Denied Disability Claim With Valid Doctor Recommendation?

If the Social Security Administration has denied your claim for disability benefits, you have 60 days to appeal that decision.  There are four levels to your appeal: 

Reconsideration Appeal Stage

Like your original application for benefits, your appeal claim for reconsideration will be submitted to and processed by your local SSA office.  From there, a state agency’s Disability Determination Services (DDS) will receive your appeal, and closely examine your:

• Doctor’s recommendation
• Your medical history
• The reason why your original claim was denied
• All of the information you submit on your appeal forms

The DDS will also send you to be examined by a physician hired by the Social Security Administration.  This physician will:

• Consider your medical history
• Conduct a physical exam, and look at the severity of your condition
• Make a recommendation back to the Social Security Administration, offering his or her professional opinion as to whether or not you are able to perform certain tasks.

Most of the reconsideration process occurs without your presence, and you will be notified of the decision in writing. 

Hearing Appeal Stage

If you do not agree with the findings during reconsideration, you can request a hearing, during which an administrative law judge will examine your case.  This judge is objective in the sense that he or she has not been involved in the original case.  The judge will typically host the hearing near your home or offer a video conferencing options, and will let you know precisely when and where the hearing will occur.  You may also be asked to submit additional information in advance of that hearing.  You may also need to provide witnesses and hear from other medical and vocational professionals. 

After your input and that of witnesses has been taken into consideration, the administrative law judge will render his or her decision, and you will be informed of that decision in writing. 

Appeals Council Review Stage

Again, if you disagree with the outcome of the hearing, you can ask for a Social Security Appeals Council review.  If the Appeals Council agrees to the hearing decision, it may deny the request, much like the U.S. Supreme Court refuses to hear a case if the lower court’s ruling and reasoning were accurate in Court’s opinion.  The Appeals Council may also reconsider your case, or send it back to the administrative law judge for further consideration.  In each instance you will be informed in writing of the decision. 

Federal Court Stage

If the Appeals Council did not hear your case or you disagree with their findings you can file a lawsuit with a federal district court. 

Getting Help

As soon as your disability claim is denied, you should consult with an experienced disability attorney if you haven't already. Your lawyer can explain any and all options to you and can assist you throughout the appeals process in convincing the SSA that you are entitled to benefits.