Frequently Asked Questions About Social Security Disability Appeals

1. What happens if I am denied benefits and I do not appeal within 60 days?

2. How do I appeal?

3. What are the two biggest mistakes people make when trying to get disability benefits?

4. Should I have my doctor write a letter to the Social Security Administration and should I gather medical records and send them to SSA?

5. How much do lawyers usually charge?

1. What happens if I am denied benefits and I do not appeal within 60 days?

You’ll have to start over with a new application — and it may mean that you’ll lose some back benefits. So it’s important to appeal all denials within 60 days. It’s better if you appeal right away so that you get through the bureaucratic denial system faster. The quicker you can get to the hearing stage the better.

2. How do I appeal?

Your denial letter will tell you about appealing. The first appeal is called a “reconsideration.” You must request reconsideration and then, after the reconsideration is denied, you must request a hearing within the 60-day time limit.

You can appeal in one of three ways:

(1) Telephone the Social Security Administration and make arrangements for your appeal to be handled by phone and mail.

(2) Go to the Social Security office to submit your appeal. If you go to the Social Security office, be sure to take along a copy of your denial letter. And be sure that the Social Security representative gives you a signed copy of your appeal paper showing that you appealed on time.

(3) Appeal online at https://secure.ssa.gov/apps6z/iAppeals/ap001.jsp. Be sure to print and retain the receipt for your appeal so that you can prove you appealed on time.

3. What are the two biggest mistakes people make when trying to get disability benefits?

Failing to appeal. More than half of the people whose applications are denied fail to appeal. Many people who are denied on reconsideration fail to request a hearing.

Another mistake, although much less common, is made by people who fail to obtain appropriate medical care. Some people with long-term chronic medical problems feel that they have not been helped much by doctors. Thus, for the most part, they stop going for treatment. This is a mistake for both medical and legal reasons. First, no one needs good medical care more than those with chronic medical problems. Second, medical treatment records provide the most important evidence of disability in a Social Security case.

4. Since medical evidence is so important, should I have my doctor write a letter to the Social Security Administration and should I gather medical records and send them to SSA?

SSA will gather the medical records, so you don’t have to do that. Whether you should ask your doctor to write a letter is a hard question. A few people win their cases by having their doctors write letters. You can try this if you want to. The problem is that the medical-legal issues are so complicated in most disability cases that a doctor may inadvertently give the wrong impression. Thus, obtaining medical reports may be something best left for a lawyer to do.

5. How much do lawyers usually charge?

Most clients prefer … and most lawyers offer … a “contingent fee,” a fee paid only if they win. The usual fee is 25% (one-quarter) of back benefits up to a maximum amount set by SSA, which is currently $6,000. The fee comes from those benefits that build up by the time you are found disabled and benefits are paid. No fee comes out of current monthly benefits.

Although the usual fee will not normally exceed the maximum fee of $6,000, if your lawyer has to appeal after the first administrative law judge hearing, your contract might allow for a fee greater than $6,000. Even in this circumstance, though, your fee is likely to not be greater than 25% of back benefits.

In addition to the fee, many attorneys expect you to pay the expense of gathering medical records, obtaining medical opinion letters, etc.