How Do I Appeal an SSDI Denial?

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How Do I Appeal an SSDI Denial? Has Social Security denied your claim for SSDI benefits?  You may think filing a new claim can be better than appealing.  However, you should appeal any denials.  Re-filing can delay the appeals process.  Your chances for getting SSDI benefits improve when you appeal. 

Where do I appeal an SSDI denial?

You can file an appeal several ways.  First, you can appeal your denial online.  This can be the easiest way to appeal an unfavorable decision.  Second, you can file an appeal with your local Social Security office.  If you have a representative, they can help you file an appeal of your SSDI denial. 

How long do I have to file an appeal?

You have 60 days to appeal an SSDI denial.  Social Security gives you an extra 5 days to allow you to receive your denial in the mail.  Therefore, you have a total of 65 days from the date on your denial to appeal your SSDI claim.  If you don’t file within the 65 days, you may have to re-file your claim.  Social Security allows you to file an appeal in more than 65 days if you have good cause for missing your deadline.

What is good cause to appeal an SSDI denial for missing your appeal deadline?

Good cause can include several reasons.  Social Security considers:

  • What circumstances kept you from making the request on time;
  • Social Security’s action misled you
  • Whether you didn’t understand what you needed to do to appeal
  • Whether you had any physical, mental, education or language limitations that prevented you from appealing on time

Examples of good cause for missing your deadline

  • You were very sick when the appeal was due and couldn’t have contacted Social Security yourself or through someone else.  You would need proof that you were seriously ill.
  • There was a death or serious illness in your family
  • Records needed for your appeal were destroyed by an accident or fire.
  • You never received your denial notice
  • Some other type of unusual or unavoidable circumstances and you could not reasonably be expected to have met the deadline

What information should I include in my appeal for SSDI denial?

Most importantly, you need to include updated treatment information on your appeal.  You should tell Social Security about all the doctors you’ve seen since filing your application.  You should include any emergency room visits, also include any hospitalizations.  On appeal, Social Security looks at any new or missing information that might change their minds. 

Why was my SSDI claim denied?

Many people receive a denial for SSDI benefits the first time they apply. Understanding why Social Security denied your claim can help increase your chances on appeal.  Specifically, you will know what your claim was missing or where your claim can be improved.  Common reasons include:

  • Lack of medical evidence
  • You are working
  • Not following your doctor’s orders
  • Ignoring requests

SSDI denials for lack of medical evidence

Frequently, Social Security denies claims because there was not enough medical proof to show your condition keeps you from working.  You must show that your symptoms cause serious problems in your functioning.  Therefore, you should see your doctors regularly.  Additionally, you should see specialists for your conditions.  Often, specialists keep better records about your symptoms and problems better than a general doctor.  They focus on specific information Social Security needs to approve your SSDI benefits. You need to Appeal your SSDI Denial on time or you will have to start over.

SSDI denials for working  

Social Security defines disability as the inability to work for at least 12 months.  Therefore, if you are working, you may not qualify for SSDI benefits.  Social Security considers earnings over a certain amount “substantial gainful activity” or SGA.  If you earn over the SGA limit, you won’t qualify for SSDI.  If you have not been out of work for at least 12 months, you won’t qualify for SSDI. 

SSDI denials for not following your doctor’s orders

If you don’t follow your doctor’s recommendations, Social Security could deny your case.  Your doctor’s treatment plan shows that you cannot work due to your condition.  Without a treatment plan, Social Security can have trouble establishing that your condition impacts your work ability.  This also includes taking prescribed medications correctly.  Additionally, when you don’t follow your doctor’s orders, Social Security can decide that your limitations would be less serious if you followed their recommendations.  This can result in an SSDI denial. You need to Appeal your SSDI Denial on time or you will have to start over.

SSDI denials for ignoring requests

Often, Social Security requires additional information to process your SSDI claim.  This may include more information about your treatment or work history.  Social Security may not be able to make a decision without this information.  When you don’t respond to their requests, Social Security denies your claim for failure to cooperate. 

Get help appealing your SSDI denial

If you’ve been denied for SSDI benefits, you should consider working with a disability advocate.  Hiring a disability advocate can significantly increase your chances of winning.  A disability advocate makes sure you don’t miss any deadlines for appealing.  They can help get your claim on the right track for winning your claim. 

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

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