Employees pay into the U.S. government’s Social Security Disability Insurance (SSDI) from each paycheck to ensure they have income if a severe injury or illness prohibits them from working. Unfortunately, the process to file a claim after an injury or illness requires ample paperwork, as well as navigating through a myriad of red tape. In fact, the Social Security Administration (SSA) denies the vast majority of SSDI claims upon receipt of the initial application. A skilled Michigan SSDI appeals lawyer can help you cut through some of the red tape and fight for the best possible outcome for your circumstances.
If you have recently applied for Social Security Disability benefits and have been denied, not all hope is lost. Contact the experienced social security attorneys at Thurswell Law at (248) 354-2222 to schedule a free consultation and learn about how we might be able to assist you.
How Does the SSA Define Disability?
Federal law defines disability as the inability to engage in any “substantial gainful activity” because of physical or mental impairments. An impairment must have lasted for at least 12 months, be expected to last at least 12 months, or result in death. Qualifications and the criteria for the determination of a disability are plentiful, but eligibility for SSDI benefits hinges on time. It is possible that you were denied Social Security because you applied too soon. A qualified Social Security attorney in Michigan will advise you on the timing of your application and if it might have contributed to your denial.
Who Qualifies for SSDI Benefits?
Title II of the Social Security Act of 1935 outlines a handful of groups of individuals who can qualify for disability benefits:
- An insured worker under the age of retirement who has been disabled
- A person who became disabled prior to age 22 who is a dependent of a parent entitled to SSDI benefits
- A dependent of a deceased parent who was insured
- A disabled widower or widow between the ages of 50 and 60 whose late spouse had Social Security Disability Insurance.
How Does the SSA Make a Disability Determination?
The Social Security Administration employs a five-step evaluation process to determine whether an applicant will receive disability payments. If you have been denied SSDI benefits, your denial letter likely includes an explanation from one of the following five areas of review:
- Work activity—The SSA reviews claimants’ current work activity to see if and how often they are working, as well as what kind of work they are doing.
- Severity of impairment—The SSA evaluates the severity of a claimant’s impairment, specifically how the impairment affects function in the work setting. When the claimant is a minor, the SSA compares the claimant to other non-impaired children.
- Medical determination of impairment—The Social Security Administration maintains a list of impairments and associated medical criteria. The SSA organizes the list by major body systems and includes impairments severe enough to prevent an individual from gainful activity. A person’s condition might not be on the SSA’s list, but this doesn’t mean he or she isn’t disabled. Instead, the claimant must provide further evidence, often in the form of medical evaluation, to prove disability.
- Ability to perform past work—Once the SSA has evaluated the above, they return to examine a claimant’s ability to perform past relevant work.
- Ability to perform other work—The SSA also assess a claimant’s ability to take another position. Age, education, and work experience factor into this part of the determination for disability.
Options After a Denial
State Disability Determination Services (DDS) handle initial claims and review medical records to make the initial determination on whether or not a claimant receives benefits. Once they deny an application, a claimant might go through a series of appeals to win their case.
Reconsideration. This is the first administrative appeal. Your case will be reviewed at the State level by a team that wasn’t involved in your denial.
Hearing
If your SSDI claim was not approved during reconsideration, you have the right to request a hearing in front of an administrative law judge. These hearings are typically scheduled within 75 miles of your home and the judge you see will have had no prior involvement in your SSDI claim.
Appeals Council
If you opt for a hearing and the judge does not rule in your favor, you have the option to request a review by the SSA appeals council in writing within 60 days of the decision. The Appeals Council might take one of three actions
An attorney in Michigan could help a person through the appeals process.
Social Security Disability Benefits & Appeals
If your disability claim has been denied, it’s important to know that you still have options. Many claims are denied because insufficient medical evidence has been provided to prove that you are disabled. Perhaps you have not been seeing the right specialists, or you may have provided inadequate medical records. It’s even possible that your doctor simply did not understand the legal requirements for your claim. And it’s possible that Social Security is at fault: the reviewers may have misinterpreted your medical records and denied your claim.
Consult an Attorney Before Applying for Benefits
Typically, the Social Security Administration won’t disagree with your medical diagnosis or the fact that you are impaired. The problem usually lies in the fact that you did not prove the legal requirement for being “disabled.” This is why you should consult with a skilled Michigan attorney who specializes in disability benefits claims and appeals. At Thurswell Law, we work closely with our clients to review the medical proof that is required for each claim.
Understanding the Appeals Process
If you have already received a denial of benefits, we can help you go through the Social Security Disability appeals process. A request generally must be made within 60 days of the date of the denial letter, and your request must be in writing.
In Michigan, as in some other states, appeals go directly to the Office of Disability Adjudication and Review, where an administrative judge will review the appeal. The wait time can be extensive, often 12 months or longer. Appeals at the hearing stage are made to the Appeals Council, which has the power to deny the appeal, remand for another hearing, or approve your claim. The only recourse after a denial at the Appeals Council is to file a civil action in the U.S. District Court.
How Thurswell Law Attorneys Can Help With an SSDI Appeal in Michigan
At Thurswell Law, we have extensive experience in handling disability claims, and we know what it takes to optimize your chances of approval. This is especially important because of there’s often a lengthy wait time to collecting benefits. A large number of claims are denied if they are not supported with sufficient medical evidence.
If your claim has been denied, we will work to prepare an appeal and help you attain the benefits you deserve. For a free consultation to discuss your options, give us a call at 248-354-2222.
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