Denied Social Security Disability… Now What?

The majority of claims for Social Security Disability benefits are denied at the initial level and at all the subsequent appeals levels. If you find yourself in this situation, what are your options?

You may be wondering:

“I’ve been denied Social Security Disability. Now what?”

“The reality is, most initial applications for disability are denied. Don’t be discouraged. You do have options for appealing your denial.”

-Scott Scurfield, Riddle & Brantley disability attorney and Board-Certified Specialist

If you’ve been denied Social Security disability, here are your options for appeal:

If your initial application is denied:

Most initial applications for benefits are denied by Disability Determination Services (“DDS”), the agency of the State of North Carolina that evaluates whether you qualify for benefits under the Social Security Administration’s (“SSA’s”) disability benefits program. In fact, statistics show that roughly 70 percent of initial claims are denied at the initial level.

After filing an initial application and waiting an average of several months, unsuccessful Claimants receive a letter from DDS telling them why their claim was denied, and the medical records and other documents on which the denial was based. If you receive such a denial letter, you have sixty (60) days to ask DDS to “reconsider” their denial.

“Reconsideration” is the next stage of the process. Instructions for how to ask for reconsideration are contained in the denial letter. Generally, it must be done either in person at a Social Security field office or in writing by the claimant or his/her disability attorney. Once you ask for reconsideration, you (once again) wait for an answer.

If your request for reconsideration is denied:

Reconsideration is supposed to be a thorough, complete review of your claim by a different individual at DDS, one who was not involved in the initial review. In theory, that new person is also supposed to review any additional evidence you or your attorney can gather and submit that was not considered at the initial level.

However, in reality, only a very small percentage of claims that are denied at the initial level are awarded benefits at the reconsideration level (less than 10%). And, the reconsideration phase itself typically takes another two to three months following your initial denial.

If you are denied at the reconsideration phase, you have another sixty (60) days to request a hearing before an Administrative Law Judge (ALJ).  So, the practical effect of the reconsideration phase is to put another roadblock between your claim and a full, fair hearing before an ALJ.

If your claim is denied after a hearing before an ALJ:

Your odds of success before an ALJ are significantly higher than they are at the reconsideration phase. Across the board, roughly 40% of claims heard by ALJ’s result in awards of benefits. However, if you find yourself in the unfortunate majority of claims that are denied again at this third step, your only recourse (other than starting a new claim) is to ask the Appeals Council to review the ALJ’s decision for errors or other problems justifying a reversal or a new hearing. Here again, you have sixty (60) days from the ALJ’s denial to seek review by the Appeals Council.

The Appeals Council will sometimes review ALJ decisions on their own, without the claimant asking for their help. In fact, they review a certain number of FAVORABLE decisions each year as a sort of “quality control” measure, to make sure that ALJ’s are doing their jobs properly. This is called “own motion review” by the Appeals Council, and it can be very scary for a claimant who has run the gauntlet of the system for a year or more, gotten approved by an ALJ after a hearing, and now faces the prospect of the Appeals Council taking their benefits away.

If your appeal is denied by the Appeals Council:

If an ALJ rules against you and the Appeals Council finds no fault with the ALJ’s denial, your next level of appeal is to the United States Federal District Court for your geographical area, and again, you must do this within sixty (60) days of the Appeals Council’s denial.

In North Carolina, there are three federal judicial districts – the Eastern, Middle, and Western – each with its own set of federal judges and magistrate judges. Appeals of disability denials from the Appeals Council are decided by these federal judges based on their review of the written record, the transcript from your ALJ hearing, and briefs written by attorneys for the claimant and for the SSA.

Keep in mind there is no such thing as a “trial” in federal court; at most, the federal court judge assigned to hear your appeal may summon the lawyers to his or her courtroom for oral arguments. Federal court appeals of disability cases can take anywhere from six months to two years to be decided; they do not seem to be a priority item for federal judges even though claimants are often extremely pressed financially.

If your Federal Court appeal is denied:

Here again, your odds of success are better in federal court than they are at the Appeals Council.  Just shy of half the appeals heard by federal court judges result in either reversals of the ALJ’s denial or remands of the case back to the ALJ to fix errors.

However, that leaves over half of these cases denied, and if this is where your case falls, your next level of appeal (again, within sixty days) is to the United States Circuit Court of Appeals, which is just one level below the United States Supreme Court.

Very few disability cases are appealed to the federal Circuit Court of Appeals. It takes experienced, knowledgeable attorneys to successfully take a case to this level, and lawyers who know their stuff only do so when they conclude that a case is both likely to succeed and to make good law going forward.

At any point in this process, you always have the ability to withdraw your claim. Maybe your medical condition improves, or maybe you find a job you can do even with the medical or mental health problems that put you out of work. There is never any penalty for withdrawing a disability claim. And, if you do withdraw your claim and then find that you cannot work after all, you can always open a new claim and start over. You are not penalized in any way for re-starting a new claim after withdrawing one.

The process of applying for disability benefits and appealing denials within the Social Security system can be complicated, stressful and time-consuming.

An experienced North Carolina disability lawyer can help.

Do you need to file a disability claim or appeal a denial?

The Riddle & Brantley disability law team exists to help our clients at every stage of the disability application and appeals process.

Our team is led by Scott Scurfield, a Board-Certified Specialist who is recognized by the NC State Bar for his experience and proficiency in handling these types of cases.

Scott and his team would love to help you if they can.

If you are unable to work and have been denied Social Security disability benefits, or are thinking about filing a claim, please call 1-800-525-7111 for a FREE consultation and case review.

We will review your case, advise you on your best legal options and if you decide to hire us, we will fight tirelessly for the disability benefits you need and deserve.

Call 1-800-525-7111 today and let’s review your case.

You may be entitled to significant disability benefits that can dramatically improve your quality of life, reduce stress, and decrease the challenges associated with expensive medical bills and other expenses.

Justice Counts for North Carolinians with disabilities and we would love to help you obtain benefits if we can.