Most people lose their original SSDI claim; in fact, 70% of claims are denied. That doesn’t mean your claim is over, just that you will will need to ask for a hearing in front of an Administrative Law Judge so you can explain your case in person. Most claims can be won at this stage, but it is best to be as prepared as possible so that you don’t have to go even further into the appeals process and wait even longer.

Here are some tips so that you understand what happened and how best to go forward in the future:

Hire a Qualified Disability Advocate or Attorney You Are Comfortable With

While many people choose to represent themselves, you will benefit from having an experienced advocate by your side. While there are no rules against representing yourself, it is generally not in your best interest to go to court alone. Even experienced attorneys usually hire other attorneys to represent them in court if they are involved in personal litigation.

Preparing Your Case

The first thing we can help with is evaluating your case and helping you decide the best way to present it to the judge. The ALJ (Administrative Law Judge) hears many cases throughout the year, but your disability attorney will help you organize your presentation so that the judge understands the seriousness of your case. Make sure your attorney has copies of all your paperwork, including medical exams and work information.

Helping You Stay Calm

The first benefit of bringing an attorney with you is that you know that you are not alone. Most people are nervous when involved in courtroom proceedings, but you will feel better knowing that you are with someone who has been through this before many times and is on your side. The more relaxed you are, the more likely you are to remember everything important you wanted to tell the judge.

Your Physical Presentation

Your attorney can also help you with your physical presentation. Courts expect a certain amount of decorum, and your attorney can help you to understand what kind of clothing and demeanor will most impress the ALJ. While you are not going to be putting on a show, being appropriate goes a long way when presenting your case in court.

That doesn’t mean that you should go out and buy a nice suit like you think an attorney might wear to court, or that you have to feel as though you have to go overboard with how servile you act toward the judge. It is more important to be neat, clean, and respectful looking and to be civil and polite with the judge.

Know Your Case

Your lawyer can help you better if you know your case thoroughly and can help explain why it is necessary for you to have SSDI. Keep up with any changes and make sure your attorney gets new information. It is never good to have a surprised attorney in court, and it could potentially keep your attorney from representing you as fully. Knowing your full medical history is important, and there are free and reduced-price services that may be able to help you develop your record.

You don’t need to become a medical expert, but you should be able to show evidence about your injuries and your treatment over a period of time. Never forget that nobody knows as well as you do how your disability is affecting your day-to-day life and ability to work. 

Never Minimize Your Disability

Many people have trouble letting go of their pride, and may not want to admit that there are some things they can’t do anymore. You probably have a picture in your head of the way you used to be, and all the things you used to be able to do. It can be really hard to admit that you aren’t the person you were before.

Get rid of those ideas, because the ALJ is not there to look down on you for your injury. Explain how your disability affects your specific abilities and how that makes it difficult if not impossible for you to continue to perform your job duties. You will not be judged as a person based on your ability to perform certain job functions.

Never Exaggerate Your Disability

Many people go the opposite way, and try to exaggerate the extent of their injuries. This is a sure way to anger a trier of fact, who has dealt with many cases like yours before and will probably immediately know if you are being dishonest. Once the ALJ finds out that someone is dishonest, that will become part of that person’s record and could affect the ability of that person to ever prevail in an SSDI case. This is the scenario we see on television, where someone in a personal injury lawsuit claims to be seriously injured and then a detective brings pictures of the person dancing the tango and skydiving.

While your experience in a disability hearing will not be that dramatic, you do need to remember to always be honest. Sometimes people exaggerate because they are worried that the judge won’t take them seriously otherwise. Don’t worry about the fact that there are people in the world who have worse injuries than you. The judge is only there that day to evaluate your case.

Use an Expert to Explain How Your Injuries Are Affecting You

Someone such as an occupational therapist can provide evidence as to how your disability keeps you from doing your particular job, and can also provide information on how your disability will keep you from transferring your skills so that you are able to do another job. This is important so you can show the Court why you didn’t just go get a different job when you became injured. An occupational therapist can show the judge why someone with your injury will no longer be able to do what is expected at your job.

