Twenty-One Questions and Answers (FAQS) about appealing your Social Security Disability Claim in Utah

We are happy to answer your questions. These twenty-one questions are commonly asked:

Your choices and time limits for a Social Security Disability Appeal

Question 1: What are the levels of appeal for Social Security Disability?
There are four levels of appeal for Social Security Disability. The first level after a denial is a Request for Reconsideration. The second level is a Request for Hearing. The third level is a Request for Appeals Council Review. The fourth is taking the claim to the United States District Court.

Question 2: Is the appeals process different for SSDI and SSI claims?
The appeals process is generally the same for SSDI claims and SSI claims. However, for SSI claims when requesting reconsideration, you have the ability to ask for a case review, informal conference, or formal conference.

Question 3: What should I do if my disability benefits have been denied?
You will receive a written letter stating that your claim has been denied or disapproved. If you have received a letter stating that the Social Security Administration has denied your claim, you must understand that you have 60 days to appeal the decision denying your claim. The safest way to compute the 60 day time period is by using the date on the letter denying the claim. The date of the denial is always found in the top right area of the letter. The appeal must be made in writing. There are forms for each type of appeal, except to the United States District Court. I would recommend that you contact an attorney at the time of the first denial so that you can receive help through the process. The attorney can evaluate your case and help you decide on a course of action.

Question 4: What are my choices after I receive a Social Security denial letter?
You have two choices after you receive a denial letter: you can appeal or you can do nothing, and your claim will end because you did not appeal. When you are denied I encourage you to contact me as soon as possible for a free case evaluation. I can explain your options and help you with your case. If you do not appeal within the 60 day time period for appeal, you will likely have to file a new case. If you choose not to appeal, you can generally re-file your claim at a later date.

Question 5: How long do I have to decide to request a reconsideration or request a hearing for an appeal?
A request for reconsideration is an appeal. You have 60 days from the date of your denial to file your request for reconsideration or a request for hearing depending upon which denial you have received. There is additional documentation that must go to Social Security with the request for reconsideration or the request for hearing such as authorization to disclose information forms and the disability report for an appeal. An appeal can be done online or it can be done by mailing the forms in. In our office we do a requ8est for reconsideration online.

Question 6: What can I do if I missed the 60 day period to appeal?
Generally, you must re-file your claim. If there is just cause to explain why you did not file the appeal within the 60 day time period, you may get your claim reinstated. For example, prior to the time for online appeals, I mailed an appeal to Social Security. I kept copies of all of the documents that I mailed to Social Security in my office. When they said they did not receive the appeal and the time for appeal had expired, I mailed documents again to show that we did send them in on time. The appeal was reinstated. If someone was having severe medical problems that could be documented, perhaps including hospitalizations, then Social Security may find just cause to extend the time for appeal. The decision of just cause to file an appeal late is made by the Office of Disability Adjudication and Review when requesting a hearing. The best approach is to file the appeal within the 60 day time period. If you do not appeal on time, for most situations the answer is that you must file a new claim.

How long does it take for a social security appeal to be decided?

Question 7: How long does a Social Security Reconsideration take in Utah?
I wish there was an exact answer for this question. Generally, a request for reconsideration will take from two to four months to be decided, although that can widely vary depending upon the medical records and whether there is a consultative examination. The decision for reconsideration is usually quicker than the initial decision that was made on the claim.

Question 8: How long does a Request for Hearing take in Utah?
After a request for hearing is filed, it takes several months until the hearing is scheduled. For years it was a six month period. It then became more than a year. It is approximately a year until you receive the hearing after filing a request for hearing. If you have exigent circumstances because of your health, the court may give you a priority hearing. This is unusual.

Winning a reconsideration of Social Security Disability benefits

Question 9: Do I need a lawyer to win a request for reconsideration or a request for hearing?
Your chances for winning increase if you have a competent attorney to help you with your case. The attorney knows what information is important to Social Security and can help present the medical and other information in such a way to increase your opportunity to win the claim. The medical records are extremely important, and the attorney can carefully read your records and find the records that help explain your impairments and the severity of your impairments according to your doctors. The attorney is also familiar with the law used to decide Social Security Disability cases.

Question 10: How is a lawyer paid to help me?
Lawyers are paid out of the back benefits that are awarded to you and your family. The government has set the fees which an attorney can be paid. An attorney can be paid 25% of your past due benefits that are awarded to you or your family or $6,000, whichever is less. The judge has to approve the fee agreement between the attorney and the client. Generally the Social Security Administration will pay your attorney directly from your back benefits if you win.

Question 11: How can I increase my chances of winning a request for reconsideration or a hearing?
One of the most important actions to increase your chances of winning a request for reconsideration is to make sure that your file contains all of your medical records. What your doctors have written about your impairments is extremely important to your case. This is considered to be objective medical evidence to prove your disability. Generally, it will be difficult to change the results on reconsideration when you were denied initially. However, the medical evidence is the substantive way to change a decision.

