How to Improve Your Chances of Winning a Disability Appeal
These tips can help you turn an SSDI denial into an award of benefits.
Frustration. Emotion. Despair.
You may feel all these emotions when you receive a Social Security Administration (SSA) letter denying your Social Security Disability Insurance (SSDI) application. These SSDI benefits would provide financial security and medical treatment for you and your family.
We have good news.
First, you are not alone. Over the past fifteen years, the SSA has denied approximately 65% of initial SSDI applications from disabled workers. Even applicants who receive an award must win one or more SSDI appeals first.
Second, the SSDI appeal process has multiple tiers. You can—and often should—appeal the SSDI denial to increase the likelihood that Social Security approves your claim.
Read on to learn why appealing a denied SSDI application is essential and what steps you can take to improve your chances of winning.
If you need help with your application, call our disability law firm today at 804-251-1620 or 757-810-5614 or complete our online form. We have won SSDI appeals for thousands of disabled workers. Let us do the same for you.
List of Tips to Win Your SSDI Appeal
Here are tips to increase your chances of a successful SSDI appeal.
Tip #1: Know where you are in the SSDI appeal process
All Social Security disability insurance claims can go through four levels of administrative review:
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- The initial determination for your application, which your state’s Disability Determination Services (DDS) will make
In addition, if the SSA denies your SSDI appeal at these levels, you can file a civil lawsuit (complaint) in federal court. And once in federal court, your SSDI claim may go through multiple appeals.
Where you are in the SSDI appeal process determines how the SSA or federal court reviews your case.
For example, the administrative law judge reviews your case de novo, meaning the lower-level findings do not bind the ALJ.
In contrast, federal court judges review the ALJ’s denial decision to see if substantial evidence supports it.
Tailor your arguments based on the review standard applicable to your SSDI appeal.
Tip #2: Appeal all SSDI denials within 60 days
Failing to appeal a denial is the biggest mistake you can make with your SSDI application.
You have 60 days to appeal an SSDI denial at each level of the administrative process.
This same time frame applies to filing a lawsuit in federal court if the Social Security Administration denies your claim at the last level.
Appeal all denials within 60 days or risk starting over. Having to start your SSDI claim from scratch increases the time you must go without income and waives some of the disability back pay you could receive if you win your SSDI appeal.
Tip #3: Obtain a copy of Social Security’s file to ensure it has all medical records and the correct earnings information
SSA regulations require the agency to gather your medical records or at least request them twice.
However, I recommend you request and review your claim file to confirm that the SSA has all your medical records.
I have seen too many files where the SSA denied a claim at the lower levels based on incomplete reports or gave up because a doctor’s office did not respond to a records request.
If your file still needs to be completed, ask the SSA to try to obtain the reports again. Or, ask your doctor to send you the office visit notes and diagnostic imaging directly. Then, you can give Social Security a copy of the paperwork.
In addition, check the earnings information to ensure that SSA is not reviewing jobs you never held.
You must prove that you are unable to perform past relevant work. If your file includes lighter exertional level jobs you never held, there is an increased risk of a denied SSDI claim. You will want to correct this information.
Tip #4: Continue to receive medical care
Out of more than one thousand disability hearings I have handled on the East Coast of the United States, I can count on one hand the number of times a client’s testimony was insufficient to win an SSDI case.
But testimony is not enough.
You also need medical documents that support your testimony during the SSDI process.
The only way to obtain this evidence is to continue receiving the appropriate medical treatment while your disability claim is pending. Even if you do not feel your doctors are helping, I still recommend following your medical providers’ treatment recommendations and following up regularly.
Otherwise, the SSA may find the medical reports do not support the nature and extent of the symptoms you allege and deny your claim. Some ALJs, not understanding the difficulty of obtaining health care when you do not have insurance or income, may say that you would have continued going to the doctor if your symptoms were that bad.
I disagree with that mindset. However, it exists, and you should keep going to the doctor to help you win your SSDI appeal.
Tip #5: Figure out why DDS or the SSA denied your claim
You can determine why DDS or the SSA denied your claim by reading the denial letter, ALJ decision, and DDS transmittals (state agency determination letters) within your claim file.
I recommend reviewing these documents to see which step of the five-step sequential evaluation process led to your denial.
For example, suppose DDS finds you can return to your past employment. In that case, you should develop evidence and give testimony that explains why your past employment required more exertion or mental demands than DDS found.
Tip #6: Read Social Security’s Listing of Impairments
Some medical impairments are so severe that the SSA will consider you disabled automatically.
