Can a dire need letter help with appealing a denial of disability benefits?

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Question:

I was recently denied disability benefits even though I have a serious disability which requires expensive medication and ongoing treatment. I am falling behind on my mortgage and can hardly pay my bills. I am in fear of filing for bankruptcy and falling into foreclosure because these benefits are not being awarded. I hear a "dire need" letter can help with appeals? How do these work?

Answer:

If you have been denied disability benefits, you have the right to appeal that decision, but each step of the appeals process can take months or even more than a year. According to the SSA, in 2010 the average amount of time it took to process a request for a hearing was 426 days. If you can prove that you are in a “dire need situation,” your appeal may be handled faster. However, you need to wait until you have requested a hearing for a dire need letter to work.

Levels of Disability Appeal

Let's back up a bit. There are four levels of appeals in SSI and SSDI cases:

  1. • Reconsideration – You can ask the SSA to review the initial denial and a claims examiner will reconsider it.
  2. • Administrative Law Judge (ALJ) Hearing – If you disagree with the reconsideration decision, you can request a hearing before an ALJ.
  3. • Appeals Council Review – If you disagree with the ALJ’s decision, you can request an Appeals Council review.
  4. • Federal Court – If you disagree with the decision of the Appeals Council, you can file a civil action with the appropriate federal District Court.

The only thing a dire need letter can do for you is to get your ALJ hearing date scheduled faster. Of course, this can be significant, as it's not unusual for it to take a year to get a hearing date.

What Is a Dire Need Situation?

If you do not have food, shelter or medicine and are unable to obtain those things, and that results in an immediate threat to your health or safety, you may be considered to be in a dire need situation. If that is the case, your claim will be processed as a “critical case” and will move through the system faster.

If you are applying for SSI, it may seem like meeting the income and resource limitations for SSI automatically means you are in dire need, but the SSA has a narrower definition of dire need. 

How to Write a Dire Needs Letter

If you believe your circumstances qualify as a “dire needs situation,” you should write a letter explaining your situation to the SSA and to the hearings officer. You should include as much documentation as possible to support your claims of dire need. Remember, having a “hardship” is not enough. You must write about (and show with documentation, if possible) that you don’t have and cannot obtain food; that you need medicine or medical care and cannot obtain it; or that you do not have a place to stay (for example, if you are homeless and there is no room in a shelter for you, or if you are facing immediate eviction and have no other place to stay). If your utilities (electricity and gas) or water are about to be turned off, include that as well.

You should be as specific as possible in your letter, and when possible include details like dates and locations. For example, you could write that on a specific date you were told by a specific worker at a specific shelter that the shelter was full and you should not check back for a specific number of days. Although you should be as detailed as possible, make sure you do not exaggerate or make things up. 

Where to Send Your Dire Needs Letter

You send your letter to your regional Office of Disability Adjudication and Review (ODAR, formerly the Office of Hearings and Appeals). Call you local SSA field office to find the closest ODAR office and its address.

Getting Help

You might want to consider hiring a representative to help you through this process. Many areas have legal aid clinics that assist low-income people in filing and appealing disability claims. And in general, disability lawyers take Social Security disability cases on a contingency basis; if you don't win back pay from Social Sec

If you have questions about whether or not your case qualifies as a dire need case, the SSA recommends you call the Congressional and Public Affairs Branch at 703-605-8000. You can also call your local SSA office and they should be able to assist you or at least point you in the right direction. 

by: , Contributing Author

This article is provided for informational purposes only. If you need legal advice or representation,
click here to have an attorney review your case .

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