20 FAQs about how the SSI appeal process works in Utah
Applying for disability in Utah can be tricky. Your SSDI or SSI claims can be rejected, even when you really need the benefits. Luckily, you can appeal a denied claim if this happens. Here’s are 20 frequently asked questions about how to appeal a denied social security disability claim and what the process looks like.
1. What is the difference between SSDI and SSI claim?
Both SSDI and SSI are disability benefits. SSDI stands for Social Security Disability Insurance. You receive this benefit based on your work history. You must have a condition which is expected to disable you for a period of at least 12 months. These benefits are not income sensitive. An individual receives the monthly benefit based on their work history regardless of whether there is another person in the household making an income.
SSI stands for Supplemental Security Income and is income sensitive, unlike SSDI. This benefit is generally available to those who don’t have a work history or if the SSDI benefit is very low. Because it is income sensitive, other income that comes to the household from a spouse may offset the SSI benefit.
2. Is the appeals process different for SSDI and SSI claims?
The appeals process is generally the same for SSDI claims and SSI claims.
3. What should I do if my disability benefits have been denied?
If you receive a letter stating that the Social Security Administration denied your claim, you can appeal the decision.
4. How long do I have to decide to appeal a denial?
You have 60 days from the date of your denial to file your request for reconsideration or a request for hearing depending upon which denial you received.
5. How do I know when my time to appeal is over?
The date of the denial is always found in the top right area of the letter. The best way to figure out the 60-day time period is by using the date on the letter denying the claim.
6. How do I appeal a denied claim for social security disability?
There are different ways to file an appeal. You can file an appeal by mail or online with the SSA or call them at their toll-free number. If your claim has been denied, you’ll receive a letter explaining how you can file an appeal if you believe your claim was wrongfully denied.
There are forms for each type of appeal, except with the United States District Court. If you’re unsure how to file your appeal, you should contact an attorney when you receive the first denial so that you can get help throughout the process. The lawyer can evaluate your case and help you decide on a course of action.
7. What are the levels of appeal?
There are four levels of appeal for social security disability. The four levels are:
- Request for Reconsideration: You can ask that someone else from SSA review the claim and submit any new evidence you may have.
- Request for Hearing: You can ask for a hearing with a judge.
- Request for Appeals Council Review: If your case was dismissed by a judge, a council will look at your case again and decide to approve it or send it back to a judge.
- Taking the claim to the United States District Court: If the council rejects your claim or doesn’t look at your case, you can appeal it with the United States District Court.
8. What can I do if I missed the 60-day period to appeal?
Generally, if you don’t file an appeal on time, you have to file a new claim. If there is just cause to explain why you didn’t file the appeal within the 60-day time frame, you may get your claim reinstated.
For example, before online appeals were available, I mailed them to the Social Security Administration. I kept copies of all the documents I sent. When the SSA said they didn’t receive the appeal and the time for appeal had expired, I mailed them the proof to show that we did send the documents in on time. The appeal would be reopened.
Another example would be is if someone had severe medical problems that could be documented, such as being hospitalized. The SSA may find just cause to extend the time for appeal in this case. The decision of just cause to file an appeal late is made by the Office of Disability Adjudication and Review when requesting a hearing. The best approach is to file the appeal within the 60-day time period. If you don’t appeal on time, you’ll likely end up having to file a new claim.
How long does it take for a social security appeal to be decided?
9. How long does a Social Security Reconsideration take in Utah?
I wish there was an exact answer for this question. Generally, a request for reconsideration will take two to four months, although that can vary depending on your medical records and whether there is a consultative examination. The decision for reconsideration is usually quicker than the initial decision that was made on the claim.
10. How long does a request for hearing take in Utah?
It takes about a year for there to be a hearing after you request one. After a request for hearing is filed, it takes several months until the hearing is actually scheduled. If your circumstances are urgent due to health issues, the court may give you a priority hearing, but this is unusual.
Winning a reconsideration of Social Security Disability benefits
11. Do I need a lawyer to win a request for reconsideration or a request for hearing?
Your chances for winning increase if you have a competent attorney helping you with your case. The attorney knows what information is important and can help present it to SSA in such a way that increases your opportunity to win the claim.
