A common question I get from my clients is what to do if their claim is denied by an Administrative Law Judge (ALJ). This is a major decision point in the process for obtaining Social Security Disability benefits. The decision carries significant ramifications so it is important to consider the advantages and disadvantages before moving forward. In this post, I will discuss the options for someone whose claim for Social Security Disability benefits has been denied by an ALJ.
If the ALJ denied your claim for Social Security Disability benefits, you have one of two options:
1) You can decide to disregard your first claim and start fresh.
OR
2) You can also decide to appeal.
Because this decision really does have significant consequences going forward, I do strongly recommend consulting with an experienced Social Security Disability attorney. Choosing one path versus another may mean giving up some rights. While each Social Security Disability claim has its unique issues, here are some basic things to consider in deciding which path to pursue:
Appealing the ALJ’s Decision. If you have received an unfavorable decision from the ALJ, you can appeal this decision to the Appeals Council. In submitting an appeal to the Appeals Council, your attorney should submit legal briefing discussing why the ALJ made mistakes in his decision regarding your eligibility for disability benefits. The advantage to this route is that you keep your alleged onset date (the date you told the Social Security Administration you could no longer work) and protective filing date (the date you filed your application for Social Security Disability benefits). This is important because it means that your back pay would be based on those dates rather than a new date in a new claim. This can be a substantial sum of money. In addition, your Medicare and Medicaid eligibility would be based on the alleged onset dates and protective filing dates rather than a new date in a new claim.
The disadvantage of this path is that the appeals process is a long process. The Appeals Council can take from 12-14 months to decide your case. During this time you are not receiving any benefits. In addition, if they agree with the ALJ, you would have waited a long time and still not been able to receive any Social Security Disability benefits. For many people, waiting this long for benefits can be very difficult, if not impossible.
It is important to note that if you have received an unfavorable decision from the Appeals Council, you will be able to file an appeal in Federal Court. With your Federal Court appeal you will be able to also file a new claim with the Social Security Administration for Social Security Disability benefits. However, this will take still more time without receiving any benefits.
Starting a New Claim. If you have received an unfavorable decision from the ALJ, you can also start a new claim with the Social Security Administration. Starting a new claim can be beneficial because it allows many claimants another opportunity to demonstrate that they are eligible for Social Security Disability benefits. In addition, in pursuing a new claim, you have a new opportunity to prove your disability with a new examiner in the initial stages of your Social Security Disability claim and, hopefully, a new ALJ at the hearing stage. These new people evaluating your case may see your case in a different light and grant you benefits. If granted, these benefits may come much sooner than if you choose to wait out the appeals process.
The disadvantage of submitting a new claim, however, is that you will have a new alleged onset date and protective filing date for your case and, as a result, give up a lot of potential back pay.
There are also certain circumstances in which filing a new case is not an option. One example is when a claimant is filing for SSDI benefits and their Date Last Insured (the date by which they must prove they became disabled) has already expired. In this situation, the only option would be to appeal the decision.
This is NOT legal advice. This blog provides general information about Social Security Disability cases. To discuss your particular circumstances and claim, please contact a lawyer in your area.
If the ALJ denied your claim for Social Security Disability benefits, you have one of two options:
1) You can decide to disregard your first claim and start fresh.
OR
2) You can also decide to appeal.
Because this decision really does have significant consequences going forward, I do strongly recommend consulting with an experienced Social Security Disability attorney. Choosing one path versus another may mean giving up some rights. While each Social Security Disability claim has its unique issues, here are some basic things to consider in deciding which path to pursue:
Appealing the ALJ’s Decision. If you have received an unfavorable decision from the ALJ, you can appeal this decision to the Appeals Council. In submitting an appeal to the Appeals Council, your attorney should submit legal briefing discussing why the ALJ made mistakes in his decision regarding your eligibility for disability benefits. The advantage to this route is that you keep your alleged onset date (the date you told the Social Security Administration you could no longer work) and protective filing date (the date you filed your application for Social Security Disability benefits). This is important because it means that your back pay would be based on those dates rather than a new date in a new claim. This can be a substantial sum of money. In addition, your Medicare and Medicaid eligibility would be based on the alleged onset dates and protective filing dates rather than a new date in a new claim.