Winning an appeal of Social Security Disability benefits

Question 12: Do I need a lawyer to win an appeal?
No, but It helps to have a lawyer for several reasons. The lawyer is familiar with the law that is used to decide a social disability case which is essential to winning your case. Second, the attorney will become familiar with your medical records and will be able to put together your case to present to the judge, and to analyze the medical evidence and the law. The attorney will frequently write a brief for the judge to explain why you are disabled based upon the medical records and the law. The attorney will also be familiar with the judges and what information is important to your case. If a doctor is willing to write a letter for a patient, the attorney can provide information that would be helpful for the doctor to address in the letter. The attorney can also take time with you to understand the subjective impact of your impairments on you so that you can be prepared for your testimony at the hearing. In all of this, experience counts. We have handled hundreds of social security disability claims over the past thirty years. You must learn the process in your one claim.

Question 13: Do I have to pay my lawyer up front to help me with my appeal?
Social Security disability claims are done on a contingent fee basis so there is no attorney fee unless you win. The attorney fee if you win is set by federal law. The attorney fee is 25% of past benefits that are awarded to you and your family or $6,000 whichever is less. Sometimes an attorney must pay to collect some of your updated medical records from your doctor. These are considered costs and you may have to reimburse your attorney for costs in your case.

Question 14: How is a lawyer paid to help me in an appeal?
The lawyer is paid out of your past due benefits when you win your case. Most lawyers are paid directly by Social Security from your past due benefits so you do not have to worry about paying them.

Other questions about Social Security Disability

Question 15: What does it mean to “reopen” my claim?
There needs to be good cause to reopen the claim. Perhaps there is medical evidence that is relevant to the claim prior to the date the decision was made. For good cause a claim may be reopened and the new evidence considered. The administrative law judge makes the decision about whether to reopen a claim. You may also reopen a claim to a prior application for benefits that were denied if the application did not go to a hearing. Again, the judge decides whether your claim can be reopened. Reopening an prior claim that was made may give you more back benefits.

Question 16: When can I request an Appeals Council review?
If your claim is denied at a hearing by the administrative law judge, then you have 60 days to appeal the written decision of the judge to the Appeals Council. The Appeals Council takes a long time to decide your case, but in many instances it reverses the decision that was made by the judge. If you win your claim at the Appeals Council, your claim is remanded to the same judge for another hearing. You do not get a new judge on your case unless your claim is reversed twice by the appeals council.

Question 17: When can I appeal to federal court?
If your claim to the appeals council is denied, it may be appealed to United States federal court in the state where you live.

Question 18: What are “the listings” in Social Security law?
The listings are the laws used by the Social Security Administration and the judge to decide your case. They are called the “listing of impairments,” and there are separate listings for adults and for children. There are listings for many types of impairments, but there is not a listing for every possible type of medical impairment. The listings are organized according to body systems and types of impairments. For example, there are listings for musculoskeletal impairments which include back and joint problems, speech and special senses, respiratory system, cardiovascular system, digestive system, genitourinary system, hematological disorders, skin disorders, endocrine disorders, congenital disorders that affect multiple body systems, neurological disorders, mental disorders, malignant diseases, and immune system disorders. Under each of these areas there are several listings for different types of impairments.

Question 19: How is a “vocational expert” used in a Social Security Disability hearing?
The judge will have a vocational expert come to your hearing. The vocational expert will identify what types of employment you have done in the past. They consider the 15 previous years of employment as your past relevant work experience. The vocational expert will discuss your case based upon hypothetical questions given by the judge. The hypothetical questions will focus on health limitations that impact your ability to work. The vocational expert will be asked whether a person can work based on impairments, both the number of impairments and the severity, which might be similar to yours. Your lawyer will also be able to ask questions to the vocational expert.

Question 20: How is a “medical expert” used in a social security disability hearing?
The judge may have a medical expert come to your hearing. Some judges use medical experts and some judges do not use medical experts. The medical expert will have had the opportunity to review the medical records that are in your file. The judge will ask the medical expert to state what you impairments are according to the medical records. The judge may also ask the expert whether the expert believes that your impairments meet or equal the listings discussed above individually or by combination of impairments. Your lawyer will be able to ask questions of the medical expert.

Question 21: What is the difference between an SSDI claim and an SSI claim?
Both SSDI and SSI are disability benefits with the following general rules. SSDI stands for Social Security Disability Insurance benefits. It is a benefit which may be received based upon an individual’s work history. You must have a condition which is expected to be disabling for a period of at least 12 months. If there is a work history which qualifies an individual to be considered insured, then that individual may receive SSDI benefits if found disabled under the listing of impairments. These benefits are not income sensitive. An individual receives the monthly benefit based upon work history regardless of whether there is another person bringing income into the household. SSI stands for Supplemental Security Income and it is income sensitive. This benefit is generally available to those who do not have a work history or if the SSDI benefit is very low. Because it is income sensitive, other income that comes to the household from a spouse may offset the SSI benefit. Both disability benefits are decided under the same medical listings, and the decision process is the same.

By Michael V. Houtz