Advice for appealing a denial of Social Security disability benefits in Riverside County or San Bernardino County
Many Riverside County and San Bernardino County Social Security disability claimants tell us they are discouraged by the denial of their applications. If your application has been denied, you are in good company. Sixty-five percent of initial applications are denied.
However, if you appeal, the odds improve significantly. The majority of claimants who appeal will ultimately be found disabled.
How do you appeal a denial of benefits in Palm Springs?
The Social Security Administration provides three ways to submit your paperwork:
1. Go to your local Social Security office. The address will be on your denial letter. You can complete all the papers at the Social Security office. A claims representative will help. You will need these three things: (1) your denial letter, (2) a list of your current medications, and (3) a list of names and addresses of all health care providers who have seen you since you last updated your Social Security file. Don’t forget to obtain a copy of everything you submit and a receipt for your appeal.
2. Request the appeal papers by phone and return them by mail. Telephone the Social Security Administration at 1-800-772-1213 and say that you want to appeal. They will send you the correct appeal form, a Disability Report – Appeal, and an Authorization to Disclose Information to the Social Security Administration (SSA-827). Fill them out, make copies for your records, and mail them back. Send them by certified mail, return receipt requested so you will have proof you appealed. Your appeal is not complete until you mail the appeal form back to the Social Security Administration.
3. Appeal on the Social Security Administration website. The website address is https://secure.ssa.gov/apps6z/iAppeals/ap001.jsp. You will need your denial letter. After you complete the appeal form, you can print a confirmation showing your appeal was made on time. You can also complete the Disability Report – Appeal online. This form will take some time so be sure to obtain a reentry number so that if you’re timed out, you can re-access the form to finish. You’ll need the names and addresses of all medical care providers you have seen since you filed your claim or last appealed, as well as a list of current medications.
Whether you appeal online or you complete paper forms, the information requested is the same. Whichever method you choose, don’t forget to get proof that you appealed on time. If you don’t and your paperwork is lost (which happens from time to time), you will have to start over with your claim.
The Appeal Process
Reconsideration: the first appeal
In most states, the first level of appeal is called a Request for Reconsideration. Ten states, including parts of California, skip the reconsideration step and go directly to a hearing. (The others are Alabama, Alaska, Colorado, Louisiana, Michigan, Missouri, New Hampshire, Pennsylvania, and parts of New York). Your denial letter will tell you whether you must request reconsideration or a hearing. If your letter indicates that you should request a hearing, skip to Request for hearing: the second appeal.
The reconsideration forms
To request reconsideration, you need to complete three forms: a Request for Reconsideration, a Disability Report—Appeal, and an Authorization to Disclose Information to the Social Security Administration.
Completing the Request for Reconsideration. Most of the questions on this form are easy to answer. One exception is the question, “I do not agree with the determination made on the above claim and request reconsideration. My reasons are:”
Just write, “I am disabled.” There is no need to elaborate.
Completing the Disability Report – Appeal. This form asks you about changes in your circumstances since you filed your application. Specifically it asks about changes in your physical and mental condition, new diagnoses, additional treatment, and changes in your daily activities.
Describe any changes in your condition carefully. Do not exaggerate but do not minimize them. If there are no changes, just say so.
Be sure to provide the name and address of every medical care provider you have seen since you filed your application. Also provide a list of all the medications you are currently taking.
Describe in detail how your activities have changed since you last completed a disability report. If your activities are the same, just say so.
Completing the Authorization to Disclose Information to the Social Security Administration (SSA-827). Don’t forget to have a witness sign and provide his or her telephone number or address. If you complete your forms online, your Social Security office will mail you this form to sign and return. When you receive it, you will know that your appeal is on track.
Supplementing the reconsideration forms. Attach any additional information you have to your appeal forms. If you filled out your appeal forms online, you can mail or bring the additional information to the Social Security office address that appears on your denial letter.
Relevant information includes items bearing on your ability to function such as:
• Medical records;
• Disability findings from other agencies like workers’ compensation judges or insurance carriers;
• Weak attendance records before withdrawal from school or job; or
• Poor performance notices from school or work.
Appeal before the deadline
The deadline for filing a timely appeal is 65 days from the date on your denial letter. You will need to start over with a new application if you are late without “good cause.”
If you were required to file a request for reconsideration and it was denied, do not be discouraged. That’s what happens to most claimants (17 out of 20, in fact). File your request for hearing, which will probably be your last appeal.
One reason that most appeals are granted after a hearing is that the administrative law judge finally gets to meet the claimant and observe the degree to which the claimant is disabled.
The appeal forms
To request a hearing, you need to complete three forms: a Request for Hearing by Administrative Law Judge (form HA-501-U50); the Disability Report – Appeal (form SSA-3441-BK); and Authorization to Disclose Information to the Social Security Administration (SSA-827).
Completing the Request for Hearing by Administrative Law Judge (form HA-501-U5). This is an easy form to complete. Most questions are self-explanatory, but here are a few tips:
Question 5 asks: “I request a hearing before an administrative law judge. I disagree with the determination made on my claim because:” You need respond only with, “I am disabled.” A detailed response is not required.
Question 6 asks: “I have additional evidence to submit.” Interpret it as asking whether you have evidence to submit in your possession right now. If you do, check “Yes” and send the additional evidence to the Social Security Administration. Check “No,” if you don’t have anything to submit right now. Checking “No” to this question does not limit your right to submit evidence later. You or your disability attorney will certainly have additional evidence to submit before your hearing.
Question 7 asks: “I wish to appear at a hearing.” Check “Yes.” You definitely want to let the judge see you and hear from you why you cannot work.
In Question 9 do not write down the name of an attorney unless you have already completed all the representation papers requested by the attorney.
Completing the Disability Report – Appeal (form SSA-3441-BK). You may have completed this form once before if you were required to request reconsideration. Completing it provides the Social Security Administration with the information it needs about changes in your condition, and medical care providers you have seen since you last updated your file.
If your condition has changed, try to provide as much detail as you can in “Section 7 – Information About Your Activities” and “Section 10 – Remarks” about how your disability restricts your daily activities.
Completing the Authorization to Disclose Information to the Social Security Administration (SSA-827). You may have completed this form before if you were required to request reconsideration. Again, remember to have a witness sign and provide his or her telephone number or address.
If you completed your appeal forms online, your Social Security office will mail this form to you. When you receive it, you will know that your appeal is on track.
Bring or mail the completed forms to your Social Security office. The address should be on your denial letter on page 4 or 5. Alternatively you may call 1-800-772-1213 for the address.
After completing the forms to request your administrative hearing, you should select an attorney to represent you at the disability hearing, if you haven’t yet done so. A Social Security hearing requires specialized training, just like a trial, even though it is less formal. You probably would not represent yourself in a courtroom. You should not represent yourself in a Social Security disability hearing either. The stakes are too high.
Help with your appeal
If your Social Security disability application has been denied and you have appealed or are considering appealing, we would be happy to evaluate your claim. Give us a brief description using the form to the right, and we will respond promptly.
Or you may e-mail us or call our office at 760-327-1285.