If Your Disability Claim is Denied, Should You Appeal or Reapply?

If your disability claim was denied, you aren’t alone.  According to the Social Security Administration’s own statistics, the disability award rate from 2001 through 2010 only averaged about 45%, meaning more than half of all applicants were rejected.  But while a denial notice is discouraging, it isn’t the end of your story.  If you disagree with the SSA’s findings, you can either challenge the original decision, or start from scratch with a new application.  So which route is more effective?  Should you appeal, or apply a second time?  It’s important to weigh the pros and cons carefully, as our Lehigh County disability lawyers will explain in this article.

Why Was My SSI or SSDI Disability Claim Denied?

When the SSA rejects your disability application, you should receive a notice explaining the reason why your claim was denied.

A small portion of rejections are based on “technical denials,” which include problems like having too many assets (for Supplemental Security Income/SSI) or not working long enough (for Social Security Disability Insurance/SSDI).  Other reasons for technical denials include:

• Committing fraud.
• Failing to update your contact information so that the SSA can stay in touch with you.
• Having a criminal conviction (under certain circumstances).

However, most rejections are medical denials.  If you receive a medical denial, it means the SSA decided you were not severely disabled and therefore did not need financial assistance.

Medical denials are frustrating.  You know you have a health problem, your doctor knows you have a health problem – why can’t the SSA see it?  There can be lots of reasons.  The SSA may claim there wasn’t enough evidence to prove the severity of your condition, or that your condition would improve if you followed your doctor’s orders, or that your condition is too temporary to satisfy the 12-month duration requirement.

Regardless of the SSA’s reasoning, it is usually better to appeal than to reapply, for reasons we will discuss shortly.  However, there are some scenarios where reapplication is necessary.

Is it Better to Apply for Benefits Again, or Appeal the SSA Decision?

Statistically speaking, you will have a better chance of getting your claim approved if you go through the disability appeals process rather than applying a second time.  At the national level, approximately one third of disability applications are approved following the initial review.  By comparison, about 60% of claims are approved during the Administrative Law Judge or ALJ hearing, the first stage of the appeals process.  In other words, if you submit a new application which is identical to your first, you only have a one-in-three chance of being approved.  If you appeal, your odds improve dramatically, increasing to two-in-three.

Note that New Jersey residents must go through Reconsideration before proceeding to the ALJ hearing. While Reconsideration traditionally has a poor outlook, try not to get too discouraged: the majority of claimants are successful at the ALJ hearing which follows.

Unfortunately, Reconsideration cannot be skipped over.  Yes, New Jersey residents must go through Reconsideration prior to the ALJ hearing, even though the ALJ hearing is far more likely to result in success.  However, Pennsylvania residents may save time by proceeding directly to the ALJ hearing.

If you plan to appeal an SSA decision, you need to act fast.  You have only 60 days to appeal, counting down from the date of the decision on your application.  If you miss the 60-day deadline, you will have no choice but to apply from scratch all over again.

You may also want to reapply if your condition has gotten worse.  This will give you an opportunity to submit additional evidence that wasn’t relevant or available the first time around.

Even if you don’t know whether you want to appeal, you should still call a social security attorney right away.  That way, you can get a head start on discussing your options, rights, and responsibilities.  If you wait for too long, you could miss your opportunity to appeal altogether, and will be forced to reapply.

If your claim was denied, call the law offices of Young, Marr, Mallis & Associates at (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania to set up a free, confidential consultation.  Our disability benefits attorneys have handled thousands of thousands of claims on behalf of Pennsylvania and New Jersey residents, and have extensive experience representing clients at all stages of the appeals process.  We will help you make an informed decision about the pros and cons of reapplying versus appealing, and can help you understand the different types of benefits you may be entitled to.