How to Appeal a Disability Claim | Cook and Associates

You’ve Been Denied Social Security, Now What?

How to Appeal a Disability Claim

We understand that the process is frustrating, especially when you get denial letters from caseworkers who have not seemed to give your claim any real consideration. There are several stages in a disability claim, so we’re sending you this letter to give you some more information about the process.

How many steps are there in a disability claim? 

Did you know that there are five total levels in a disability claim?! Yes, five! Fortunately, most claims are won at the third level. You will receive two denials before given the opportunity to see a judge. At that third level is when you really need a lawyer to help you make sure the evidence you have is well presented, and to walk you through the hearing process. Read on to learn more about each step.

First level:

If you have filed your initial claim with social security and have been contacted via phone by a case worker, then you have so far been dealing with the “Disability Determination Service”, or “DDS” for short. First understand that DDS hardly ever approves claims on the first go-round, except for people who are very, very sick. So, don’t worry, you’ve still got a chance.

Second level:

If you have received your first denial letter from DDS, then you will need to file what is called a “Reconsideration Request” with the Social Security Administration. For your convenience, we have included with this letter the form you need to file, SSA Form 561. You can also file this form online at https://www.ssa.gov/forms/ssa-561.html . Make sure to file this form within 60 days of your denial letter.

Also, look at the last few pages of your first denial letter, and note the medical evidence listed there. If any doctor’s offices or dates of treatment are missing, get those records from your medical service providers, and mail those in with your form 561. And keep a copy for yourself, you may need them when you meet with your attorney later.

Don’t get discouraged if this ‘Reconsideration Request’ is also denied. In our experience, this stage is basically just a ‘rubber stamp’ of the first decision, and a delay tactic the administration uses to paying your claim. You should receive an answer within 3-5 months after the ‘Reconsideration Request’ is filed with SSA.

Third level: (or when should I hire an attorney?!):

After (and if) you get this second denial, then it’s time to “lawyer up”! Call our offices to help you file your next appeal, which is the “ODAR” or “OHO” level. This is the appeal level that is going to take you to see the Administrative Law Judge, and where having an attorney is absolutely necessary. Make sure you get an appointment to meet with a lawyer as soon as you receive this denial, because you only have 60 days to appeal and your lawyer needs all the time she can get for preparation!

Fourth level, Appeals Council:

If you have already seen the judge and received a “Notice of Decision – Unfavorable”, then your next step is to ask the Appeals Council to review your claim. Sometimes, this is a good idea, and sometimes you should just file anew claim. You really need to speak with a lawyer at this point, who can help you decide what your best course of action is. There is also a 60 day statute of limitations on filing your Notice of Appeal after you receive your Unfavorable Decision.

Fifth level, Federal Court:

If you have been denied by the Appeals Council, then your next step is to file your case with the United States Federal District Court. Like the third and fourth levels, you absolutely need an attorney’s help to do this. Again, you have 60 days to file the appeal, so get to an attorney ASAP!

Can I talk to Ms. Cook or one of your representatives before my Reconsideration Request is denied?

We know that even the first levels of the process can be nerve wracking, and Google doesn’t answer all your questions (that’s why we’re here)! So, if you are at the first two levels in the process, we offer one free 15-minute phone consult with an accredited representative or attorney who can answer your questions. No charge and no obligation!

When can I come to meet my representative?

Once you receive your second denial letter, that’s the time to have a thorough meeting with your lawyer. We offer in-person or video conference meetings to clients who are ready to retain our services. There’s never any charge unless you win your case! There’s a lot of paperwork involved, so video conference meetings are recommended only for those who have access to a computer and can print, scan, and email documents.  Once you are ready, we invite you to call our office at 334-356-7879 to make an appointment. If you do not have transportation available to you, call our customer care specialist, and she can help you arrange transportation to make your appointment on time. We look forward to helping you with your case!

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