What Is The Process Of Social Security Disability Benefits?
What Does The Denial Letter From Social Security Actually Say?
If it is a denial letter, first of all it will indicate that you were denied benefits based on your application. It will give you a general explanation of why you were denied, such as if you can do other work, or that they believe you can do work that you have performed in the past. In that case, it will give a list of what records they have reviewed to make that determination. The date on the top right hand corner is important, because you have sixty days from that date to appeal the decision along with five days from the date the denial was mailed.
Does Someone Actually Have To Appeal Or Could They Just Refile?
Nobody has to appeal. You can do either one, but appealing or refiling is to ones benefit. It depends on the circumstances of each case and what level you are on. If you are not at the hearing level, then generally if you believe the decision is wrong, you should appeal. If you are at the hearing level and you are denied by a judge, then you have to make a decision to appeal or refile. You cannot appeal to the appeals council and begin a new application process at the same time.
Previously, attorneys used to be able to do both of those for clients, but several years ago; they instituted a new rule that said you have to pick one. At the initial and reconsideration level, if you appeal, you have a protective filing date from your initial application date which is important when you are determining back benefits. If you decide to refile because you have missed your appeal period, then you may ask for a reopening of prior applications. However, there are time limits on how far you can go back with the applications in order to reopen and you may be giving up your rights to past benefits, if you refile instead of a timely appealing a denial.
What Is The Reconsideration Review?
The reconsideration review is an appeal that is filed after the initial denial is done. Essentially, it is the same review process that is conducted at the initial level. It is just conducted by a different person at the Social Security Administration. They look at the alleged impairments, at the medical records and they look at your work history as well as any current work that you may be doing to determine whether or not you are truly disabled. One thing to remember at this level is there is only an eleven percent approval rating, which means approximately eighty-nine percent of the people that are filing for this request for reconsideration are resulting in denials.
What Happens At The Hearing Before An Administrative Law Judge?
It is generally an in person hearing before an Administrative Law Judge. However, they are doing video conference hearings now as well. If you do not object to this video hearing timely, they may require that you do your hearing in that manner.
I do not generally recommend a video hearing in lieu of an in person hearing. The judge cannot get a good feel for the claimant over a video the way they can in person. The Administrative Law Judge, also known as the ALJ, will generally open the hearing, which is recorded, by introducing everyone in the room. This would include the judge, the assistant who is handling the recording equipment as well as the claimant, the attorney if one is present for the claimant, and any experts that may either be there in person or sometimes by telephone.
After that, an opening statement of what the judge is there to decide is generally read into the record. In case an attorney is present, they are usually asked to give an opening statement or their theory of the case as to why the claimant should be granted social security benefits. Attorneys usually take this opportunity to point out the specific exhibits which most support the disability allegations such as forms that the doctors may have filled out, which goes along with the listing or a particular rule for social security disability.
At that point, the judge will ask the claimant questions about the general personal history, work history, education, their impairments and medical conditions and why they feel they cannot return to work. Alternately, they will have the attorney for the claimant ask the questions. This is an individual decision by the judges. Some of them like to ask their own questions; others like to have counsel do it and they will just interrupt when they feel that they need more information on a subject. Once that is completed, if the judge has any additional questions, he or she will ask them. If there are experts involved such as a medical or a vocational expert, they will be asked for their opinions based on specific facts provided by the judge, which are supposed to be derived from the written record along with the information provided during the hearing.
A closing statement may be provided by the attorney, depending on the judge’s wishes at that time. The judge may provide their decision or they may advise you that you will receive a written decision in the mail. You may get the decision in as little as a few weeks or as much as a few months. No one should walk away from a hearing that they do not have a decision, feeling they lost. There are some judges that absolutely will just not give you a decision at the time of the hearing, whether you win or lose. They will not do it. So, just because you do not get a decision at the end, does not mean it will not be favorable.
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