After claimants go through the long process of completing paperwork to apply for Social Security disability benefits, it is common for them to receive the unfortunate news that their claim has been denied. The Social Security Administration (SSA)’s initial review is conducted by a state agency, the Disability Determination Bureau (DDB). The DDB is responsible for processing the claim, ordering consultative examinations if necessary, obtaining medical records, and determining whether the claimant meets the standards of Social Security disability benefits.
Request for Reconsideration
About 75% of claims for Social Security Disability Insurance and Supplemental Security Insurance are denied. A claimant has a maximum of 65 days from the date of the denial letter to appeal the decision. It is of the utmost importance to file a timely appeal. Otherwise, a denied claimant may be forced to file a new claim unless they can prove that there was an exceptional circumstance to explain why their appeal was not timely filed. When the claimant is appealing the DDB’s initial denial, this is called a “request for reconsideration.” A claimant has the right to legal representation and a qualified attorney can help a claimant file a request for reconsideration.
The chances of success at the request for reconsideration level are grim. Over 90% of all requests for reconsideration are denied. Because of the high rate of denial, some believe that the request for reconsideration stage results in rubber stamp denials. In fact, some states, like Michigan and Pennsylvania, have actually eliminated the request for reconsideration stage. However, Indiana still requires a denied claimant to file a request for reconsideration. Filing a request for reconsideration involves submitting an appeal in writing or online at the following website: http://www.ssa.gov/online/ssa-3441.html. In addition, the claimant must provide the DDB with updated medical information in a disability appeal report found here: (.pdf file of Disability Appeal Report, Adobe Acrobat required).
Request for a Hearing Before an Administrative Law Judge
If a claimant’s request for reconsideration is denied, then the next step is to file a request for a hearing. Statistically speaking, a claimant’s chances of being approved are much higher at the hearing level. Filing a request for a hearing includes essentially the same steps as filing a request for reconsideration. The claimant or his or her representative must file the request for a hearing within 65 days of the date of the denial letter and must include a disability appeal report. Again, the claimant or their appointed representative can file their request electronically or in writing. As of May 2013, the average wait time for a hearing is between 5.5-16.5 months (depending on location) from the time a hearing is requested.
Obtaining Legal Representation
Although the waiting process for a Social Security disability claim is long, the wait may be worth it if the claimant can prove that they are entitled to disability benefits. A claimant’s chances of success improve significantly when they are represented by a skilled attorney. The claimant is entitled to legal representation at any stage of the Social Security disability claims process. The fees for an attorney in a Social Security disability case are regulated by the SSA. Generally speaking, an attorney can receive 25% of the claimant’s back benefits up to $6,000. For example, if a claimant’s back benefits are $10,000 and the attorney has requested fees for their representation, then the attorney will receive $2,500. If the claimant’s back benefits are $25,000, then the attorney will receive $6,000 – the maximum under the rules governing Social Security disability cases. Although these general rules apply, please be sure to consult with the attorney about other expenses or fees associated with their legal representation.
Contact O’Ryan Law Firm
The O’Ryan Law Firm handles Social Security disability claims and may be able to help you if your benefits have been denied. Please contact the O’Ryan Law Firm at 317-255-7010 today so that we may investigate your Social Security disability claim.