Currently Social Security denies over 65% of all disability applications. Many of these denied claims, including yours, may be deserving of approval, but for a variety of reasons, you have been turned down. If you are denied, you should not give up. Instead, you need to file an appeal called a Request for Reconsideration within sixty (60) days from the date you receive your denial notice.
You can file your appeal online, using paper forms or even over the phone. Or you can hire a lawyer (under a no fee unless you win contract) to prepare and file your reconsideration appeal.
Statistically, only about 10% of reconsideration appeals are granted. This is because the claims adjusters (called state agency adjudicators) are looking for “magic words” in your medical record. More specifically they are looking for statements in your medical records that you meet a Social Security listing.
Listing level cases involve very, very severe medical problems. Here are some examples of “listing level” claims:
- 53 year old male whose heart is functioning at 20% of capacity
- 45 year old female with Type I diabetes whose blood sugar cannot be controlled with an insulin pump
- 48 year old female with “failed back syndrome” who is no longer a candidate for surgery and has been referred to long term pain management
- 45 year old female with symptomatic muscular dystrophy
You do not need to have a listing level impairment to qualify for Social Security disability benefits. At the initial application and reconsideration levels, however, the adjudicators are not authorized to look much beyond the medical records.
In addition to the 10% of cases that are approved at reconsideration, about 45% of claimants who continue their appeal and go to a hearing before a judge are approved. So there is a very good chance that you can still win even if your original application is denied.
At a minimum, you need to file your reconsideration appeal in order to keep your case alive. If you do not file for reconsideration within 60 days of your initial denial, you case will be closed. Unfortunately the reconsideration appeal process will add between 4 and 6 months to the process. This can be very frustrating, especially since your odds of winning at recon are small.
How to Improve Your Chances at Winning Your Reconsideration Appeal
While the odds are not great, you can improve your chances at winning at recon by following a few simple steps. Even if you don’t win, these steps can make your case more solid and improve your chances when you eventually do see a judge.
First, review the initial application denial notice to identify which medical records were used to by the adjudicator to deny your claim. Many, many times, you will see that one or more of your doctors did not respond to the adjudicator’s request for records. If you can get those records to the adjudicator that may be enough to get your case approved. If you see that records are missing, you can get copies from your doctor and send them in, or can verify your doctor’s address and make note of this omission in your reconsideration appeal forms.
Second, ask your doctor to help you by writing a narrative report that explains how your medical condition meets or equals a Social Security listing. The listings are online – visit my website MeetaListing.com for more information about how to find and use the listings.
Third, if your doctor does not believe that you meet a listing, ask your doctor to write a report describing reliability problems you would likely have a job. Remember that Social Security defines disability in terms of how your medical issues impact your capacity to perform the tasks of a job. So if you are likely to miss excessive time, need to take unscheduled breaks, or cannot concentrate because of severe pain, you may very well meet SSA’s definition of disability.
Fourth, if you are over the age of 50, look at Social Security’s “grid rules” to see if you qualify. The grid rules apply if you are over 50, have a limited education and minimally skilled work experience. Adjudicators often do not fully understand the grid rules so your case may not be considered under this theory of disability. You can learn how the grid rules work and view the grid tables at my website GridRules.net.
Finally, when you complete Form SSA-3441-BK (Disability Report – Appeal) make sure to include new information supporting your claim for disability. In other words, explain to the adjudicator why the prior denial was improper.
Don’t Miss the 60 Day Deadline
Although two months (60 days) sounds like a lot of time, it can go by very quickly and you should not wait to file your appeal. I recommend to my clients that they look at the date on the denial notice as opposed to the date when the denial was actually received. Make sure to file your appeal so that it arrives at Social Security long before the 60 day deadline.
If you file your appeal online, make copies of everything you upload and check your claim’s staus online at ssa.gov. If you file using the paper forms, send everything by registered mail (with return receipt), keep a copy and follow up online or over the phone to make sure that SSA received your forms.
Filing the Reconsideration Appeal is Mandatory
Whether you view the reconsideration process as a waste of time or a real opportunity to win your case early, you have to go through the process and you have to file your paperwork on time. If you choose to bring a lawyer on board, your lawyer will file your reconsideration appeal electronically and both you and your lawyer will receive notifications about your case status and anything else that SSA needs to evaluate your case.
If Ginsberg Law can assist you with your reconsideration appeal, please contact us using the form on our website or by phone at 770-393-4985.