Your medical records are also extremely important. Your attorney can go through them to help explain your impairments and their severity according to your doctors. The attorney is also familiar with the law used to decide Social Security Disability cases.
12. How can I increase my chances of winning a request for reconsideration or a hearing?
One of the best ways to increase your chances of winning a request for reconsideration is to make sure that your file contains all your relevant medical records. What your doctors have written about your impairments is extremely important to your case. The SSA considers this objective medical evidence to prove your disability. Generally, it will be difficult to change the results on reconsideration when you were denied initially. However, the medical evidence is most important when deciding.
Winning an appeal
13. Do I need a lawyer to win an appeal?
You don’t need a lawyer, but it helps to have one for several reasons. The lawyer is familiar with the laws used to decide these cases, which can be essential to winning your case. Second, the attorney will become familiar with your medical records and will be able to put together your case to present to the judge.
The attorney will write a brief for the judge to explain why you are disabled based upon the medical records and the law. The attorney will also be familiar with the judge and what information is important to your case.
If a doctor is willing to write a letter for a patient, the attorney can provide information that would be helpful for the doctor to address in the letter. The attorney can also take time with you to understand the subjective impact of your impairments on you so that you can be prepared for your testimony at the hearing. In all of this, experience counts. We have handled hundreds of social security disability claims over the past thirty years.
14. Do I have to pay my lawyer up front to help me with my appeal?
You don’t have to pay your lawyer unless you win your appeal. The attorney fee is set by federal law. The attorney fee is 25% of past benefits that are awarded to you and your family or $6,000 – whichever is less.
Sometimes, an attorney must pay to collect updated medical records from your doctor. You may also have to reimburse your lawyer for these. The judge has to approve the fee agreement between you and your attorney. Generally, the SSA will pay your attorney directly from your back benefits if you win.
Other questions about Social Security Disability
15. What does it mean to reopen my claim?
You can sometimes reopen an old claim. There needs to be good cause to do this. An example of this would be if there is new medical evidence that is relevant to the claim before the decision was made. You may also reopen a claim to a prior application for benefits that were denied if the application did not go to a hearing.
An administrative law judge makes the decision about whether to reopen a claim. Reopening a prior claim may give you more back benefits.
16. When can I request an Appeals Council review?
If your claim is denied at a hearing by the administrative law judge, then you have 60 days to appeal it with the Appeals Council. The Appeals Council takes a long time to decide your case, but in many instances, it reverses the decision that was made by the judge. If you win your claim at the Appeals Council, your claim is sent back to the same judge for another hearing. You do not get a new judge on your case unless your claim is reversed twice by the Appeals Council.
17. When can I appeal to the federal court?
If your claim to the Appeals Council is denied, you can appeal it with United States federal court in the state where you live.
18. What are listings in Social Security law?
Listings are the laws the SSA and the judge use to decide your case. They are called the “listing of impairments.” There are separate listings for adults and for children.
There are listings for many types of impairments. The listings are organized according to body systems and types of impairments. For example, there are listings for musculoskeletal impairments which include back and joint problems, speech and special senses, respiratory system, cardiovascular system, digestive system, etc. You can find a list on the SSA’s website.
19. How is a vocational expert used in a Social Security Disability hearing?
The judge will have a vocational expert come to your hearing. The vocational expert will identify what types of employment you have had in the past. They look at the past 15 years of employment as your relevant work experience.
The vocational expert will discuss your case based on hypothetical questions asked by the judge. The hypothetical questions focus on health limitations that impact your ability to work. The vocational expert will be asked whether you can work based on impairments. Your lawyer will also be able to ask the vocational expert questions.
20. How is a medical expert used in a social security disability hearing?
The judge may also have a medical expert come to your hearing. Not all judges use medical experts. If a medical expert comes to your hearing, they will have reviewed your medical records. The judge will ask the medical expert to state what your impairments are. The judge may also ask the expert whether they believe that your impairments meet or equal the listings discussed above. Your lawyer will also be able to ask the medical expert questions.
Winning a social security disability appeal doesn’t have to be hard or overwhelming. For over thirty years I’ve been helping clients appeal their denied claims. I understand everything there is to know about filing disability claims in Utah. Contact me today for a free consultation to see how I can help you appeal a denied claim.