How to File a Long-Term Disability Claim Appeal

Filing to appeal a long-term disability claim can be a long and frustrating process and requires patience because in many cases, your initial claim will be denied. One way to improve your chances of approval is to have a social security advocate or attorney on your side. The process of appeals involves 4 stages, or levels of appeal. These stages consist of Reconsideration, an Administrative Hearing, an Appeals Council Review, or your case being tried in the Federal District Court.

Reconsideration

Within 60 days of your initial denial, you are required to submit a request for reconsideration. At this point an examiner who has not previously been involved in your case will review your submitted information from the initial claim and any new information you provide. During this process you are not required to be present, but in later stages your presence may be necessary. It is not uncommon at this stage for the denial to be upheld giving you the opportunity to file for an administrative hearing.

Administrative Hearing

After you receive your denial from the reconsideration, you will again have 60 days to request an administrative hearing. Once they receive your paperwork, a hearing will be scheduled within 3 months to a year. Prior to the hearing, you may be asked to provide more evidence or clarify information regarding your claim.

Typically the hearing is held within 75 miles of your residence or it can be conducted by video conference. The hearing is your opportunity to present your disability case to an Administrative Law Judge who will be familiar with your case prior to court. The focus of this hearing is to determine your level of functioning. In helping the judge to make this decision, you will be asked to state your case and witnesses or experts may or may not be called to testify. If your claim is denied at this stage, the judge will notify you in writing. This process may take about 2 months.

Appeals Council Review

If you disagree with the determination made by the Administrative Law Judge you have the opportunity to request a review by the Social Security’s Appeal Council. The Department of Social Security can help you with this process if you are having difficulty. At this point, the Appeal’s Council will review your case and make a decision. If they are in agreement with the Administrative Law Judge’s decision they will deny your claim or return your case back to an Administrative Law Judge. Otherwise, they may make a decision to overturn the Judges’ decision. Either way, you will receive a written letter stating their determination.

Federal Court

The final step of this process is having your claim reviewed by the Federal Court. If you disagree with the decision of the Appeals Council then you are able to file a lawsuit in the Federal District Court. The letter sent by the Appeals Council regarding their decision will instruct you on how to have your case reviewed in court. It is important to make sure you have secured council that is familiar with disability appeals in order to adequately represent your case therefore maximizing the outcome.



Can you get free counsel to file a long-term disability claim appeal?



In some cases, you will be able to find an attorney that will represent you on a pro-bono basis for a disability claim appeal. However, in most cases, the attorney will want to get a portion of the long-term disability claim if she wins the case. With this process, if you win the case, she can charge you a maximum of $6000 for the services even if she engages in a great number of hours of work on your behalf. In order to find a free attorney, check with your local bar association to see who provides this type of service. 



How many times may you appeal a long term disability claim?



If you need to appeal a long-term disability claim, you can generally appeal three times. There are three stages in the process that you can go through in order to have a successful appeal. First, you will have to go through a hearing with a judge. The judge will hear your case, and if she denies the claim, you can appeal again. You will then go to the appeals council. They might deny the case immediately if they believe that the hearing was correct. If you do not like the decision of the appeals council, you can take it to federal court. 

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