Advice for appealing a denial of Social Security disability benefits
We regularly talk to Social Security disability claimants who are discouraged by the denial of their applications. They should not feel bad, for 65% of initial applications are denied.
However, the majority of claimants who appeal will ultimately be found disabled, so if you feel you cannot work you should appeal.
How to appeal a denial
The Social Security Administration (SSA) provides several ways to appeal. Whichever way you choose to appeal, it is a good idea to obtain proof that you appealed on time (so that if SSA loses your paperwork, which happens from time to time, you won't have to start over with your claim).
Go to your local Social Security office to file your appeal. You can find the address in your denial letter. Take along the denial letter, a list of current medications and a list of names and addresses of all medical care providers you have seen since you last updated SSA - since you filed your claim or last appealed - so that you can complete all appeal papers at the Social Security office with the help of a claims representative. Be sure the SSA claims representative gives you a copy of everything you submit and a receipt for your appeal.
Appeal by phone and mail. Telephone SSA at 1-800-772-1213 and explain that you want to appeal. You will be sent the appropriate appeal form, a Disability Report - Appeal, and an Authorization to Disclose Information to the Social Security Administration (SSA-827). Your appeal is not complete until you have mailed the appropriate appeal form back to SSA. Mail the appeal papers back by certified mail that requests a return receipt for merchandise.
Appeal online on SSA's website at https://secure.ssa.gov/apps6z/iAppeals/ap001.jsp. You'll need to have your denial letter handy. It takes only a few minutes to appeal online and you can print a confirmation that shows you timely appealed. You can also complete the Disability Report - Appeal online but this form takes more than a few minutes. Obtain a reentry number so that if you're timed out, you can get back in to finish the Disability Report - Appeal. You'll need the names and addresses of all medical care providers you have seen since you filed your claim or last appealed as well as a list of current medications.
The first level of appeal in most states is called a Request for Reconsideration. In ten states, claimants skip the reconsideration step and appeal by requesting a hearing. Your denial letter will tell you whether you must request reconsideration or a hearing.
Completing the reconsideration forms
Request for Reconsideration. This short form is easy to complete; most of the information requests are simple and self-explanatory.
Do not elaborate where the form says, "I do not agree with the determination made on the above claim and request reconsideration. My reasons are:"
Instead, simply write, "I am disabled."
Disability Report - Appeal. This form is designed to gather information about changes in your condition, new diagnoses, additional treatment, and changes in your daily activities since you filed your application. If there are no changes, it is OK to say so. If there are changes, describe any changes in your condition carefully. Do not exaggerate but do not minimize them either.
Focus on how your activities have changed since you last completed a disability report. If your activities are the same, you won't need to spend much time on the Disability Report - Appeal.
Be sure to provide SSA with a current list of medications and the name and address of every medical care provider you have seen since you filed your application.
Supplementing the reconsideration forms
If you have any additional relevant information such as medical records, etc, attach it to your appeal forms. Or if you appealed online, you can mail or take the additional information to the Social Security office address that appears on your denial letter.
Relevant information includes items bearing on your ability to function such as any disability findings from other entities like workers' compensation judges or insurance carriers, weak attendance records before withdrawal from school or job, or poor performance notices from school or work.
You have 65 days from the date on your denial letter to file your appeal. If you are late without "good cause," you will need to start over with a new application.
17 out of 20 claimants who file a Request for Reconsideration will have that request denied. Do not let a reconsideration denial discourage you. Begin work as soon as possible on your second and probably last appeal.
Most second appeals are granted, partly because SSA decision-makers at long last get to meet disability claimants and see for themselves the degree of impairment suffered.
Only one of the forms you need to file to start your second appeal will be new to you; the other two are repeats from your first appeal.
Completing the forms
Whether you appeal online or you complete paper forms, the information requested is the same. Here are tips for completing the paper forms:
Request for Hearing by Administrative Law Judge (form HA-501-U5). This is another short and easy-to-complete form.
Do not provide a detailed response to this question: "5. I request a hearing before an administrative law judge. I disagree with the determination made on my claim because:" You need respond only with, "I am disabled."
Interpret question 6, "I have additional evidence to submit" as asking whether you have something you want to submit in your possession right now. If so, check "Yes" and send the additional information to SSA. If you don't have anything to submit right now, check "No." You or the attorney you retain will certainly obtain additional evidence to submit before your hearing. A "No" in the checkbox on this form does not limit your right to submit evidence later.
Check "I wish to appear at a hearing" for question 7. It would be a mistake not to let the judge see and hear directly from you why you cannot work.
Do not put down the name of an attorney unless you have already completed all the representation papers, contract, etc., requested by the attorney.
Disability Report - Appeal (form SSA-3441-BK). You completed this form when you requested reconsideration. SSA needs information about changes in your condition, current medications and a list of all medical care providers you have seen since you requested reconsideration.
If your condition has changed, don't forget to provide as much detail as you can in "Section 7 - Information About Your Activities" and "Section 10 - Remarks" about how your disability is currently restricting your daily activities.
Authorization to Disclose Information to the Social Security Administration (SSA-827).You should also recognize this familiar form. Don't forget to have a witness sign and provide his or her telephone number or address. (If you completed the Request for Hearing and the Disability Report - Appeal online, your Social Security office will mail you this form to sign and return. When you receive it, you will know that your appeal is on track.)
After you have completed these forms, bring or mail them to your Social Security office. Its address should be on page four or five of your denial letter. Or you may call SSA at 1-800-772-1213 for the address.
Your next task is to select an attorney to represent you at the disability hearing. While shorter than a court trial and much less formal, a Social Security hearing requires no lesser amount of specialized training. If you would not choose to represent yourself in a courtroom when the stakes are high, you should not represent yourself in a Social Security disability hearing.
If your application has been denied and you are wondering whether it is worth appealing your Social Security disability case, consider obtaining an expert evaluation. Give us a brief description of your claim using the form to the right, and we will respond promptly.