If You've Been Denied Social Security Benefits
The Social Security Administration (SSA) routinely denies over half of the applications it receives, so don't be surprised if your application is denied. Many, if not most, appeals result in a favorable decision, so it's almost always worth your time to appeal. Finally, be aware that the appeals are very time sensitive, so read through the guide below and start the appeals process as soon as possible.
Why Were You Denied Social Security Benefits?
First, take the time to read the decision the SSA sent you to figure out exactly why you were denied in the first place. Once you know why you were denied, you can begin to collect the necessary documentation to correct the error. If you were denied Social Security disability benefits, the most likely reasons for the denial are:
- You make more than $940 a month. If you make too much money, you will be denied disability benefits outright.
- Your disability will not last at least 12 months.
- You didn't follow treatment prescribed by your doctor. There are approved exceptions to this including:
- You cannot pay for treatment.
- It's against your religious beliefs.
- The doctor prescribes treatment that is not effective.
- You have a mental illness that prevents you from following the prescribed treatment.
- You did not comply with the SSA's requests for information or medical records.
- The SSA can't locate you.
When to Appeal
Your appeal must be filed within 60 days of the denial decision as dated in the letter. If you wait longer than the 60 days, you will have to start over and reapply at the initial level and get denied all over again, a tremendous waste of time and something that won't look good on your appeal. So get started immediately on your appeal.
Where to Appeal
The preferred method for appealing is to use the SSA's internet appeals process at (www.ssa.gov). There are two parts to the internet appeals process:
- Fill out the Appeal Request Internet form, and
- Fill out an Appeal Disability Report that gives the SSA additional information about your condition
Your other option is to appeal the denial of benefits in writing. There are several forms to complete, depending on what you are appealing, including:
- Form SSA-561-U2 (Request for Reconsideration) to appeal the denial of an initial claim
- Form SSA-3441-BK (Disability Report, Appeal) to appeal the denial of disability benefits
- Form SSA-789-U4 (Request for Reconsideration, Disability Cessation) to appeal if your benefits have stopped
The Appeals Process
The appeals process can be rather lengthy and has several different potential steps. Here's an outline of the levels of appeal available to you:
- Request for Reconsideration: This is the first level of appeal, and it must be filed within 60 days of the date of the application denial. Reconsideration is done by the same state agency that denied you in the first place, so it's likely that you will be denied again.
- An Administrative Law Judge: If your appeal at the request for reconsideration fails, which it is likely to do, you must request a hearing using Form HA-501 provided by the SSA. The appeals process leaves the state level at this point and the hearing will be held before an Administrative Law Judge. This judge has considerably more power and leeway than the state agency below it, so this is your best bet for getting your denial overturned.
- The Appeals Council: If you want to appeal the Administrative Law Judge, you'll have to file Form HA-520 and request a hearing before the Appeals Council. The council will allow you to present additional evidence and will reconsider your case.
- Federal District Court: Finally, if you want to appeal the decision of the Appeals Council, you can file in your local U.S. District Court.
Consider contacting a social security benefits lawyer during this process, but especially if you plan on going before the Appeals Council and definitely before you end up in U.S. District Court.
What to Bring to Your Appeal
Once you've determined why your application for benefits was denied, you'll know how to respond. Don't try to be technical or confrontational, simply respond to the reason you were denied with proof that the situation is otherwise. The best forms of evidence come from professionals such as your employer or doctor, rather than relatives or other related witnesses. Documentation from your employer or doctor will often be the key to changing the SSA's mind.