How do I appeal my Social Security Disability (SSDI/SSI) claim?

You filed your application for disability. You completed all of the paperwork that Social Security required you to complete. You attended all of your regularly scheduled appointments as well as the appointments Social Security scheduled for you. So, you are taken aback when you go to your mailbox and find that your application for disability has been denied. You try to figure out why your claim could possibly have been denied. Unfortunately, this is the story that over half of the applicants in the United States face on a daily basis. While there are millions of individuals approved for Social Security Disability benefits each year, more than 50% of the applicants who apply for disability will be denied. While there are a variety of factors that can result in a claim being denied, the focus of this article is to address the steps and the process you need to take to appeal your Social Security Disability claim.

Time limits to filing the appeal: Social Security gives applicants a limited amount of time to file an appeal. At all levels of the disability process, Social Security grants you sixty (60) days from the date posted on your decision notice to timely file an appeal. In most decision notices, Social Security will allow for a 5-day grace period to allow for the time it takes for the decision notice to be printed and delivered to your mailing address. At the maximum, you have sixty five (65) days to timely file an appeal.

How to appeal my decision: After you've determined to appeal your decision, you have two options for getting this accomplished. First, you can make an appointment with your local Social Security office. A representative will take your appeal application in the office. Any documents that require your signature to initiate the appeal should be completed during this visit. The other option is by appealing your decision online. The online application takes approximately 30 minutes to complete. If you decide to complete the application online, here are a few things you will need to complete the application in a timely manner.

1. You will need to have the personal decision notice handy. Most importantly, you will need the date on the decision notice. Social Security will ask you for this information to determine if you are filing an appeal timely.

2. You will need to provide a 3-5 sentence explanation detailing why you disagree with the decision and your reason for filing the appeal. It is ideal to make remarks about your condition(s) you feel like your personal decision notice did not give much emphasis to. For example, if your one of the primary complaints is leg pain as a result of low back pain, you can make a remark that you feel that Social Security did not investigate your claims of pains in your leg as it was not mentioned anywhere on your personal decision notice. While it may have been an oversight on the examiner's part who wrote your decision notice, the fact that you did not see any mention of it in your decision notice will give the next examiner/judge something to investigate to see if there's any validity to your claim.

3. You will need to detail any changes you have experienced in your condition(s) for better or worse since you received your decision notice. If you report that your condition(s) has declined or has gotten worse and is now affecting either a work activity or daily activity more so than you initially reported, this information could be enough to warrant further investigation and could quite possibly alter the way your appeal is processed.

4. You will need an updated treatment history of providers you've seen since you last spoke to someone at Social Security. Most individuals filing for disability are under continued doctor's care while their applications are being processed. Depending on how long ago you filed your application, your treatment history may be 3-6 months older and hasn't been updated. Putting updated treatment history on your appeal will put more pressure on your analyst to develop your claim even further. The more information Social Security is able to obtain about your condition(s) the greater your chances are of getting a more accurate and possibly more favorable assessment.

5. You will need to provide Social Security with any changes to your work history, if applicable. If you were not working during your previous case evaluation but then decided to return to work, you need to let Social Security know. While making a change from not working to working may seem counterproductive to your disability claim, it could very well have the opposite effect. Hypothetically, let's say the work you have performed over the past 15 years has been that of a construction worker. This work typically requires you to do a lot of standing and walking. In order to keep an income coming in, you decide to take a temporary job as a call center representative because it doesn't require a lot of standing and walking. One of primary reasons why you are alleging disability is a progressive worsening of peripheral arterial disease (PAD). Making an adjustment to less demanding work could possibly have a positive outlook on your application as you now have evidence that shows that your condition has significantly affected your ability to perform the relevant work that you've done in the past.

Consult a professional: If your claim has been denied, the reasons for the denial are not always evident. Every claim is different, so the facts surrounding each case are different. Having a lawyer or advocate review your decision notice and ask you case specific questions will help you make an informed decision about the possibility of winning your claim on appeal. Not all requests for appeal are successful. However, your chances of getting approved are increased with the assistance and guidance of a professional.

My firm offers consultations FREE of charge during business hours Monday through Friday. If you have questions about Social Security Disability, I have an answer for you. Get help with your Social Security Disability claim now.

Published February 5, 2020

Michael Vallien is a Baton Rouge-based non-attorney representative for Social Security Disability claims. He runs and operates Disability Blueprint, LLC, a firm dedicated to helping individuals get the Social Security Disability benefits they deserve.