Wednesday, January 05, 2011

Appeal Denied SSDI Claim at Application or Reconsideration

In almost all situations, if you want to win your Social Security disability claim you should request a hearing if you are denied at application in states that don't have reconsideration or if denied at reconsideration in states that do have it. This may seem obvious, but I have seen so many people come to me who did not appeal their denial at application or reconsideration in time and instead filed a new application either right after the denial or months or years later. This is a big mistake in most cases for several reasons. One reason, is that in an SSDI claim you can be paid benefits one year prior to your application and in SSI cases you can get paid benefits from the date of your application. Therefore, if you do not appeal you may be losing back due benefits that you would have been entitled to had you appealed instead of filing a new application. If you made this mistake, you may want to seek the help of a Social Security Disability lawyer, since depending on when you filed your new application it is often possible to reopen the prior claim and preserve the past due benefits that would be owed to you under the old claim. Another reason you should request a hearing, is that your chances of winning at the hearing stage is in most cases is better than your chance of winning on a new application. This was confirmed by a report done by the office of the Inspector General (OIG) for the Social Security Administration (SSA). They found that certain medical conditions were approved at significantly higher rates at the hearing level then at application or reconsideration. The medical conditions that stood out the most were diabetes mellitus, back conditions, osteoarthrosis and similar disorders, and medical conditions of muscle, ligament and fascia. One of the reasons appears to be that more claimants were represented at the hearing level then at application or reconsideration. The OIG report mentions other conclusions as well such as the claimant's age impacted disability determinations at application, reconsideration and hearing levels. Cases were approved at hearing based on a different medical condition then the medical condition that the application and reconsideration decisions were based on. They also found that hearing offices and administrative law judges had significantly different allowance rates with wide variations. The OIG based on this report plans to further investigate the causes of these differences. In my opinion, the fact that more people were represented at hearing is probably the biggest reason for the higher allowance rates at hearing then at application reconsideration. To see the full report by OIG for SSA you can find it at
I also want to note that just because the percentage of cases that win at hearing are higher than at application this does not mean that all cases are denied at application which is a widely held belief on the Internet. In fact, I believe if more people were represented at application this gap in approval rates between application and hearing would shrink significantly saving the claimant and Social Security a great deal of time and reduce overall processing times of claims in general.