You can find these conditions in the SSA’s Listing of Impairments.
I recommend looking for the listings that best match your medical conditions and reading the SSA criteria to decide if you meet a listing.
This information helps you in two ways.
First, it shows what evidence the SSA will examine to determine if you are disabled. You can use this knowledge to present testimony at the next stage of your SSDI appeal.
Second, the listings tell you what evidence to gather to increase the likelihood of winning your claim. For example, you may need a written prescription for an assistive device (cane, crutch, walker, wheelchair) or an MRI that shows a herniated disc compressing a spinal nerve root to meet a listing. Therefore, you will want to obtain copies of these medical papers.
Tip #7: Start to think in terms of work capacity
You will not win an SSDI appeal or persuade the ALJ that you are disabled by telling Social Security how much you hurt.
General statements lose. You must give details on how your symptoms impact your work capacity.
I recommend you find a written job description for the jobs you have held in the past five years.
Read the physical and mental demands for each position, then think about how symptoms from your medical impairments limit your ability to do each physical or mental task.
You can also review my article on residual functional capacity (RFC) to learn more about how the SSA determines disability.
At a minimum, you must use the disability forms (such as the SSA-3373 Adult Function Report) and your hearing testimony to tell the SSA how much you can lift, carry, push, pull, or reach, how long you can sit, stand, walk, or concentrate, and what problems you have interacting with others.
Tip #8: Be honest
Be truthful.
As I said earlier in the article, a claimant’s testimony is usually good enough to win an SSDI appeal—if Social Security believes it.
Therefore, you must protect your credibility at every stage.
Do not exaggerate your symptoms or give false information when competing paperwork. For example, do not testify that you use a cane all the time if you show up to the hearing without one.
Credibility is hard to get back once lost.
Tip #9: Know what vocational evidence the SSA uses to decide you can do other work
Proving that you can no longer do your past relevant work is a start.
Depending on your age, you may also need to exclude other jobs in significant numbers in the national economy.
The SSA uses vocational experts (VEs) and the Dictionary of Occupational Titles to decide if other jobs exist.
Research what types of hypothetical questions to ask the vocational expert in your case to exclude all jobs and how to attack the foundation of testimony that finds you can perform other jobs.
In my experience, unfounded VE testimony is a great wait to reverse a denied SSDI claim on appeal.
Tip #10: Attend all scheduled consultative examinations (CEs)
The SSA may schedule a consultative exam with a doctor you have never seen or heard of.
Attend the appointment.
Otherwise, the SSA will likely say it needs more evidence to award your claim at the initial or reconsideration level and deny your application.
Tip #11: Make sure your doctor knows your symptoms and limitations
Talking to a doctor can be intimidating.
This intimidation factor, combined with the fact that doctors are busy, may cause you to avoid discussing all your symptoms and how they limit your daily living activities or work capacity at medical appointments.
Try to overcome this fear and tell your doctor everything.
Then, get copies of your reports and confirm the doctor wrote down what you told them about your symptoms and limitations.
If your office visit note needs more information, bring this up at the next visit and ask your doctor to document all your complaints.
Many physicians need to become more familiar with SSDI appeals and need an explanation of what Social Security looks for when reviewing applications.
Having this information in your reports establishes your credibility with the SSA. In addition, accurate medical records make it easier for the doctor to complete forms addressing your RFC.
Tip #12: Hire a disability attorney
Some people wait until the ALJ hearing level to hire a disability lawyer.
People who are organized with paperwork and can read and understand the Social Security Administration’s regulations can usually wait to hire a lawyer until they receive a denial at the initial or reconsideration levels.
However, hiring a skilled disability lawyer at the ALJ hearing stage (or earlier if you need help with the paperwork and evidence development) can improve your chances of success because an advocate can:
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- Assess your claim’s strengths and weaknesses.
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- Gather evidence to minimize your claim’s weaknesses.
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- Prepare you for testifying before the ALJ assigned to your case.
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- Ensure you meet all deadlines, including those for appeals and the submission of evidence before the hearing (the five-day rule).
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- Communicate with your doctors about the types of reports that can help win an SSDI appeal
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- Educate you on disability law and how the SSA determines applications
Need Help with Your SSDI Appeal?
The right approach can help you successfully appeal a denied SSDI claim.
Contact us today if you need help preparing the best SSDI appeal possible. With Virginia, Maryland, and Florida offices, we help disability applicants nationwide.
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