Regardless of whether or not a person is represented by an attorney, they should appeal an initial decision; it’s free to do so, and there is no reason not to. When an attorney is considering an appeal, it’s important to determine whether or not the claimant is receiving medical treatment. If a claimant has not received medical treatment for years but simultaneously purports to have a physical or mental condition that precludes them from working or functioning in daily life, then the judge may have a problem with that. It is important that a claimant is in treatment and is following the advice of their doctors.

In some cases, a claimant’s work history will be reviewed. However, there are two different programs, one of which is based on a person’s work history and another that is similar to welfare for disabled people. This means that even if a person has never worked or has not worked for a long time, they may still be able to receive SSI. In order to receive SSI, a person must have a medical or mental impairment, just as they must to receive the benefits that are based on one’s work record. If a claimant is over the age of 50, then it will likely be easier for them to obtain benefits because the rules for qualification change at age 50. A claimant who is in their 20s may have more difficulty receiving SSI unless they are severely and clearly disabled. In some cases, it may be recommended that a young claimant consider vocational rehabilitation training and explore avenues of employment.

What Is The Criteria For An Appeal Of An SSD Or SSI Denial?

The criteria to file for an appeal against an SSD or SSI denial will depend on the particular case at hand. If someone was denied for not having worked enough quarters, then nothing can be done to help them appeal that decision. If someone has assets over $2000, such as a 401(k), then that likely will knock them out of qualifying for SSI. This is something that should be considered beforehand so that no one’s time will be wasted. If it is decided that a denial should be appealed, then the case will be sent to another disability examiner for re-evaluation of the medical evidence and the claimant may possibly even be sent to a doctor for an independent examination paid for by the Social Security Administration.

What Are The Time Limits To File An Appeal To The Hearing-Level Decision?

Once a claimant has received a hearing-level decision from a judge, they have 60 days from the date of the decision to file an appeal. There is usually a five-day grace period added to this 60-day window in order to account for the time it may have taken for the letter to be mailed, so the absolute deadline is 65 days after having received a decision. With that said, it is safer to file an appeal within 60 days of receiving a decision.

What Happens When A Review Against An ALJ Hearing Decision Is Requested?

After filing the appeal, the claimant will be given additional time to submit evidence. After about 30 days have passed since filing the appeal, the claimant will receive a letter notifying them that they have 25 days to submit additional evidence. At that point, the claimant may have additional evidence which was not available at the time of the hearing, which is something that would be submitted.

Once all of the documents have been submitted, the waiting begins. It can take a year for a brief to even be reviewed, simply because they are so backed up with appeals. This means that a claimant can expect to wait up to two years before receiving an answer from the Appeals Council.

For more information on Appealing Initial SSD Decision In Texas, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (214) 373-3761 today.

by Carl M. Weisbrod
Managing Partner of Morgan & Weisbrod, Board Certified in Social Security Disability Law

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