Do Not Miss Your Hearing

Just like with other important appointments, it is crucial to be present and show up on time for your appointment. If you expect a potential time conflict, go ahead and move to continue your hearing in advance. If you simply miss your hearing without a very good reason, the ALJ is going to default you, and you will lose your case. You may not be able to move on from this point after you lose by default at this hearing.

Keep In Touch With Your Attorney

As soon as you have a disability attorney, make sure you keep in close contact. If your attorney calls you, call back as soon as possible. By the same token, make sure you advise your attorney every time you get new information that may apply to your case. There are many times where a client did not give the attorney information crucial to the case, and it resulted in losing the case. Don’t worry about bothering your attorney if you have crucial information to share. Your attorney chose to help clients with disability claims and wants you to call.

Be Patient

It can take up to 2 years from the start of your claim before you get a date in court. Waiting for a long time can be frustrating, especially when you can’t work and you have to figure out how to live without your regular income. Don’t let the ALJ see if you are feeling anxious about how much time has passed. Your initial hearing is your best chance at winning your claim, so you want to take full advantage of it when your day finally arrives.

At Joel Thrift Law, we understand how frustrating it is to deal with the SSDI process, especially when it seems as though it should be easier to get something you feel you have a right to. Especially if you worked for a long time before your injury, you may be wondering why the process is so difficult to get benefits to which you should be entitled. 

Even though there are many similarities in cases, your case is still different from other cases in important ways. We at Joel Thrift Law will help so that when you go to court, the judge will see why your case is so important. If you or someone you love has a potential or active disability claim, give us a call today.

Social Security Disability Insurance (SSDI) provides monthly benefits to individuals who can no longer work due to a disabling medical condition. To qualify for SSDI, you must have worked enough years to accumulate work credits. The Social Security Administration grants work credits according to yearly wage amounts. For people who do not have enough work credits to qualify for SSDI, the SSA’s Supplemental Security Income (SSI) is available to financially assist low-income disabled children and adults.

When a medical condition improves enough to allow an SSDI recipient to return to work, their benefits will stop as soon as they receive their first check. In some cases, they may return to work for several months only to discover symptoms of their condition returning. Or, they may injure themselves while on the job because they weren’t physically ready to return to work. Whatever the reason someone needs to restart SSDI benefits, the SSA offers “expedited reinstatement” to apply for SSDI without completing a new disability application.

What is an Expedited Reinstatement (EXR) for SSDI?

An EXR avoids filling out an entire disability application while shortening the time it takes to start getting monthly benefits. In addition, when you apply for expedited reinstatement, the SSA may approve you for provisional benefits for as long as six months.

Qualifying for SSDI initially meant you had to prove to SSA disability evaluators that you could not maintain substantial gainful activity (SGA) that gave you income of no more than $1260 per month. If you return to work and start earning over that amount, you no long qualify for SSDI. You must always notify the SSA whenever you obtain employment while getting SSDI payments.

You are eligible for EXR if your income earnings fall below the substantial gainful activity amount set for 2020 and you applied and were approved for SSDI within the last five years. For example, someone who was approved for SSDI in 2013, reentered the work force in 2017 but became disabled again in 2020, they would not be eligible for expedited reinstatement of their SSDI benefits. Instead, they would have to file a new application complete with new medical documentation and updated information about their condition. Also, if the SSA approves an EXR request, the claimant may be entitled for up to a year of retroactive payments from the date the EXR request was filed. Eligibility for retroactive benefits varies from case to case and does not apply to everyone filing an EXR request.

What Happens After You Apply for an EXR for SSDI?

The SSA will sent your EXR application to a local disability determination agency that reviews criteria establishing the definition of a disability. In addition, the agency will examine your medical documentation and doctor’s reports to determine if you have had any improvements in your condition since you first applied for SSDI. According to the SSA, a medical improvement is evidence that your condition is not as severe as it was when you initially qualified for SSDI. Medical improvement must also be substantial enough to allow you work and earn “gainful” income.

Medical improvement must be directly related to a person’s ability to remain employed and to the impairment for which you were previously receiving SSDI. For example, if you were receiving SSDI for irritable bowel syndrome, returned to work when you responded well to treatment but had to stop working due to a return of SBI, the SSA cannot deny your EXR because they state you are no longer anemic.

