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My social security disability claim was denied in Missouri? Can I appeal?

My social security disability claim was denied in Missouri? Can I appeal?Those who can’t work due to a disability may qualify for Social Security Disability benefits. The key word here is “may.”  A number of things must happen before government administrators grant an applicant Social Security Disability Income, commonly known as SSDI. 

Disability Defined

According to the Social Security Act, a “disability” is any physical or mental disorder expected to cause death or that has lasted or can be predicted to last for a duration of not less than 12 months and prevents the person from engaging in any major gainful activity.

Requesting Social Security Disability Income

The Social Security Administration carefully weighs a variety of factors when determining whether a condition is eligible and severe enough to justify the award of benefits. In deciding whether the applicant can still perform the previous work, the SSA also takes into account the applicant’s age, education, and work experience.

 Applicants must demonstrate their disability through the documentation they submit. The Social Security Administration then makes a decision using just the data included in the application. Filling out these required forms is challenging and a complex task to complete. Fully completing these forms, however, is vital. It could increase the likelihood that your application will be accepted upon first try. While there is no assurance that it will be, failing to fully fill out all paperwork gives the SSA a reason to automatically reject your application.

Even if you can demonstrate that your medical condition qualifies, the Social Security Administration may nevertheless reject your claim. In too many cases, a claim is rejected out-of-hand, unless something undeniable is shown. Like blindness, loss of a limb, stage 4 cancer, and so on. Upon rejection, your next course of action is to consider an appeal.

What to do if your application is rejected

There is still hope if you get a denial of benefits letter from the SSA. You can always contest the judgment. There is a presumption that you got the SSA rejection letter within five days of it being sent, starting the clock on the time to appeal which is 60 days. The appeal notice must be made in writing.

Three Stages of Appeal

There are three stages of appeal that can be pursued following a denial:

Administrative Hearing by a Judge

The appeals hearing, the first stage of the appellate process, is primarily designed to review the “disability” condition. Typically, this covers whether you have a disability, when it started, and whether it has stopped. The hearing will be presided by an unbiased Administrative Law Judge (ALJ) who was not involved in the initial denial of your claim. 

You will get a chance to make your case in person and to submit fresh evidence at the hearing to back up your claim. You may also call witnesses to testify in your favor. The SSA may also have representatives present to question you and to speak on why your claim should be rejected. In addition, the ALJ is free to ask you questions as well.

The ALJ makes their conclusion in writing after considering the evidence presented at the hearing. 

We at Shea Kohl Law, LC. strongly urge an applicant to have a lawyer present at this hearing and to have worked with them beforehand to prepare for the hearing. 

This hearing is the best chance for an applicant to fully develop the record, that is, to bring out everything in their favor before the facts of the case are put down in an official case file. If a decision is appealed, it is this record that will be reviewed, with little to no chance of submitting further testimony or documents.

The Appeals Council’s Review

Following the appeals hearing, you may ask the Social Security Appeals Council to conduct additional review if you are once more refused benefits. If the council concurs with the ALJ’s ruling, it will take the request for review into consideration but is not compelled to examine your claim. Otherwise, the Council has two options: either it will determine your matter on its own, or it will ask the ALJ to review it again. You will get written notification of the Council’s decision.

A Federal Court’s Review

You may bring a lawsuit in federal court if the Appeals Council upholds the ALJ’s rejection of your claim or if they choose not to consider your case at all. A lawsuit must be filed within 60 days of the Council’s decision. If you haven’t already, you should get legal counsel now because the SSA cannot help you file the complaint.

The duration of this phase of the appeals procedure can be at least a year. There are now three likely outcomes for this case: the case could be returned to the ALJ for reconsideration; the court could uphold the ALJ’s decision to refuse your claim; or the court might overturn the ALJ’s decision and grant you social security payments.

Will you need legal services to make a SSDI appeal?

If you believe you might be eligible for Social Security Disability Income, you need a social security lawyer who is familiar with the program and knows how to submit an application that will be accepted or who will put out the effort necessary to win your case on appeal.

Contact Us

Many people quit the application process and decide not to appeal their cases. It is our professional opinion at Shea Kohl Law, LC,  that by getting professional assistance, you’ll have a much better chance of getting the benefits that you need. Don’t give up. We can help. 

Call us at (636) 946-9999 to speak with a knowledgeable social security attorney about your appeal.

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Shea Kohl Law, LC serves clients in Missouri including St. Charles, Troy and Lincoln and throughout Warren and St. Louis counties. We also serve clients in Illinois.