Understanding The SSDI Appeals Process

The Social Security Disability Insurance application can be a daunting task due to the fact that you have to talk about the disability and also fill out the complicated applications. When a claim has been denied, you have the right to appeal. There are many instances in which legitimate claims have been denied only to later be approved. To achieve this, you have to appeal the initial decision and your SSDI lawyer can help you with this.

You are not required to hire an attorney when seeking SSDI benefits. However, many people find that working with a skilled lawyer can make the application and appeals processes less stressful and more likely to be resolved favorably. In southern Minnesota and Fargo, North Dakota, the easy choice for representation is Reitan Law Office, PLLC.

SSDI Application Process

Before entering the appeals process, applicants must navigate the initial SSDI application, which requires careful preparation and thorough documentation to improve approval chances.

Gathering Documentation

Successful SSDI applications depend on comprehensive documentation supporting your disability claim. Essential information includes:

• Medical records, including hospital records, doctor visit summaries, diagnostic test results, imaging studies and treatment histories from all health care providers
• Proof of income documentation, including tax returns, W-2 forms, pay stubs and earnings records from the past five years

Current medical evidence typically carries more weight than older records, so maintaining ongoing treatment relationships strengthens your claim.

Submitting The Application

Applications can be submitted online, by telephone or in person at local Social Security offices. The online process is often the most convenient, allowing you to save progress and complete forms at your own pace.

The application requires detailed information about your medical conditions, work history, daily activities and how your disability affects job-related tasks. Be thorough and honest when describing limitations and symptoms, as incomplete information can lead to delays or denials. Consider working with an experienced SSDI attorney to navigate the complex application requirements and improve your chances of approval.

SSA Review Process

Once submitted, your application enters the Social Security Administration’s review process at the state Disability Determination Services (DDS) office.

Review Of Application

Trained disability examiners and medical consultants evaluate your claim, verify completeness and request additional medical records if necessary. The examiner may contact your doctors for clarification about your condition.

Disability Determination And Evaluation

The SSA uses a five-step evaluation process to determine eligibility. Here is a summary of these steps: 

1. Are you working? If you are working and your average monthly earnings are over a certain threshold level, then Social Security will not consider you disabled. The threshold level changes from year to year.
2. Do you have a severe impairment? Your condition must interfere with basic work-related activities for your claim to be considered. If it does not, the Social Security Administration will find that you are not disabled.
3. Does your disabling condition meet a listing? For each of the major body systems, the Social Security Administration maintains a list of medical conditions that are so severe that they automatically mean that you are disabled. If your condition is not on the list, Social Security will have to decide if your condition is of equal severity to a medical condition that is on the list. If it is, then they will find that you are disabled.
4. Can you do the work you previously did? If your condition is severe but not at the same or equal level of severity as a medical condition on the list, then Social Security must determine if it interferes with your ability to do the work you did previously. If it does not, your claim will be denied.
5. Can you do other types of work? If you cannot do the work you did in the past, Social Security will see if you are able to adjust to other work. The Social Security Administration will consider your medical conditions, your age, education, past work experience and any transferable skills you may have. If you cannot adjust to other work, your claim should be approved.

Medical consultants review evidence to determine impairment severity and functional impact. They may request consultative examinations if additional medical evidence is needed.

Decision

After evaluation, the DDS office issues a decision to approve or deny your claim. Approved claims receive information about benefit amounts, back pay calculations and payment schedules. Denied claims receive explanations outlining specific reasons for denial and comprehensive information about appeal rights and deadlines.

SSDI Appeals Levels

There are four levels of SSDI appeals. They are:

1. Asking the Social Security Administration to reconsider whether or not the initial decision was the correct one. These reviews do not typically result in the overturning of the decision.
2. Requesting an administrative hearing. This is a formal hearing that occurs before an administrative law judge.
3. If you receive a denial at the hearing, you can ask the SSA Appeals Council to do a review of the case. They will look at your case and the decision that the administrative law judge made. These individuals do not usually overturn the judge’s decision.
4. If the Appeals Council denies the case, a lawsuit can be filed in U.S. Federal District Court. There are not many claimants whose cases are heard at this level.

Requesting Reconsideration Of A Denial

When you request the denial to be reconsidered, you have to submit a request for reconsideration. Your Social Security disability attorney can help you fill out these forms and file them.

When the reconsideration process occurs, it is a total review of the initial claim. A medical consultant may be selected to assist in the matter. This individual most likely was not a part of the initial decision. Because of this, it is possible for the initial decision to be overturned.

Contact Our Minnesota And North Dakota SSDI Lawyers Today

SSDI claims are not always approved the first time around, which is why the appeals process exists. The appeals process has to be approached carefully and methodically. At Reitan Law Office, PLLC, we will ensure the appeals process is carried out properly so the chances of being approved increase for you and you can receive the benefits that you deserve. To learn more, call 952-448-2800 (Chaska), 701-581-7854 (Fargo, North Dakota), 507-388-1800 (Mankato) or 612-424-6011 (Minneapolis) for a free case evaluation.