Social Security Disability Appeals

Why Could My Claim Have Been Denied?

In New York the Social Security Administration utilizes state disability agencies to decide initial claims using their rules. The state agency will attempt to obtain medical records going back in time for a year prior to the application. They will also attempt to obtain consultative examinations from local doctors and work history from you. Often times their attempts result in an incomplete record. Further the analyst are often overworked and under trained to deal with the complex legal and medical determination they are asked to make. As a result errors and omissions occur that will result in an initial claim being denied that should not be. Our knowledge and experience help us to pinpoint where these errors and omissions occurred, request a disability hearing and help get you back on the right track to obtaining your disability benefits.

Levels of SSDI Appeals:

Administrative Law Judge hearing: You must request review of an initial denial in writing. You may do so by writing to the Social Security Administration, visiting a local office of Social Security, or on Social Security’s website at www.ssa.gov. A request for a hearing is a request that an employee of Social Security known as an Administrative Law Judge review your case and issue a new and independent decision on the claim. You may request to have a hearing with the Administrative Law Judge where you can explain your case to them. At this stage most claimant who are represented by an attorney are approved. In the Syracuse and Albany areas the wait times for a hearing are in excess of a year and a half (1 ½ years).

Appeals Council Review: You must request review in writing. You may do so by writing to the Appeals Council directly or visiting a local office of Social Security. The Appeals Council is the last stage of administrative appeal within Social Security. More than eighty (80%) of cases presented to the Appeals Council are rejected. If the Appeals Council decides to review your case, it will either decide your case itself or return it to an Administrative Law Judge for further development and review. When the Appeals Council reviews your case it may consider any of the issues considered by the Administrative Law Judge, including those issues that were decided in your favor. It may also review new and material evidence that was not presented to the Administrative Law Judge.

Civil Suit in a Federal Court: If you disagree with the Appeals Council’s decision you may then file a civil lawsuit in a federal district court. If you bring a civil action seeking judicial review of the SSA’s final decision the Federal Court will review your claim under a deferential standard known as substantial evidence. There is a fee for filing a civil action in Federal court, which, can be waived based on financial circumstances.