Do I Need a Lawyer for a Social Security Disability Appeal?

On This Page

1. Why Would the Social Security Administration Deny a Benefits Claim?
2. What Happens During the Social Security Appeals Process?
3. Why Can It Help to Have an Attorney Working on an SSD Case?
4. Call Us: We Can Appeal Your Denied Social Security Benefits Claim

REVIEWED BY

C. William Kenny

May 05, 2022

Board certified by National Board of Trial Advocacy

No, you do not need an attorney for a Social Security disability appeal. You can file and go through the process alone without outside help. We do not recommend that you do this. There are multiple stages during the Social Security disability appeals and strict deadlines that must be met. This is why some applicants hire Pittsburgh Social Security Disability lawyers to represent them. Legal professionals understand complicated language and track all the moving parts of the disability application process, including the initial paperwork and applicable deadlines.

Additionally, if you are denied benefits the appeals process can become more complex, including a hearing before an Administrative Law Judge. If you think the Social Security Administration (SSA) made an error when it denied your initial claim, you can hire a disability benefits attorney who can offer legal advice and handle your claim. They will be familiar with Social Security disability policy and procedures and protect your interests and rights.

Why Would the Social Security Administration Deny a Benefits Claim?

The SSA oversees two distinct disability benefits programs:

• Social Security Disability Insurance (SSDI)  beneficiaries qualify for benefits based on their earned work credits. You earn credits by contributing to the Social Security fund through taxes on your wages or self-employment income. To be eligible, you usually have to have a minimum of 20 work credits (five years of work).
• Supplemental Security Income (SSI)  recipients qualify based on financial need. Beneficiaries must have minimal income or resources. Eligibility does not depend on work credits.

SSDI and SSI recipients must have a qualifying condition that is disabling – meaning it will prevent them from doing substantial gainful activity (SGA) for at least 12 months. According to the SSA, the 2024 SGA limit is $1,550, or $2,590 for blind recipients.

Given the program requirements, many application denials are due to insufficient medical evidence or issues with your income. However, technical errors can also cause a problem. Common reasons for claim denials include:

• You make too much money.
• You do not have enough earned work credits.
• You did not supply enough medical evidence.
• You made a technical or clerical error on your application.
• Your contact information is incorrect or out of date.
• You did not correctly complete an Adult Disability Report.
• Current drug or alcohol abuse materially contributes to your disability.
• You did not submit your most recent W-2 or tax return.
• You did not provide an original copy of your birth certificate or proof of citizenship.

An attorney with our firm can review your initial application and decision letter and determine why the SSA denied your benefits. We can correct mistakes and fill in gaps in your medical records, work history, and financial documentation and prepare your appeals. 

Qualifying Medical Conditions for Social Security Disability Benefits

To be eligible for disability benefits from the SSA, you must have a qualifying medical condition. The federal agency lists qualifying disabilities in its Blue Book, which includes but is not limited to:

• Chronic heart disease
• Chronic kidney disease
• Skin disorders
• Endocrine disorders
• Neurological disorders
• Hearing, vision, and speech problems
• Mental health disorders
• Blood disorders
• Cancer
• Musculoskeletal disorders
• Digestive system issues
• Congenital disorders
• Immune system disorders

What If My Medical Condition Is Not Listed in SSA’s Blue Book?

You can also receive benefits if the Blue Book does not list your condition. You will have to provide proof to establish your claim, including how severe your condition is and how it affects your quality of life. Working with your doctor on a Social Security case is important for various reasons. They can document your condition, its severity, the treatments you receive, and the healthcare professionals who administer them. 

They can also provide the results of all tests you’ve taken, prescription medications, and treatment plans and offer testimony that supports your claim.

What Happens During the Social Security Appeals Process?

You can appeal the SSA’s decision for medical or non-medical reasons. The process starts with requesting a reconsideration of the initial determination. Your application will undergo a review by a party not involved with the original decision.

If reconsideration is not successful, you can ask for a hearing before an Administrative Law Judge (ALJ). The hearing can occur in person, online, or over the phone. During the hearing, the Judge will review the evidence and may question witnesses, such as medical and vocational experts.

If the ALJ does not decide in your favor, you can request a review by the Appeals Council. The Appeals Council may decide on your case or send it back to an ALJ. Finally, if the SSA still denies your benefits, you can file a civil action in United States District Court.

How Long Do You Have to Appeal a Denied SSD Claim?

You have 60 days from receiving notice of the SSA’s initial determination to file for reconsideration. You then have 60 days from notice of the reconsideration results to file for a hearing, 60 days from the hearing decision to ask for an Appeals Council review, and 60 days from that decision to file a court case.

Appeals can take a long time, and the waiting period between stages can be anywhere from six months up to a year and a half. In fact, according to the SSA, the national average for processing ALJ hearings was 450 days as of the second quarter in 2023.

Why Can It Help to Have an Attorney Working on an SSD Case?

Unfortunately, our attorneys cannot eliminate the wait times between the steps of your appeal. However, they can ensure you are ready for each step and will work to resolve your claim during its early stages. Our Social Security disability attorneys can:

• File and complete your disability claim, saving you time and helping you avoid costly errors
• Evaluate your initial application to determine the reasons for your denial
• Gather new or missing medical evidence, financial information, and work history
• Correct clerical or technical errors on your application
• File for every stage of your appeal
• Guide you through the appeals process and represent you during an ALJ hearing

Call Us: We Can Appeal Your Denied Social Security Benefits Claim

While you don’t need a lawyer for a Social Security appeal, it can help to have one advocating for your benefits compensation. These cases can become increasingly complex the longer they go on, which is why many people hire legal representation so they can get the help they need to see an appeals case through.

Working with an attorney from a reputable law firm can give you confidence to go forward with your case and help improve your chances of getting approval. To get answers to your questions and help with a Social Security disability appeal, call Berger and Green today for a free consultation.