The disadvantage of this path is that the appeals process is a long process. The Appeals Council can take from 12-14 months to decide your case. During this time you are not receiving any benefits. In addition, if they agree with the ALJ, you would have waited a long time and still not been able to receive any Social Security Disability benefits. For many people, waiting this long for benefits can be very difficult, if not impossible.
It is important to note that if you have received an unfavorable decision from the Appeals Council, you will be able to file an appeal in Federal Court. With your Federal Court appeal you will be able to also file a new claim with the Social Security Administration for Social Security Disability benefits. However, this will take still more time without receiving any benefits.
Starting a New Claim. If you have received an unfavorable decision from the ALJ, you can also start a new claim with the Social Security Administration. Starting a new claim can be beneficial because it allows many claimants another opportunity to demonstrate that they are eligible for Social Security Disability benefits. In addition, in pursuing a new claim, you have a new opportunity to prove your disability with a new examiner in the initial stages of your Social Security Disability claim and, hopefully, a new ALJ at the hearing stage. These new people evaluating your case may see your case in a different light and grant you benefits. If granted, these benefits may come much sooner than if you choose to wait out the appeals process.
The disadvantage of submitting a new claim, however, is that you will have a new alleged onset date and protective filing date for your case and, as a result, give up a lot of potential back pay.
There are also certain circumstances in which filing a new case is not an option. One example is when a claimant is filing for SSDI benefits and their Date Last Insured (the date by which they must prove they became disabled) has already expired. In this situation, the only option would be to appeal the decision.
This is NOT legal advice. This blog provides general information about Social Security Disability cases. To discuss your particular circumstances and claim, please contact a lawyer in your area.
I like what you had to say in your blog. It was very helpful since I have been denied from the ALJ. I know have to decide what to do. I do have some questions about this process that you didn't cover like if you start over a new claim do you have to give SS new medical records or just the new updated medical records from the ALJ decision? Can you submit new medical records the the appeals council while waiting? What is the wait time if you refile your case for the first stage of your SS claim? I hope this makes sense. Thanks!
ReplyDeleteApplying for or Appealing a Social Security Disability Case can be very challenging. It was very challenging for me, especially the first time my application was denied and I had to file an appeal. I completed an online Social Security Disability Appeal form and submitted it. Little did I know that it would take up to two to three years to even get a court date scheduled. I said to myself, “I can’t wait two to three years just for a court date because by then I will be homeless with no money, no food, and lose everything I ever owned.” Also, going back to work was out of the question because I was not physically or mentally ready to return and would eventually get terminated from a job.
DeleteSo I started doing intensive internet research for nine months to find a way to get my Social Security Disability Appeal Case approved without waiting two to three years for court date to be scheduled. I utilized the information I found and won my Social Security Disability Appeal on my own without a court date. I did not have an attorney because I did not want to lose 25% of my back pay to attorney fees and I wanted to decide my own fate. After going through the whole process, that’s when I decided to write this book to explain in detail what documents and tests you need to try to win your Social Security Disability case the first time around or appeal without a court date.
I do not want anyone to go through what I experienced in trying to get approved for my Social Security Disability for a whole year. It is hard for someone to get approved when they do not know what to do or what documents and tests you may need in order to prove you are indeed disabled. This information really helped me get approved for a Social Security Disability Appeal without a scheduled court date. I recommend that you download “How To Win Your Social Security Disability Without An Attorney” so you can start utilizing this information for your Social Security Disability Appeal or the first time you apply.
If this information was available when I was trying to win my Social Security Disability Appeal, I would have ordered it. But during my nine months of research, I couldn’t find anything like this book out there on the internet. Please take advantage of this information because it takes you step-by-step through how to get your case reviewed without a court hearing and how you first apply for Social Security Disability. This will be the best money you ever spend on a self-help book.
I created this website to help people better understand the Social Security Disability process. I have also written a book called “How To Win Your Social Security Disability Without An Attorney.” Download this book for $19.99, which is a special limited time offer. Do yourself a favor and purchase this book so you can start trying to get approved for a Social Security Disability Appeal or the first time you apply for Social Security Disability Benefits. To download book click on www.socialsecuritydisabilityandyou.com At the bottom of the webpage click on the Cart Tab to purchase the book “How To Win Your Social Security Disability Without An Attorney.”