In most cases, the claim of a medical improvement involving an EXR is difficult to prove, especially when you have past and present medical documentation proving you have received a clinical diagnosis of your disabling condition.

What is the Provisional Benefit Period?

While waiting for an EXR to be approved, the SSA will pay temporary benefits for up to six months. However, provisional SSDI benefits will stop when you receive a decision about an EXR request or if you earn income above the substantial gainful activity amount. Provisional benefits will also be discontinued if you turn 65 years old (full retirement age) before a decision is reached. If your expedited reinstatement request is denied, you do not have to repay provisional benefits as long as no overpayments were involved.

Monthly provisional benefits are generally equal to what you were receiving while on SSDI. Occasionally, this amount is adjusted if underpayments, overpayments or cost of living increases enacted by Congress have been established since your last benefit payment. Additionally, you are also entitled to health insurance while receiving provisional benefits. SSDI recipients are usually covered by Medicare.If your EXR is denied, Medicare will stop paying for your health costs.

What About Dependent Benefits and Reinstating SSDI Benefits?

If a spouse or child was receiving SSDI or SSI based on your income and their disability benefits ceased due to your income, their benefits will resume following approval of your EXR. Be aware that the SSA does not restart spousal, disabled child or parent’s benefits automatically. Reinstatement of their benefits must be requested online, by telephone or by mail.

Can You Appeal an Expedited Reinstatement Denial?

Yes, you can appeal an EXR but the appeal must be filed within 60 days of receiving your denial letter. The document you need to send to the SSA is called a “Request for Reconsideration”. Your local disability determination agency will review your application to determine if an error was made in denying your request.

Denials of Requests for Reconsideration can be appealed within 60 days of receiving a denial letter. This appeal will be held in a courtroom where an administrative law judge (ALJ) will preside over the case. The appeals process at this point resembles the appeals process in other types of disability appeals.

If an ALJ denies your second Request for Consideration, you have another chance to appeal the denial by taking it to the Social Security Appeals Council. The Appeals Council reviews why the ALJ decided to deny your request. Sometimes, an ALJ may make a procedural or legal error that the Appeal Council will catch and overturn. They will also examine all documents included in your case. You are allowed to provide the Appeals Council additional information pertinent to your medical disability.

Once the Appeals Council is finished reviewing your Request for Consideration, they will take one of three possible actions:

• Deny the request. If this occurs you can file another appeal in Federal District Court
• Overturn the denial made by the ALJ and approve your SSDI benefits case
• Remand your appeal back to an ALJ for the purpose of having the ALJ reconsider your case. At this point, the ALJ will either issue another denial or approve your case

If the Appeals Council flatly denies your case, you cannot ask that it be sent back to the ALJ. The only option is appeal again at the federal level. An Appeals Council that remands a case to an ALJ has probably found some type of technical error or a failure on the part of the ALJ to consider all the medical evidence you provided. Remands by Appeals Council happens in about two out of every 100 disability appeals. Less than three percent of all disability appeals are approved by an Appeals Council.

How Do You Appeal an EXR at the Federal Level?

You will need to file a civil complaint at a U.S. District Court nearest your location. Civil complaints are simply concise statements describing your disability and other aspects of your case. When you file an appeal at the federal level you are essentially not suing the SSA. Instead, the defendant named in your appeal’s complaint is the current commissioner of the Social Security Administration. 

The SSA cannot assist you in completing a civil complaint since the case involves the SSA Commissioner. If you do not have a disability attorney at this point in the appeals process, it is likely your civil complaint will be rejected due to legal omissions and errors. The SSA and other disability experts strongly advise anyone to hire an experienced disability lawyer who give your case the legal expertise it needs to stand a chance at being approved in a Federal District Court.

Contact Joel Thrift Today for Legal Help with Reinstating Your SSDI Benefits

The amount of paperwork and legal knowledge required to ultimately get an EXR approved is extensive and complex in nature. Don’t just start filing appeals without having a disability attorney representing your best interests throughout the appeals process. Call today to schedule an immediate consultation appointment at Joel Thrift Law Offices.