Social Security Disability Lawyer Explains the Four Levels to Benefit Appeals

When you contact a Baltimore Social Security disability lawyer about receiving a denial for benefits, they will most likely have you come in for a consultation to discuss the appeals process. Everyone who is denied disability benefits has the right to appeal that decision. It is very important, however, that applicants follow all of the rules of procedure for filing an appeal or seek legal assistance. There are four levels of appeal that an applicant has the right to use when they have been denied benefits. Their Social Security disability lawyer will explain to them each step of the appeals process and what to expect as an outcome.

First Level of Appeal – Request for Reconsideration

In most states, if you are given a denial for benefits or a denial for continuation of benefits, you must file a Request for Reconsideration as your first step in the appeals process. The letter that you receive that states that you have been denied benefits will explain to you how to file a reconsideration request and how much time you have to file the claim. Your Social Security disability lawyer will work with you to make sure that the request is filled in enough time for reconsideration. Failure to make the request in that time period will result in the closure of the case. You will then have to start the application process all over again if you need to receive benefits. During the reconsideration period, your case will be completely re-evaluated by a medical examiner or consultant that works for the Social Security Administration (SSA), but was not a part of the initial evaluation of your case. Known as Disability Determination Services (DDS), about 5 to 10 percent of cases that are re-evaluated in this manner are given disability benefits. If you have been denied the continuation of your disability benefits, you will have the same option to have your case reviewed by an independent consultant from DDS. Continuing benefits are generally only denied if:

• The SSA determines your physical condition has improved and you are now able to work.
• You failed to cooperate with the re-evaluation process.

Benefit determination is re-evaluated periodically for everyone that is receiving benefits. If you feel that the re-evaluation of your benefits and subsequent denial were unfair, you can request an appeal. Many people will find that using a Social Security disability lawyer to fight this decision is very effective.

Second Level of Appeal – Administrative Judge Hearing

If you have requested reconsideration and were still denied benefits, or if your state does not require a request for reconsideration, the next step in your appeal process is presenting your case before an Administrative Judge. An Administrative Judge is an attorney that is employed by the Social Security Administration’s Office of Disability Adjudication and Review. A majority of their case load is to review cases pertaining to disability denials. This includes cases for new disability claims as well as denial of continuing benefits. An Administrative Judge has the authority to overturn the decision of the SSA adjuster who denied the claim for benefits, or the can uphold the decision to deny the claim. The judge will closely review the case and will also speak with the claimant about their medical condition and disability. The judge has the right to request additional information and expert testimony. About 67 percent of all cases that go before an Administrative Judge are overturned and benefits are granted. Your Social Security disability lawyer will help you through this proceeding to try to obtain the best outcome.

Third Level of Appeal – Appeals Council

The third level of appeal is a very difficult level and not many people have success in winning their appeal. However, this step is necessary to take if you intend to progress to the fourth level of appeal. The Appeal Council does not accept all the cases that are presented to them. On average, they will only select about five percent of all cases that are submitted to conduct a review. They are not interested in any of the facts of the case itself, such as medical conditions and outcomes. The Council is more interested in the procedures of the case and determines if anyone has made mistakes in evaluating your petition for disability. The Council looks for:

• Any legal errors that were made by the adjustor or the Administrative Judge
• A decision to deny benefits that does not have supporting evidence
• A flaw in a procedural issue

Your Baltimore Social Security lawyer will tell you how difficult it is to have your case reviewed by the Appeals Council. However, if it is appealed, about 2 percent of these cases are overturned and benefits are granted.

Fourth Level of Appeal – Filing a Lawsuit against the SSA

The final level of appeal is when the applicant files a lawsuit against the Social Security Administration in Federal District Court. The hope of these plaintiffs is to have their case heard by a jury and for the jury to find in their favor. Less than one percent of all disability cases ever reach Federal Court. This is because the process to sue the SSA is very time-intensive and very expensive. Most attorneys will not recommend this course of action or will not accept this type of case.

Speak to a Baltimore Social Security Disability Lawyer Today

If you need to file for disability benefits, or if you have recently been denied benefits, it is in your best interest to speak to a disability attorney. The experienced attorneys at Disability Benefits, Inc. will be able to review your case and determine the best method to help you secure your disability benefits. Applying for benefits can be a long and frustrating process. Being denied benefits can be devastating. You do not have to face this alone. Working with a skilled attorney improves your chances of receiving benefits in a timely manner. If you have any questions about disability benefits, call 800.899.7040 and speak to one of our Baltimore Social Security disability lawyers today.