What is the Process to Appeal a Social Security Disability Denial?

Individuals often pursue social security disability benefits when they are unable to work due to a long-term injury or illness. To qualify for these benefits, individuals must be unable to engage in a substantial gainful activity because of their medical condition. They must also have worked for a certain number of years and paid a sufficient amount into the system.

Not surprisingly, applications for social security disability benefits are frequently denied for various reasons. In fact, it is not unusual for an applicant to have to submit his or her application for benefits multiple times before it is finally approved.

An experienced social security disability benefits lawyer in your area could assist you with submitting all of the necessary documentation and filing an application for benefits. If your application is denied, your attorney could assist you with filing an appeal of the claim denial and pursuing the disability benefits that you need.

Why are Social Security Disability Benefits Applications Routinely Denied?

There are several reasons why social security disability benefit applications are routinely denied by insurance companies. In some instances, the applicant fails to follow the necessary procedural protocols to obtain benefits. At other times, the benefits application lacks the necessary medical documentation. In order to qualify for benefits, an applicant will typically show, based upon medical evidence, that an injury or illness prevents them from engaging in a substantial gainful activity. If that medical documentation is not present in the application packet, the insurance company will most likely deny the benefits claim.

What are the Steps for Appealing a Benefits Denial?

Insurance companies are required to give you at least one opportunity to administratively appeal a benefits claim denial. If the insurance company denies your claim for benefits, it must send you a letter stating why your application has been denied. The letter must also outline the steps that you need to take in order to file an administrative appeal. You should follow the steps indicated in the letter exactly and provide the insurance company with all of the requested documentation, in hopes that the benefits denial decision will be reversed.

Once you have exhausted all of the administrative remedies offered by your insurance company, you then have the option of filing a federal lawsuit if your claim is still denied. It is important that you supplement the record with all of the necessary medical documentation at the administrative level because once a lawsuit is filed, you will no longer be able to add medical records and other documentation. In federal court, a judge will make the final determination about whether or not you are entitled to receive disability benefits.

A knowledgeable social security disability benefits attorney in your area can assist you with taking all the necessary steps to file a benefits claim. Then, if your claim is denied, your lawyer can assist you with administratively appealing the denial – and if necessary, with filing a lawsuit against your insurance company in the federal court system.