FM/CFS/ME RESOURCES - U.S. Disability Appeal FAQ's

 

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U.S. DISABILITY APPEALS FAQ's Disability Information

The Social Security Administration (SSA) decides whether you are eligible for benefits. They will send you a letter explaining their decision. If you do not agree with their decision, you can ask them to look at your case again. This is called an appeal.

When you ask for an appeal the SSA will look at the entire decision, even those parts that were in your favor. The following are frequently asked questions about the appeal process:

The following information will give some insight to how the hearing process works.

To start the Appeal Disability Report please click here.


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When And How Can I Appeal

ANSWER: If you wish to appeal, you must make your request in writing within 60 days from the date you receive your letter. The Social Security Administration will assume you received the letter five days after the date on the letter, unless you can show them you received it later.

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How Many Appeal Levels Are There

ANSWER: There are three levels of appeal. They are:

1. Hearing By An Administrative Law Judge
If you disagree with the initial decision, you may ask for a hearing on the "disability" issues of your claim, such as whether you are disabled, when your disability began or whether it has ended. An administrative law judge who had no part in the first decision about your case will conduct the hearing.

The hearing is usually held within 75 miles of your home. The administrative law judge will notify you of the time and place of the hearing.

You and your representative, if you have one, may come to the hearing and explain your case in person. You may look at the information in your file and give new information.

The administrative law judge will question you and any witnesses at the hearing. You or your representative also may question the witnesses.

It is usually to your advantage to attend the hearing. If you do not wish to do so, you must tell the SSA in writing that you do not want to attend. Unless the administrative law judge believes your presence is needed to decide the case, he or she will make a decision based on all the information in your case, including any new information given.

After the hearing, the SSA will send you a letter and a copy of the administrative law judge's decision.

2. Appeals Council
If you disagree with the hearing decision, you may ask for a review by Social Security's Appeals Council.

The Appeals Council looks at all requests for review, but it may deny a request if it believes the hearing decision was correct. If the Appeals Council decides to review your case, it will either decide your case itself or return it to an administrative law judge for further review. You will receive a copy of the Appeals Council's decision or order sending it back to an administrative law judge.

3. Federal Court Review
If you disagree with the Appeals Council's decision or if the Appeals Council decides not to review your case, you may file a lawsuit in a federal district court.

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Can Someone Help With My Appeal

ANSWER: Yes. Many people handle their own Social Security appeals with free help from Social Security. But you can choose a lawyer, a friend or someone else to help you. Someone you appoint to help you is called your "representative."

Your representative can act for you in most Social Security matters and will receive a copy of any decisions we make about your claim.

Your representative cannot charge or collect a fee from you without first getting written approval from Social Security. If you want more information about having a representative, contact Social Security.

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Contacting Social Security

You can call toll-free at 1-800-772-1213.
Hours are 7 a.m. to 7 p.m., Monday through Friday.
Automated phone service available 24 hours a day.
For the deaf or hard of hearing: TTY number, 1-800-325-0778.

[Back to U.S. Disability]

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Mistakes To Avoid On Your Application

Below are some tips and techniques regarding the filling out of the SSDI Application:

  1. Claimants inadvertently make a number of errors which cause applications to be denied. A simple, but fatal, mistake, is to submit an application with blank spaces or fields. Each field, space or line must be filled with something. If there is no answer, place "NA", (not applicable), in the space.

  2. Trusting that the Social Security Administration is on your side. They're not.

  3. Disability examiners are under very strict time constraints to make a determination on an application, so it's best to organize the application and supporting documentation in a logical format.

  4. Assuming a diagnosis is sufficient for the SSA to award benefits is a serious and frequently fatal, mistake. Disability cases aren't won by diagnosis but by the presence of limitations, conditions and symptoms that prevent you from working..

  5. Downplaying the severity of your medical conditions or symptoms may be a socially accepted attitude, but when applying for benefits understating or denying the significance of your symptoms places your claim in jeopardy. Write your responses to the questions as if it were one of your worst days. On the other hand, never exaggerate, mislead or lie. Any dishonesty will be apparent; examiners will sense it, and deny the claim.

  6. Excluding the presence or treatment of psychological issues can be a contributing cause for denial. Everyone with severe impairments has mental health issues, to one degree or another. Reporting all support systems used to cope with mental health issues adds credence to your case for disability.

  7. Misunderstanding the concept of disability as defined by SSDI is a common and fatal mistake. In order to receive benefits you must prove that your limitations are so severe you're incapable of doing any work.
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