What Does it Mean to
Appeal a Disability Denial?
The Social Security disability decision making process is unlike most legal proceedings in that you will need to be alert to quick decisions and you will be required to file written appeals within very short time limits.
In every State, you must start your Social Security claim by either calling the Social Security Administration at 800-772-1213, visiting your local Social Security office or applying online. Thereafter, your claim will be assigned to a disability adjudicator, who will request medical and other records. Once these records are collected, your adjudicator will organize the records and give your file to a physician or psychologist who contracts with Social Security to review records. This process is called the initial application phase of your case.
The reviewing physician/psychologist will evaluate your case based on the medical records in the file. The reviewing doctor will prepare a written report - which becomes part of your claims file - and return the file to the adjudicator. Although some deserving cases are approved at initial, many are not. There are many reasons why a deserving case is not approved at the initial application phase so you should not be discouraged if your case is turned down.
Once the adjudicator decides to turn down your claim, he will issue a denial notice that sets forth the reason for the denial and identifies the medical records used in making the decision. The denial notice will also advise you that you need to appeal within sixty (60) days of your receipt of the denial notice, and it will contain the address where you should mail your appeal.
It is very important that you file your appeal in a timely manner. If you do not file your appeal, your case will be closed and you will have to start over again, thereby adding more delay to your case.
Appeal Forms to File and Where to File Them
Although Social Security is a national program, every State has its own rules for the processing of Social Security disability claims. In some States, the appeal form used after an initial denial is called a Request for Reconsideration. In other States, there is no reconsideration and your next step is a Request for Hearing.
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You should mail your appeal to the appeal address shown on your denial notice, preferably by registered mail, return receipt requested.
If you have misplaced the address for appeal, call SSA at 800-772-1213 to ask for a mailing address. Otherwise, look up the address in the phone book. If you are nearing the 60 day deadline, hand deliver your appeal to your nearest Social Security office and make sure to get a receipt for your filing.
Even if you send your appeal to the Social Security Administration at the wrong address, your appeal date will most likely be protected as long as someone, somewhere at Social Security received it. Even a fax will suffice.
Similarly, if you cannot download the appeal form, prepare something in writing that references your name and Social Security number along with a statement that you want to appeal, and get it to SSA.
Whenever possible, always include two or three blank Medical Authorization forms (form SSA-827) along with your appeal.
Much has been written about how to fill out Social Security’s forms, but try to keep two points in mind:
- the big picture issue in your Social Security claim is whether or not you can perform simple, unskilled employment. Make sure to give Social Security information that addresses your work capacity
- provide SSA with the name and address of every health care provider you have seen, and with every possible medical condition you have (even if not formally diagnosed). For example, most claimants suffer some level of depression as a result of not being able to work. If you allege depression, it is likely that SSA will send you out for a free consultative examination with a licensed psychologist. In many cases, this evaluation will result in the imposition of minor to significant vocational limitations on you, thereby improving your chances at receiving disability.
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