your attorney save you some hassle, but having an attorney will also increase your chances of having your disability claim accepted. Social Security lawyers don’t collect anything unless your disability claim is approved and most claimants agree that the percentage of their back pay which covered their lawyer’s fees was well worth the help they received.

In some cases, SSI will be awarded after the request for reconsideration is reviewed. If it is, you will receive a letter of acceptance and will begin receiving benefits, including back pay. More often, however, a request for reconsideration is denied and you will have to continue to a disability hearing before an administrative law judge.

Your hearing is the one time in the appeals process during which you will actually meet with real people to explain your disability and your situation. Most claims which are accepted in the appeals process are accepted at this stage. Whereas most SSA representatives are merely looking at your paper file, the administrative law judge will speak with you and question you personally. He may also have a vocational expert and/or a medical expert on hand to question you and advise him regarding what, if any, kinds of work you may be capable of doing.

The administrative law judge has somewhat more leeway in rendering his decisions than anyone else in the Social Security Disability system. It is important that you attend your hearing, and it is also highly recommended that you have your disability lawyer of advocate present with you.

If the administrative law judge upholds the denial of your claim, your file will be sent to the Appeals Council, which is made up of other administrative law judges. The Appeals Council will not consider any new evidence, and you will not even see them directly. They will, however, review the facts in your case to ensure that your administrative law judge was impartial and acted within the bounds of the law and the SSA’s policies and regulations.

The Appeals Council will usually uphold the administrative law judge’s decision. They do, however, have two other options which they occasionally exercise. One is to send the case back to the administrative law judge with additional comments and notes to be considered. In this case, the administrative law judge will reconsider your case. This is not a guarantee that he will reverse his decision, but he will review it. The other option is that the Appeals Council can overturn the decision and award you SSI disability, if they find significant errors in the administrative law judge’s decision.

The Appeals Council is the final stage of appeal within the SSA’s system. To further appeal your claim, you and your Social Security lawyer will need to request a federal court review of your disability claim.