What happens if my claim is denied?

If your initial claim for disability benefits is denied, your first level of appeal is called a “Request for Reconsideration.” At this level, you submit new or additional medical evidence supporting your claim and the SSA office reviews your original evidence and any new evidence you submit and determines if your original claim decision should be changed and benefits granted. However, this only happens in a small percentage of cases.

If, like the vast majority of claims, your reconsideration request results in another denial of benefits, you can appeal this decision and ask for a hearing before an Administrative Law Judge (ALJ). The ALJ schedules a hearing where he takes testimony and receives written evidence from you and your representative, reviews your claim information and any new medical evidence, and issues a decision regarding your case. The ALJ is not bound by the decision of the SSA at the initial or reconsideration phase; he or she will make a totally new decision on your case, based on his or her independent review of the evidence, the law, and the arguments you and your representative make at the hearing.

If the ALJ does not award you disability benefits after your hearing, you can request a review of that decision by the Appeals Council. This Council is made up of a panel of ALJ’s, with a large supporting staff. Their job is to review the decisions of ALJ for errors. The Appeals Council can affirm the decision of the ALJ, or reverse it and award you benefits, or remand it back to the ALJ to fix errors they believe can be corrected.

Finally, if the Appeals Council affirms the ALJ’s denial of benefits, you can file a lawsuit in Federal District Court asking that Court to reverse the ALJ’s decision. At this stage, your attorney files a document explaining why the ALJ and Appeals Council’s decisions were incorrect. After that document (and the SSA attorney’s response) are filed, there may be oral arguments before a federal court judge. The federal judge then issues his or her decision.

Our firm can assist you at every step of this process, from the initial application to a federal district court filing. Call (800)525-7111 to speak with the attorneys at Riddle & Brantley, LLP.