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Should I Appeal My SSDI Denial?

Applying for Social Security Disability Insurance is often anything but a smooth, quick process. The reality is that only about 30 percent of SSDI applications are approved on the first turn. Those cases often involve those who are the sickest and whose claims are very straightforward. If there is any question whatsoever about the viability of your claim, it’s likely you’ll be denied. That sets the stage for an appeals process, which in all truth, can take many months and possibly even years. man

The circumstances of every case will be different, but we generally encourage people to go ahead and pursue an SSDI appeal because their chances of prevailing in those later stages are much higher.

That said, of course, if you can avoid a denial in the first place, that’s the ideal situation. That’s why we stress the importance of hiring an SSDI attorney right from the beginning. That way, you are certain that your paperwork is properly filed, it’s completed on time, it has all the necessary information and it is delivered to the correct Social Security Administration agent for appropriate review. If there are circumstances that warrant an expedited process, your attorney can help facilitate that for you as well. 

As far as the timeline, all cases are going to be different in terms of a person’s impairments and medical evidence, and disability cases don’t have deadlines. However, if your initial application is denied, you can typically get a reconsideration fairly quickly, typically in about a month or two. However, if you do not prevail at that level, you have to schedule a hearing. The average wait time, depending on what region you’re filing in, is probably going to take nine months to a year. Administrative law judges also probably won’t issue a decision on your case immediately.

When you go before an administrative law judge. If that judge hands down an unfavorable ruling, you can then take your claim to the Appeals Council. Approximately two-thirds of the requests for review by the Appeals Council are denied. About 22.5 percent are remanded to an administrative law judge. Three percent result in the council issuing a new decision. About 2.5 percent of cases are dismissed, usually do to statutory limitation issues.

These can seem like some daunting figure. However, consider that of the cases that are remanded, a significant number go on to eventually receive partial or full benefits. Plus, the more time that goes by since the original decision by the administrative law judge, the more your condition may have deteriorated and you’ll have additional evidence to present to prove your disability has worsened over time.

The Appeals Council is going to consider in your SSDI benefits claim whether the administrative law judge disregarded important medical information, failed to review the opinion of an examining or treating doctor, failed to ensure there was a vocational expert present or didn’t have all the relevant evidence. It’s often helpful to send along a brief statement with the request for review that can outline the basics of the case, and it’s advisable to have an attorney – who is experienced in communicating these points effectively – to craft it for you.

If the Appeals Council denies review or if they issue an unfavorable ruling, you also have the option of taking your case to the federal district court, where you have a higher likelihood of having the claim decided in your favor.

So in short, the decision to appeal is a personal one, and should be based on conclusions reached after careful consideration and consultation with an experienced SSDI attorney.

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:

Disability Planner: How You Qualify, Social Security Administration

More Blog Entries:

SSDI Appeal Results in Affirmation of Denial, Feb. 15, 2017, Boston SSDI Attorney Blog