Please click cart on the upper right side of the website to place order.
Good Luck
Applying for or Appealing a Social Security Disability Case can be very challenging. It was very challenging for me, especially the first time my application was denied and I had to file an appeal. I completed an online Social Security Disability Appeal form and submitted it. Little did I know that it would take up to two to three years to even get a court date scheduled. I said to myself, “I can’t wait two to three years just for a court date because by then I will be homeless with no money, no food, and lose everything I ever owned.” Also, going back to work was out of the question because I was not physically or mentally ready to return and would eventually get terminated from a job.
DeleteSo I started doing intensive internet research for nine months to find a way to get my Social Security Disability Appeal Case approved without waiting two to three years for court date to be scheduled. I utilized the information I found and won my Social Security Disability Appeal on my own without a court date. I did not have an attorney because I did not want to lose 25% of my back pay to attorney fees and I wanted to decide my own fate. After going through the whole process, that’s when I decided to write this book to explain in detail what documents and tests you need to try to win your Social Security Disability case the first time around or appeal without a court date.
I do not want anyone to go through what I experienced in trying to get approved for my Social Security Disability for a whole year. It is hard for someone to get approved when they do not know what to do or what documents and tests you may need in order to prove you are indeed disabled. This information really helped me get approved for a Social Security Disability Appeal without a scheduled court date. I recommend that you download “How To Win Your Social Security Disability Without An Attorney” so you can start utilizing this information for your Social Security Disability Appeal or the first time you apply.
If this information was available when I was trying to win my Social Security Disability Appeal, I would have ordered it. But during my nine months of research, I couldn’t find anything like this book out there on the internet. Please take advantage of this information because it takes you step-by-step through how to get your case reviewed without a court hearing and how you first apply for Social Security Disability. This will be the best money you ever spend on a self-help book.
I created this website to help people better understand the Social Security Disability process. I have also written a book called “How To Win Your Social Security Disability Without An Attorney.” Download this book for $19.99, which is a special limited time offer. Do yourself a favor and purchase this book so you can start trying to get approved for a Social Security Disability Appeal or the first time you apply for Social Security Disability Benefits. To download book click on www.socialsecuritydisabilityandyou.com At the bottom of the webpage click on the Cart Tab to purchase the book “How To Win Your Social Security Disability Without An Attorney.”
Please click cart on the upper right side of the website to place order.
Good Luck
Hi Brad-
ReplyDeleteWhile I cant comment about your specific case, here is some general information:
1. If you start a new claim you are able to allege a disability back to the day after the ALJ's hearing decision. That means the most important medical information to provide is medical records and doctor's opinions that relate to your condition after the ALJ's hearing decision. The prior medical information may still be relevant depending on your medical condition.
2. With respect to the Appeals Council, in general the medical records and information that you submit should relate to the time period prior to the ALJ's hearing decision because the Appeals Council is only reviewing that time period. However, there are situations in which post-dated medical records can be pertinent. Again, this depends on the specific facts of the case.
3. With respect to the wait time, unfortunately it is difficult for me to comment on that because it greatly depends on the area you are located. Often times the wait time is similar to what you had in the past but can be faster.
I hope this helps. It is a difficult decision to make - starting a new claim or filing an appeal with the Appeals Council. I would definitely recommend consulting with an experienced attorney before making the decision.
Michelle Shvarts
Hello!!!
ReplyDeleteAbsolutely rightly you have mentioned all the points which are very important. I would love too see more blogs on disability claims benefits & all the stuffs.
thanks a lot for sharing
long term disability claims
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ReplyDeletemore--In many situations, calls for hope via a post conviction appeal. For many men and women, working with a trial is a and tiring process. If ever the outcome is not a good one, many people just quit believing include no other option for improving their lives and finding their voice heard. Yet, this is not necessarily circumstance. Many individuals november 23 appeals and when they do, they maybe better leads. The key to success is finding a professional you’ll trust to with you thru this system.
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ReplyDelete