Practical advice from an experienced Alabama SSDI attorney
For many Americans who have been injured and are unable to work, Social Security disability insurance (SSDI) benefits are a life preserver. But around two-thirds of all first-time SSDI claims are rejected for a variety of reasons. What happens if the claim you believe is legitimate is met with a denial? With proper guidance from an experienced Alabama SSDI attorney at Carey & Hamner, P.C. in Dothan, you can appeal that denial and vastly improve your chances of success.
Common reasons SSDI claims are denied
First-time claims for Social Security disability benefits are denied at a high rate, both for substantive and clerical deficiencies. The Social Security Administration issues denials for such reasons as:
- Inadequate medical information — Your medical records fail to establish that you have a qualifying condition and that you are, in fact, disabled.
- Failure to claim a recognized condition — If you don’t use precise language in your claim, the claim processor might not make a connection between your symptoms and a condition the SSA recognizes as disabling.
- Failure to follow treatment — If you haven’t followed your doctor’s prescribed therapy and have no valid medical or nonmedical excuse, the SSA can reject your claim.
- You continue to earn too much money — SSDI is not compensation for an injury. If you are gainfully employed despite your injury, you may not be disabled for SSDI purposes.
- Your disability is not regarded as permanent — SSDI is for people who are permanently disabled. If your prognosis for recovery is good, you may be disqualified.
- Your disability is due to drug or alcohol abuse — If there is a causal connection between your disabling condition and your drug and/or alcohol use, the SSA could deny your claim unless you demonstrate you are no longer using those substances but are still permanently disabled.
- Your claim appears to be fraudulent — SSDI fraud is an enormous problem and claim processors are trained to recognize errors, oversights and omissions as red flags for fraud.
It’s important to understand why your claim was denied, so you can appeal the decision effectively. An Alabama SSDI lawyer at our firm can review the denial letter and determine how to approach your appeal.
The SSDI appeals process
If the SSA initially determines you are ineligible for SSDI benefits or offers a monthly benefit amount you believe is too low, you can appeal the decision. There are four steps for an SSDI appeal:
- Reconsideration — This is a fresh reading of your claim by another claims reviewer. To apply, you must file Form SSA-561 (Request for Reconsideration) or a Form SSA-789 (Request for Reconsideration - Disability Cessation) within 60 days of receiving your denial.
- Administrative law judge hearing — If the reconsideration is not favorable, you can apply within 60 days to present your case to an administrative law judge (ALJ). You can appear at a hearing in person or by video conference or ask a judge to decide based on your file.
- Appeals Council review — If the ALJ hearing results in an adverse decision, you can request a review by the Appeals Council within 60 days of the decision. The Appeals Council can also decide on its own to review the decision.
- Federal court — If the three previous steps have not yielded a satisfactory result, you can file a lawsuit in U.S. District Court within 60 days of receiving the notice of the Appeals Council action.
SSDI applicants generally fare better on appeal with the assistance of capable and seasoned legal representation. But deadlines come quickly, so make sure you contact us as soon as you receive a denial of your claim.
Contact our Alabama law firm to appeal your SSDI benefit denial
Carey & Hamner, P.C. in Dothan represents clients in appeals of SSDI denials. To schedule a consultation, call 855-435-4797 or contact us online. Our office is located across Main Street from the First United Methodist Church.