What Happens If Your SSDI Application Is Denied?

Facing a Social Security disability benefits denial can be both frustrating and demoralizing. Sometimes, it may seem like the system is designed to exhaust you. However, it does not necessarily mean that you should give up your fight. You can appeal the Social Security Administration’s decision. The good news is that you may have a better chance of getting approved for the benefits you deserve once you attend a hearing with a disability judge. However, the bad news is that you generally will have to wait a long time to attend the hearing. 

If your application for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) benefits is denied, you would need to request an appeal within 60 days of the denial. In some cases, even if you have a legal representative, you must do so in person to “formally” file the appeals request as soon as possible. 

• Choosing to appeal

Surprisingly, most denied disability claims will not be appealed. In some cases, the claimant abandoned the procedure, filed an appeal too late, or filed a new claim (in error). Failure to appeal on time or file a new claim can have the same end result: the claimant’s loss of the right to appeal, requiring them to reapply for SSI or SSDI benefits. 

• Reconsideration review

If you disagree with the initial denial of benefits, you can start a Social Security Administration (SSA) appeal requesting a so-called reconsideration review. The denial letter you received will tell you how to request a reconsideration. Whether you appeal online or submit a hardcopy form, which you can find on the SSA’s reconsideration page), the SSA must receive your application within 60 days of when you received notification of the decision by email. 

The disability reviewer will review your file, including any new evidence that you provide, before they make their decision. The reconsideration process can take more than three months. 

Do not be surprised if you receive another rejection at this point. Almost all cases are rejected at the reconsideration review. However, completing this part of the process gives you the right to request a disability hearing, which can be more likely to be successful. 

• Request for a disability hearing

You would need to follow a very similar process to request a hearing with a disability judge. You can appeal online or submit a hearing request form within 60 days of receiving the reconsideration decision notice. At the same time or soon after (within 10 days), you would also need to submit other forms that contain the latest information about your medical condition, treatment that you have undergone, medications that you take, and activities you can perform.

• A long wait to see a disability judge 

In general, people have to wait an average of 15.3 months for a disability hearing date, but the wait time can vary greatly. Now is the hard part: waiting for your hearing. Research shows that nearly six out of every 10 applicants had to wait more than a year to obtain the hearing date. 

In different Social Security Offices across the country, the average waiting time for a hearing ranges from eight to 22 months. Unfortunately, you may face heavy financial pressure during the waiting period. 

But, if it is possible, you should continue seeing a doctor and taking your medications while you wait for your hearing. This can be difficult when you are not working and do not have health insurance. Some doctors may continue to see you after they know you have applied for Medicaid. You can also try going to a free clinic or a hospital emergency room. 

On the bright side, if you enter a higher age group while you are waiting for the hearing, you may have a better chance of receiving benefits. For example, if you are 60 years old (in some cases, 59 ½) at the time of the hearing, the SSA will apply different rules to people who are very close to retirement age, which can make it easier to prove disability. 

If you are physically capable of performing part-time work, please know that you may endanger your eligibility for benefits if you earn too much, which is what the SSA considers substantial paid activity ($1,310 per month in 2021).

What actually happens at the disability hearing? 

The appeal process can be quite lengthy and complex, especially if you do not know all the rules. It is better to have a professional by your side to avoid making mistakes. Disability hearings are informal and brief (usually 30 minutes to an hour) and are usually held in small conference rooms rather than courtrooms. The SSA may try to arrange your disability hearing through a videoconference, but you have the right to insist on attending the hearing in person. Video hearings may be more convenient and happen more quickly, but it may be easier to persuade a judge of your disability in person. 

The judge may start the hearing by asking you questions about what you can and cannot do because of your health. If you bring witnesses, they will have the opportunity to testify. In some cases, career experts will attend (usually over the phone) to answer questions about the jobs that restricted people might do. Sometimes the judge will have medical experts testify. You or your lawyer can ask the medical experts follow-up questions.

Consider hiring a Pittsburgh disability Lawyer to help you appeal a denial. An experienced attorney will understand the legal process and guide you through the process.