I just got unfavorable decision for my SSI Disability and I can hardly walk or use my hands. I have RA and my doctor said I was permanently disabled. So why am I being denied?
– LaTrica
My response: LaTrica, firstly you should understand that there is an appeal you can filed to challenge the unfavorable decision. In most jurisdictions, the appeal would be to the Appeals Council in Falls Church, Virginia. In some limited jurisdictions the appeal would be directly to federal district court.
Either way, you should speak with your attorney about filing the appropriate appeal. Your appeal needs to be filed within 60 days, so don’t delay. You should also speak with your attorney about filing a new claim for benefits.
Appellate work and new filing strategies should not be pursued without the aid of an attorney. With regard to the appeal, there are some lawyers who specialize in post-ALJ hearing appellate work. If your lawyer does not regularly handle appeals, you should ask for a referral. Whatever you do, don’t wait until the last minute.
As far as why your case was denied, there could be many reasons that your judge relied upon:
- did you have a definitive diagnosis of RA from a rheumatologist, or did your internist or an emergency room physician suggest that you might have RA?
- is there evidence of substance abuse that served as a “material contributing factor” to your inability to work?
- was the judge arbitrary and unreasonable?
- are there medical reports in your file that suggest you are a malingerer, a drug seeker, or that you are exaggerating your limitations?
- did your lawyer fail to develop testimony that painted a true picture of your limitations?
- was there a lack of convincing support from your treating doctors?
Every case has some strengths and some weaknesses. The judge is supposed to set out clearly his reasons for turning you down. A good appellate lawyer will identify weaknesses in the judge’s reasoning and find an angle to attack the logic of the decision.
I can only imagine how frustrating it must be to receive an unfavorable decision when your medical condition truly limits your ability to function. Best of luck to you.
I agree with John 100%. You definately need to talk to your attorney or representative about your appeal options. And do it sooner than later. You should also consider filing a new claim for benefits while you appeal your unfavorable decision.
I have been a disability representative since 2001, and I recently had a client who was denied by the Administrative Law Judge and then the Appeals Council. She filed a new application while her current appeal is pending in federal court. Her new application was approved at the initial level. She at least has an income now while the denial of her previous claim continues in federal court. If you wait to file your new claim after receiving a federal court denial, then you will be starting from scratch when you could have already been having your new claim processed the whole time your appeal was pending.
Although difficult, cases can also be won at the Social Security Appeals Council. I just received an order from the Appeals Council remanding one of my clients’ cases back for a new hearing after it was determined that the Administrative Law Judge made several mistakes. If you have any new evidence, and you appeal to the Appeals Council, then you should make sure that you submit it with your appeal. Your attorney or representative should also file a written brief with the Appeals Council arguing why the Administrative Law Judge’s decision should be overturned.
And by all means, if you are not represented, then you need to find a representative in your area who can help you. It will be worth it to you to pay a representative a portion of your back pay if that is what it takes for you to have an income for the rest of your life and get medicare to help pay your medical bills.
I was wondering if anyone has had a five year CDR for rheumatoid arthritis. I am scheduled for one shortly and I am wondering what to expect and if there is anything I can start doing now to make it easier. Thanks.
Mr Ginsberg,I think I must have read everything you wrote about the Disability process..I hope you can write my appeal.I whould love to talk to you if only for 5 min..Judge Cornik looked for any small issue to deny me…I’m sitting here in pain right now wondering what to do..will any one hire a unskilled,over 50 afican american man with a bad back..this women is so wrong…I hope you can help me file HA-520..I dont like to loose when I know I’m right.I’ll stick this out for years if I have to…
I have been denied once at the ALJ level, and have just had a new hearing this past week. My cervical spine disc disease is well documented with a powerful RFC from my long time (10-years)internist.
Regardless, I’ve just been informed(after the hearing)that the ALJ’s are even less inclined to approve your claim after you’ve been turned down at the first hearing!
Is this true? I’m fifty and my benefit has run out(12/9/09)and I cannot file a new claim, is it likely that the ALJ had made his corrupt mind up long before I even saw him?
Chris, in my experience I have not noticed any bias on the part of an ALJ hearing a case that had previously been denied at a hearing. Of course, there are some ALJs out there who rarely approve anyone, whereas others (hopefully the majority) who give every case a fair hearing. I have not seen any statistics about approval rates when a claimant appears for a 2nd hearing. Two issues of concern based on your comment: 1) you reference an RFC from your internist. I wonder if the ALJ might expect an RFC from an orthopedist or other specialist – could that be an issue, especially if that RFC was not given controlling weight in a prior hearing? 2) your statement “is it likely that the ALJ made his corrupt mind up long before I even saw him.” I don’t think that very many ALJs are “corrupt.” Some may be overly demanding in terms of the evidence they want to see, but since Social Security disability is non-adversarial, I don’t know that there are corrupting influences at work here. If, however, a claimant gives off an antagonistic vibe to an ALJ, that ALJ may subconsciously be less inclined to approve a case where there is conflicting evidence or perhaps evidence from a less compelling source. I’m not saying that’s what happened in your case but ALJs are people and if one approaches a hearing with an antagonistic attitude, then bad things can happen.
While I was waiting for my case to be heard for the first time, I read a lot of your articles and many others online and I saw that most people spoke about how long they had to wait for a positive outcome – after appeals, etc. So I tried to prepare myself for a similar experience and be patient. I was lucky to have purchased a LTD policy at the company where I worked and so during my wait, I received an income of 50% of my earned income from the LTD policy. Suprise of suprises, my case was approved without any hearing, without add’l questions, and to my Christmas Surprise, I went to my bank and found a $5000.00 deposit in my checking account (which I thought was a bank error ofcourse)!! because I hadn’t received any paperwork stating I had been approved yet! Instead, it was 4 months back pay of my disability payment from SS. In total, it only took 4 months for approval and for my first check to arrive; and I was approved for 5-7 years. I have RA and have had it for 7 years. I’m 58 years old and my RA has been in a flare for almost 2 years while I struggled to work. Last year I missed over 100 days of work and was laid off. (ofcourse the company didn’t use that as their excuse) 🙂 I guess what I wanted to say to people reading this is that in some cases, your reqeust for SSDi can be processed without a hitch and I thank all my doctors for responding quickly to the request for information from SSDI. Anyone applying for the first time…. Keep thinking positive and although it doesn’t make my living with RA any easier, it helps me to know that I won’t have to worry about searching for a job while struggling to just get out of bed each day. Praise God.
@Connie: Hi connie. i read your story and was very encouraged by it. i have been diagnosed with RA and have been living with it for three years. I am going to be applying for SSDI soon and i was hoping you can provide me with some insight on the process. what medical records did you submit. did you have to provide a letter from your doctor. How far back did you have to provide medical info? Any info would be a blessing to me…Thank you and God Bless You!
My case was denied after my hearing with the Judge. I appealed to Federal and my case was sent back to ALJ. I called to follow up on my next hearing date and was told a decision had been made without me going back to Court. I don’t if this is a positive thing or not. Has anyone else had this happen to them.
Carol, generally if a decision is made without a hearing on an Appeals Council remand, it will be good news. I don’t see how a judge could deny your case in the face of explicit remand instructions from the AC.