Published on:

Help! My SSDI Claim Was Denied By the Appeals Council

There is no doubt that the quest for Social Security Disability Insurance (SSDI) benefits can be an arduous one. Unless you have a condition that is exactly specified by the Social Security Administration (SSA), you’re facing an uphill battle to prove you’re unable to work. gavel211

In fact, the majority of initial claims are denied. At that point, you have the choice of whether to appeal to that determination to the Appeals Council. The council can do one of a few things at that point: Refer the claim back to the administrative law judge for a review of the initial decision, review a claim directly or uphold the ALJ’s original decision.

No matter what stage you are in the process, having an experienced attorney to guide you through the most viable step is important. If it’s worthwhile to keep fighting, you’re going to need a strong advocate. If your claim isn’t likely to win, you need someone who will tell you that too. 

Our experienced Boston SSDI attorneys want to make sure your best interests are protected. We have handled many, many SSDI cases and we base our legal recommendations on years of experience and an in-depth understanding of the system’s inner workings.

In many cases, it is worth it to continue moving forward with an appeal because these benefits ensure those with disabilities have what is necessary to cover their routine bills, medical expenses and other financial obligations.

The first thing to understand is that the Appeals Council doesn’t act with great swiftness. It may take months or even more than a year to get an ALJ hearing, and you could end up waiting almost as long for the Appeals Council to weigh in.

In cases where the appeals council refers the case back to the ALJ for review, it’s best to have some new, compelling evidence you can present. The ALJ isn’t likely to delve deeply into second-guessing their own opinion unless there is a convincing reason to do so. That’s why the work of your lawyer is ongoing. We’re constantly working to gather additional evidence, collect new doctor affidavits, provide more records for the judge to review.

In cases where the Appeals Council chooses to review a case directly, it’s somewhat rare for them to outright reverse the ALJ. Again, that usually occurs when additional evidence is presented or when a strong case can be made to show the ALJ’s decision was improper. Often, that comes down to a highly-technical argument.

In other cases, the Appeals Council could affirm the ALJ or refuse to review the case at all.

While this is a necessary step after an ALJ denial of SSDI benefits, it’s a frustrating one because it often ends in disappointment. But the good news is your attorney doesn’t have to wait for this decision to start preparing for the next phase in the process.

The SSA does allow claimants to file a new claim even before the Appeals Council has weighed in on the first. This could be the best course of action if your condition has significantly worsened or if there is new evidence of claimant’s limitations.

The other option is to appeal the Appeals Council’s decision to a federal court. Not many clients do this because of the time and expense involved, but it may be worth exploring, depending on the individual facts of your case.

If you or a loved one is seeking Social Security Disability Insurance in Boston, call for a free and confidential appointment at 1-888-367-2900.

Additional Resources:

Appeal a Decision, Recent Medical Decisions, SSA

More Blog Entries:

Boston SSDI and Taxes: What You Need to Know, July 6, 2016, Boston SSDI Lawyer Blog