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What if a Social Security benefits claim is denied?

On Behalf of | Nov 10, 2021 | Firm News

The Social Security Administration rejects about two-thirds of the applicants who initially file a claim. There are many reasons why a claim gets denied, and sometimes it is simply a missed deadline or error in the paperwork. The good news is that the injured claimant has several opportunities to appeal that denial. Like the legal system’s step-by-step appeals process, the worker can appeal the denial of benefits.

Claimants often increase their odds of success by working with an attorney who understands the process and can prepare the client for it. They can also help uncover new evidence and enlist expert witnesses like a physician to support the claim.

Four steps to an appeal

The circumstances of each worker’s initial denial are different, so this progression is considered a fair and accurate way to address a claim. It’s important to note that there are deadlines for claimants to pursue these options:

  1. Reconsideration: This basically involves refiling the claim, using updated supporting information or following appropriate protocols. There is also about a one-third approval rate with a reconsideration.
  2. Disability hearing: Depending upon the complexity of the claim, these are relatively informal and can be as short as 15 minutes. The claimant appears before an administrative judge to support their claim. They may also bring along an expert witness or legal representative.
  3. Review by the SSA Appeals Council: They may accept or deny the request. If it is accepted, it is either reviewed by the Appeals Council or sent back to the administrative law judge. The hearing takes place at the Social Security office. The claimant and representative may then present their case.
  4. File a civil suit in federal district court: This involves the Social Security Administration and the claimant arguing the case with documentation, witnesses and representation.

While the approval rate is about 33.3% in the first two stages, the chances of success go up in the later stages.

Workers deserve these benefits

It’s important to remember that the Social Security Disability program is run by the government, with all workers supporting it through payroll deductions. Applicants are looking for the benefits they deserve when they cannot work due to injury or illness. Nevertheless, claimants can increase their odds by using an experienced and well-organized representation.