Can I Appeal for Social Security Disability Benefits After Being Denied Once?

Navigating the Social Security Disability Insurance (SSDI) application process can be complex and challenging, especially if your application was denied after your initial claim. If you find yourself in this situation, you might wonder: Can I appeal for SSDI benefits after being denied once? 

The short answer is yes; many individuals initially denied SSDI benefits eventually succeed in obtaining them through the appeals process or, occasionally, by submitting a new application. This means there is a real possibility of success for you, too! 

There are two paths to securing benefits after being denied: appealing an existing claim or submitting a new application. In most cases, appealing is preferable, but sometimes re-applying is more appropriate. 

If your initial application was denied and you believe the decision was incorrect, appealing is the best option, but you need to request an appeal within 60 days of receiving the denial notice. One of the primary benefits of appealing is that if you’re successful, you may receive retroactive benefits from the date of your original application. 

Re-applying should only be considered when the 60-day appeal deadline has passed, your medical condition has significantly worsened since the denial or an Administrative Law Judge (ALJ) has denied your claim after the appeals process. 

Understanding Reasons for Denial 

For you to successfully appeal or reapply for SSDI, it’s crucial to understand why your claim was denied. By knowing the reasons, you can address them effectively and increase your chances of approval.  

Some common reasons why SSA denies SSDI claims are:  

1. Insufficient Medical Evidence: you fail to provide adequate medical evidence – such as detailed medical records and notes from treating doctors – that demonstrate the severity of your condition and its impact on your ability to work.   
2. Being Previously Denied: Past denials can impact current claims, so appealing a claim with new evidence is the way to go. If appealing is not an option, your best chance for approval is to submit a new application for a different condition. 
3. Unwillingness to Follow Treatment: You must demonstrate that you are putting effort into managing your condition. If you’re unable to do so, you should consult a social security disability lawyer to help you explain reasons for non-compliance. 
4. Inability to Meet Non-Medical Requirements: Meeting non-medical criteria around income thresholds, employment status, and compliance with administrative guidelines such as attending appointments are essential for eligibility. You should stay in close contact with your caseworker or attorney to understand program-specific limitations. 
5. Drug or Alcohol-Related Illness: While substance abuse-related illnesses can be disabling, cessation and recovery leading to the ability to work can impact SSDI eligibility, though severe conditions resulting from substance abuse (e.g., cirrhosis, mental illness) may qualify for benefits. 

 If you think you’re falling short of any of those requirements, it does not mean that you can’t do anything about it, but you should consult a SSDI expert to determine the best way to remedy the deficiencies.  

What are the Steps Involved in the SSDI or SSI Appeals Process?  

There are four levels of the appeals process: 

1. Reconsideration:
   

   If your initial application for SSDI benefits is denied, the first step to take is to request a reconsideration. During reconsideration, your case will be evaluated by an examiner or team of examiners who were not involved in your initial decision. This is your chance to provide new or further evidence to support your claim. A side note – some states skip this step and proceed directly to the next stage of the appeals process, but social security disability appeals in both Louisiana and Alabama include the reconsideration level of the process. 

2. Administrative Law Judge (ALJ) Hearing:
   

   If your claim is denied at the reconsideration stage or if reconsideration is not available in your state, you can request a hearing before an Administrative Law Judge (ALJ). The ALJ hearing is a formal proceeding in which you and your legal representative if you have one, can present your case in person. The ALJ will review the evidence, ask questions, and may also hear testimony from vocational or medical experts. 
   This stage of the appeals process often provides the best opportunity for approval, as ALJs have more flexibility in considering all aspects of your case. 

3. Review by Appeals Council:
   

   If the Administrative Law Judge denies your claim, you can request a review by the Social Security Administration’s Appeals Council, which will either accept or refuse your request. If it accepts, it will carefully examine the decision to ensure it adheres to Social Security laws and regulations, and then approve your claim, deny it, or send it back to the ALJ for further review.  

4. Review by Federal Court:
   

   If you disagree with the Appeals Council’s refusal to review your case, or their decision after the review, your final recourse in the SSDI appeals process is to file a lawsuit in federal district court. The court will not conduct a new hearing. Rather, they will review the administrative record to determine whether the SSA’s decision was based on substantial evidence, and they followed proper legal procedures. 
   The federal court will then either uphold the SSA’s decision or remand the case back to the SSA for further review.
   It is worth noting that although these are the general steps in the appeals process, it can vary slightly depending on individual circumstances and location. Also, note that each level has a specific deadline. So, it is essential to be aware of and adhere to all of them. 

What Additional Evidence Can You Provide to Support Your SSI or SSDI Appeal?  

While appealing to reopen your case, any additional documentation/evidence you can provide to prove your eligibility for SSDI benefits is useful. Here are the most common ones: 

• Latest medical records like test results, hospital visits, bills, etc., from all healthcare providers that are up to date and clearly and truthfully state your medical condition. 
• Doctors’ statements clearly stating your diagnosis, treatment, and how your condition impairs you from holding a job. 
• Medication and treatment history stating all the medicines and treatments you have taken and will need to take in the future for your condition, as well as any side effects from the medications/treatments. 
• Employment history stating your job function before your condition, the demands of your job, date of employment, the organization you worked for, and how your disability prevents you from continuing. 
• Activities of daily living reports describing how your condition affects your ability to perform daily tasks such as bathing, getting dressed, cleaning, cooking, driving, and more. Indicate whether you need additional assistance from a nurse or caregiver with these daily tasks. 
• Witness statements from family members, friends, neighbors, colleagues, employers, or caregivers who can attest to your disability and its impact on your daily life and ability to work. 
• Specialized testing (e.g., cognitive testing, psychological evaluations, functional capacity evaluations) to provide objective evidence of your impairment and its impact on your ability to work. 
• Reports from a vocational expert who can evaluate your ability to perform work-related tasks. 

Given the complexity of the application and appeals process, you will likely benefit from the assistance and guidance of a disability attorney or advocate. 

Frequently Asked Questions 

What is the deadline to re-apply for an SSI or SSDI claim?  

• You have 60 days to appeal from the date of receiving the notice of the decision.

How can I reapply for disability benefits?  

• You need to send in a written or online request for appeal. You can submit a request form online at www.ssa.gov/forms 

Do I need legal representation to reapply for disability benefits?  

• You have a right to representation— whether it be an attorney, someone familiar with your case and social security laws. You can also request assistance from that SSA itself, but the best option is usually to enlist the help of a social security attorney who has gone through thousands of similar cases. 

How many times can you appeal for SSI or SSDI benefits?  

• There is no limit to how many times you can apply for benefits or appeal your claim. But it’s critical to understand when to start a new application or appeal your case. 

 

Overcoming SSDI Denial with the Help of a Disability Attorney 

Being denied SSDI benefits can be discouraging, or even frightening–doubly so if you are the sole breadwinner of your household. The best defense from those doubts and fears is to arm yourself with knowledge, and getting the right SSDI attorney is often the best way to get it. With locations in Louisiana and Mobile, Alabama, we have multiple locations to serve your needs. Contact us today.