Do You Need a Lawyer to Appeal an SSDI Denial?

You do not need a lawyer to appeal an SSDI (Social Security Disability Insurance) denial, but having one can make the process easier to manage. Applying for disability benefits is often stressful and complicated for people not familiar with its complexities or prepared to deal with them.

If you seek legal counsel for a denied benefits claim, our law firm can advise you on your options and next steps. You can learn more during a free consultation about how a Greenville Social Security Disability lawyer from Pilzer Klein can help your case.

What Does It Mean When an SSDI Claim Is Denied?

An SSDI claim denial means the Social Security Administration (SSA) has reviewed a person’s application and determined it does not meet the criteria for receiving disability benefits.  

This can occur for various reasons, including:

• Medical ineligibility: The most common reason for a denial is that the SSA does not consider the applicant’s medical condition severe enough to have a qualifying disability. The condition must significantly limit one’s ability to perform basic work activities for at least 12 months.
• Lacking work credits: SSDI benefits are based on your work history and the taxes you paid into the Social Security system while working previous jobs. You may receive a claim denial if you do not have enough work credits.
• Non-compliance with treatment: If the SSA thinks you are not following prescribed treatment that could help improve your condition, it can deny your claim. You can challenge this by showing a valid reason for not complying with the treatment.
• Inadequate documentation: Claims can be rejected if an applicant lacks medical evidence to prove the disability is severe enough to prevent them from working. This can be due to missing information or not having enough evidence from your healthcare providers.
• Income and resources: This is less often a reason for an SSDI denial compared to supplemental security income (SSI); however, if you are engaged in what SSA considers “substantial gainful activity” earning above a certain monetary amount), it can deny you benefits.

Read Your Claim Denial Notice Carefully

If SSA denies your claim, it will send a detailed notice explaining the reason for the decision.  You should carefully review this letter because it explains the reasons for the decision and provides information on how to appeal it.

The appeal process involves several stages, which an attorney at our law office can explain in more detail. These stages include:

• Reconsideration (the stage you are currently in)
• Administrative Law Judge (ALJ) hearing
• Appeals Council Review
• Federal court review (This process occurs outside the SSA’s appeal process.)

How Our Lawyers Can Help You Appeal a Denied SSDI Claim

It can be disheartening to learn your disability benefits claim is denied. Social Security denies disability claims for various reasons, including those unrelated to a medical condition. Examples include not having enough work credits or not working recently.

Fortunately, a denial notice is not the end of the road. You can file an appeal within 60 days of receiving it, and our attorneys can help. We encourage you to file your appeal as soon as possible. 

The SSA will need time to review and decide whether to approve or deny your request for reconsideration. When we work on your claim, we will assess the strength of your case and identify any weaknesses or areas needing stronger evidence. 

We Can Take Care of Your Entire Disability Benefits Case

Our team will review your situation and determine the steps we need to take. We also can:

• Gather and organize your medical evidence: We will collect essential medical documents and work with your healthcare providers to obtain medical evidence that effectively addresses the SSA’s criteria for disability.
• Navigate complex SSA procedures: The legal complexities of SSA processes can be hard to follow, especially when you need time to take care of your health. Our disability benefits attorneys understand what it takes to appeal a denied SSDI claim and will complete and submit all paperwork on time.
• Plan your case strategy: We will identify and develop the best legal strategies to take at various points in the appeal process. The strategy will address your unique circumstances and the medical and non-medical factors that led to the claim denial. We can also work to show how your situation meets SSA’s criteria for a qualifying disability.

Having legal representation can help your chances of appealing an SSDI denial. Hiring a legal professional who understands the process will ensure all aspects of your case are carried out properly.

What Happens if My SSDI Appeal Is Denied?

If your case advances to an Administrative Law Judge (ALJ) hearing, our Social Security Disability hearings lawyer can prepare you for what to expect. Pilzer Klein can represent you during this formal proceeding, question witnesses, and argue for your benefits claim on your behalf. 

We will use our 50-plus years of collective legal knowledge to your advantage. If the ALJ issues a denial, we can request a review from the Appeals Council. The council can deny your request for review if it agrees with the ALJ’s decision. 

However, if the council accepts your case, it could be reviewed or returned to an ALJ for further examination. Federal court could be the next step if the Appeals Council denies your claim or refuses to review it.

How Much Does It Cost for a Lawyer to Appeal an SSDI Denial?

There is no upfront cost to work with a Social Security Disability attorney. Most attorneys who handle these cases work on a contingency basis, meaning they only get paid if you start receiving disability benefits. Their fee is usually a percentage of the back pay SSA awards you.

A disability reconsideration decision can take a long time, but our team will be with you throughout this process. We will monitor your claim’s status and keep you up to date. We will also answer your questions and tell you what to expect at each stage of the process.

Call Us to Review an Appeal for an SSDI Denial — We Can Help

While you do not need a lawyer to appeal an SSDI denial, working with a knowledgeable attorney with years of experience navigating these claims can take some of the stress, uncertainty, and mystery out of the process.

Pilzer Klein’s guidance could increase your chances of a successful appeal. If you go forward without legal representation, you must be well-prepared and thoroughly understand the SSA’s requirements for proving disability. Before you decide, give us a call or contact us online to explore your options during a free consultation.