Social Security Disability Lawyers In Pa – Disability benefits are designed to help people with serious illnesses or injuries pay for medical bills and other expenses while their health prevents them from working. At the end of 2019, the SSA (Social Security Administration) reported that over 16 million Americans had some form of disability, with an average monthly benefit of $1,259. However, it is a very difficult process that often requires applicants to appeal to qualify. In this post, the Philadelphia disability attorneys at Young Marr & Associates explain how the appeals process works and what to do if your Social Security disability claim has been denied.
Unfortunately, obtaining a disability certificate is not an easy task. Applying may seem like a simple task, but once the SSA receives the application, it goes through a very rigorous review process that often ends with a denial notice.
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Statistically, it is much more likely to be rejected than approved. The national average rejection rate is around 65%, which means that only 35% of applicants, or only one-third, are approved. Pennsylvania’s denial rate is estimated to be between 63% and 69%, which is about the same as the national denial rate.
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If you’re like most disability applicants, your application for monthly benefits will likely be rejected, at least initially. The good news is that it doesn’t have to be a final denial. Even if you have already been rejected by the SSA, there are additional steps you can take to get approved.
Before you begin the appeals process, however, you should be sure you understand why the SSA denied your claim. This will increase your chances of getting approved on your next attempt.
There are two basic categories of rejection. One is a less common technical disclaimer and the other is a common medical disclaimer.
Common reasons for technical denials include missing deadlines or excessive earnings ($1,310 or more per month or $2,190 or more per month for blind claimants).
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A medical denial usually occurs when the applicant’s disability does not meet the severity criteria of the Blue Book or Disability List, or when the health condition does not meet the SSA’s 12-month time period requirement. (However, there are some exceptions for very advanced and serious illnesses called “compassionate benefits”).
One of the key elements required for a permanent disability claim is solid medical documentation and evidence supporting the severity of the condition. Without sufficient medical evidence, it is almost impossible to prove that your symptoms affect your ability to work. Not only must your medical records meet the SSA’s criteria for your specific condition, but you must also have evidence that shows you are unable to perform normal work-related tasks.
Medical evidence of your condition is essential, but so is the continuation of your prescribed treatment. If you do not follow your doctor’s instructions about retreatment, your chances will be much lower.
While it is important to have proof of your disability, it is equally important to follow the treatment prescribed by your doctor. Failure to complete medical treatment or recommendations greatly increases the likelihood of your claim being denied. The SSA must determine whether your condition is treatable in order to determine whether you can work. If you do not follow the doctor’s recommendations or treatments, SSA will not be able to assess whether your condition will improve.
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When a claim is denied, it is not uncommon for people to think that the best option available is to file another claim in hopes of not making the same mistakes that caused the first denial. However, it is best to appeal a rejected claim. Submitting additional evidence instead of submitting new evidence. If the SSA examiner notices that you previously filed a denied claim, he or she will likely deny your new claim. When you dispute a claim, you submit new evidence and demonstrate your efforts to uphold the original claim.
Another thing to remember is that cooperation is a key element of the application and appeal process. If you don’t cooperate, don’t meet the deadlines, or don’t provide the information the SSA requests, your claim or appeal will likely be denied. This includes keeping scheduled medical appointments and meetings with SSA.
If your claim is denied, the SSA must send you a written notice explaining the reasons for the decision. If you do not agree with this explanation, you may wish to file a dispute.
The appeal process follows a series of steps. Exactly how many of these steps you need to take depends on how your claim is assessed at each stage.
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The first step in the appeals process is to submit the initial denial of benefits or application for termination. If your initial application is denied, you will receive a denial notice with information about your right to appeal. The notice will contain text explaining your medical disability.
When the SSA considers a claim, it will be a full review. This review is carried out by Disability Determination Services (DDS). However, the actual review is carried out by medical examiners and consultants who were not involved in the original decision. Basically, the SSA gets a new pair of eyes to review your initial claim.
If your claim is rejected at the reconsideration level, you will receive a rejection notice and an explanation of why your claim was rejected. The next step after a denial of review is to request a hearing before an administrative law judge.
Even if your initial claim is approved, it will continue to be reviewed from time to time. This process is called a Continuing Disability Review (CDR). At this point, SSA can remove your disability for a variety of reasons. For example, your condition may have improved, you may be working on SGA, or you may have been uncooperative during the testing process.
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If your disability benefits end, you can appeal the decision by applying for a reconsideration of your CDR. The first step in a reexamination of termination benefits is another review by a medical examiner and another consultant. If benefits are not returned, your case will be referred to a Disability Hearing Officer (DHO).
The DHO will form an independent medical opinion regarding the severity and impact of your health condition. The most important thing here is that the SSA must provide evidence that your condition has improved. This is a medical decision and the SSA must consider your doctor’s opinion. If the DHO rules against you, you can request a hearing before an administrative law judge.
If you request reconsideration, whether for the original claim or for the purpose of stopping benefits, you must request a hearing with an administrative law judge. This request must be made within 60 days of the refusal.
ALJs are attorneys who work with the SSA’s Office of Hearings (OHO). A significant part of their work involves reviewing decisions to deny initial claims or terminate disability benefits. Usually, at this level, claims are won in about 50% of cases. However, it is recommended that you be represented at your ALJ hearing by an experienced Doylestown disability attorney.
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If you lose your appeal before an ALJ, you have the right to ask the Board of Appeals to review your claim. The Appeals Board randomly selects cases for review and has discretion to deny, grant or deny requests for review. In addition, the Appeals Board may reject your claim without examination, unless certain circumstances can be proven.
First, there must be an abuse of discretion. For example, the hearing may have been accidentally cut short. This abuse may also involve legal or procedural errors, such as not allowing the prosecutor to cross-examine a witness.
An ALJ’s decision must be supported by substantial evidence. If not, the decision must be re-examined in the Appeals Council.
Important deadlines for filing an appeal. If you file a late objection or miss the deadline, your case may be dismissed without review.
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From a procedural standpoint, the Board of Appeals will look for flaws in the ALJ’s decision before granting review of your case. They are unlikely to succeed at the appeal board level. Only about 1% of denials are considered and overturned. About 10% will be sent back to the ALJ with instructions to review the claim. You should not take this step without an experienced disability attorney to advise on your position.
It may seem hopeful, but if you want to continue fighting for your claim, you must complete the Social Security appeals process before filing your claim in federal court.
The next step in appealing a denied disability claim is to file a lawsuit in U.S. District Court. If you haven’t hired a Bucks County disability attorney for any reason, you should do so now.
A federal judge will hear your disability case without a jury. Technically, the judge is supposed to examine the claim and determine whether a legal error has occurred. However, some judges also consider questions of fact. In most cases, a federal judge will not overturn a decision by the ALJor’s appeals committee. However, in about half of the cases heard by federal judges, the federal judge remands or remands the disability case. They often direct the SSA to review the treating physician’s medical opinion and the claimant’s symptoms.
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The chances of winning a federal appeal or being reinstated by the SSA are relatively high, but the process
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