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Articles on Disability and Workers' Compensation

How to File an Appeal

The biggest mistake people make is not appealing a denial. You have to keep appealing these cases until you get your case in front of a judge. There is a myth out there that you have to get turned down 3-4 times before you can win your case so people will just keep filing new applications instead of appealing. This myth comes from the fact that most people have to appeal at least two denials before they eventually win the case at a hearing. People have confused “appeal multiple times” with “apply multiple times” and are doing the worst possible thing as a result. If you get turned down, do not file a new application: appeal.

 Before you appeal, you’ll want to check why you were denied. At this level, the denial won’t include a lot of detail, but it will tell you if you were turned down for medical reasons or technical reasons. If your denial says you did not have enough credits to get disability, then you have a technical denial. There’s not much you can do about a technical denial. You either paid into the system or you didn’t. Your only option is to make sure you filed for SSI in addition to SSDI because you do not need credits for SSI. If you get a technical denial go down to your local social security office to make sure you also have an SSI application pending.

 If you get a medical denial, the explanation will probably say one of two things. It will either say that your condition does not keep you from working or it will say that your disability is not expected to last 12 months. If it says you can do some kind of work, then the person that reviewed your case just didn’t think your condition was bad enough to keep you from working. You’re probably going to have to go all the way to a hearing to get a different decision and you’ll need to work to get an opinion from your doctor that you can’t work.

 If the decision says your condition isn’t expected to last 12 months, then the person reviewing your case might have found that you were disabled but wouldn’t remain disabled for the full 12 months required to get disability. This often happens when people apply because they had a life altering event like a stroke or had a major surgery. If you get turned down because your condition isn’t expected to last 12 months, then you’ll want to get an opinion from your doctor that your condition is expected to last 12 months. If you get turned down because your condition isn’t expected to last 12 months, you have a decent chance of winning at reconsideration. You should try to get a letter stating your condition is expected to last at least 12 months. Also, by the time a decision is made on reconsideration, more time will have passed so it will be easier to tell if your condition is expected to last 12 months just by looking at medical records to see if you have improved.

 Now that you’ve read the decision, it’s time to appeal. The best way to appeal is online. You’ll want to go to ssa.gov and click on “online services.” Then click on “appeal a decision” and from the drop down menu click on “appeal a recent medical decision.” Social Security occasionally changes their website so if the menu has changed since I wrote this guide, follow the prompts as best you can until you’ve gotten to the screen where you’re appealing.

 Your appeal does not have to be complicated. In the part where it asks why you disagree with social security’s decision, you can put something as simple as “I am totally disabled and unable to work.” Spare yourself time and stress. No one is going to read a long explanation on why the decision is wrong.

 You will want to spend some time on the medical section if you have received treatment from any new doctors. Make sure you enter the names and addresses of any new doctors who have treated you since your initial application and include any hospital stays or ER visits. At the reconsideration level, Social Security continues to get records for you so let them know where you are treating.

 Finally, if you have any additional information to include, the online appeal allows you to upload documents at the end. This is where I often submit my notice of representation if a client hires me to file the appeal, but you can also upload documents your doctor gave you and be confident that they will wind up in the file.

You’ll want to a save a copy of the appeal and a copy of the cover sheet at the end. You will want to mail a copy of the cover sheet to the address provided at the bottom of the cover sheet along with a medical release. If you forget this step, your appeal will still be processed but someone from social security might pester you about filling out a medical release.

Your appeal is now done and you can move on to the next level of your case. You’re probably a little depressed that you were denied, but you just have to keep trucking ahead. Almost half the people that are denied and eventually make it to a hearing win their cases so you still have a good chance of winning your case.