If your claim for Social Security Disability is denied, you need an experienced SSDI attorney to bring an appeal. You’re already in a difficult situation recovering from or living with your disability. The appeals process can be frustrating and hard to navigate, but with the right lawyer on your side you have options. The New York Social Security appeals lawyers at Fusco, Brandenstein & Rada, P.C. handle cases like yours every day. Call us right away at 516-496-0400 to get started.

Why You Need A Lawyer For Your Social Security Disability Appeal

Having a skilled attorney on your side greatly increases your chances of having a successful claim. Having the right evidence is incredibly important at this stage, and a good lawyer can make sure that all your records are in order and that all evidence is filed on time. Claims are often denied because of incomplete evidence or missed deadlines.

Your lawyer can speak with doctors on your behalf, and prepare you for the questions you will need to answer at your hearing. A good SSDI attorney is very familiar with the entire appeals procedure, and they can make sure you know exactly what to expect at each stage and that you are well informed throughout the process.

Why Hire Fusco, Brandenstein & Rada, P.C. To Handle Your Appeal?

Fusco, Brandenstein & Rada, P.C. has represented thousands of disabled and injured New Yorkers for over four decades. Our veteran team of advocates knows what it takes to ensure that a claim is successful and we work tirelessly to make sure you get the benefits you deserve. You can read about some of our clients’ successes here. As our client, your well-being is important to us, and we are available 24/7 to answer any questions you have about your case.

Claim Denial And The Appeals Process

Many claims are denied on the initial evaluation, but it’s possible to appeal this decision. It’s important to go through the appeals process, as a reviewer may deny a claim that has obviously been filed and turned down before, and they may deny it for the reason the first claim was unsuccessful.

Once you receive a decision denying your claim, you have 60 days from receiving the decision to request an appeal, in writing. There are four levels in the appeals process:

  1. Reconsideration – You request a complete review of your original claim. A new medical examiner will consider the evidence and make a decision. If your claim is denied again, you will receive an explanation, similar to the one you received for your first denial. If you already receive benefits, your case may be reviewed periodically and either continued or terminated.
  2. Administrative Law Judge (ALJ) – If you wish to pursue your claim after the reconsideration, you must request a hearing before an ALJ within 60 days of the denial. You may be asked to provide more evidence or new information to support your claim. Your attorney may gather experts to testify about your condition. It may be possible to attend the hearing remotely, through video conference.
  3. Appeals Council – If the ALJ hearing is unsuccessful, you may request a review by the Appeals Council. Your case may be reviewed if the council finds a flaw in the ALJ decision. Appeals Councils do not often overturn a decision without strong cause. This step is necessary, however, if you wish to take your case further.
  4. Federal Court – Once you have exhausted all of your appeals, you may file a lawsuit in U.S. District Court. The judge will review your case for legal errors and possibly for factual problems as well. They may remand your case to the Social Security Administration if they believe further consideration about your condition is required. A federal lawsuit may take years to be resolved, however, and could end up being more trouble than it’s worth.

An experienced attorney can guide you through each of these steps and advise you along the way. The success of your claim may rest on the evidence you are able to provide about your impairment, your age, and your ability to find other employment.

Injuries And Disabilities Covered By SSDI

According to the Social Security Administration, a considerable portion of the disabilities in this country are caused by illnesses and injuries sustained on the job. Even if your job is not responsible for your illness, however, you may qualify for benefits. Disability insurance protects workers who can no longer perform their work due to life-altering conditions.

There are a few basic requirements that your condition must meet in order to qualify: You must be physically or mentally impaired. That impairment must prevent you from remaining gainfully employed or doing a substantial amount of work (you may qualify even if you can still do some work). Your impairment must be expected to last or have lasted at least a year. Some of the conditions that may qualify you for SSDI include:

  • Musculoskeletal disorders such as herniated disks;
  • Neurological disorders such as cerebral palsy or epilepsy;
  • Sensory problems like loss of speech, hearing, or vision;
  • Respiratory diseases like lung disease or asthma;
  • Mental disorders like PTSD, schizophrenia, bipolar disorder, or depression;
  • Autoimmune diseases like HIV or Lupus;
  • Blood disorders such as anemia or sickle-cell disease;
  • Cardiovascular conditions like high blood pressure, heart disease, or blood clots;
  • Endocrine or glandular problems such as thyroid disorders or certain types of obesity;
  • Certain cancers such as sarcoma, lymphoma, leukemia, lung cancer, breast cancer, and cancers of the small or large intestine.

The average for most SSDI payments is currently between $800 and $1800 per month. Each individual’s monthly benefit is calculated based on their earnings over the years, and may be reduced if they are receiving benefits from other sources, like workers’ compensation or state benefits programs.

Frequently Asked Questions About Social Security Disability Insurance Appeals

We understand that right now you probably have a lot of questions. The SSDI appeals process is not simple or easy to understand. We recommend directing any questions about your own case to your attorney during your consultation. Here are a few general answers to questions you may have.

What If I Recover From My Illness Sooner Than Expected?

When applying for SSDI benefits, the expectation is that you will be disabled and unable to work for at least 12 months. If you end up recovering sooner, you will be able to keep the benefits you received as long as the original estimate was legitimate. The SSA will review your case, however, and your benefits may be terminated if you have made a recovery.

How Long Does An Appeal Decision Take?

The answer to this question depends on the level of appeal, and may require patience. Reconsideration may take between a few weeks and a few months, depending on the  SSA’s current caseload. A decision from an administrative law judge may take a year or more. An Appeals Council decision usually takes at least a year, sometimes two. A federal case often lasts at least a year, but may stretch to as long as several years. Even the most experienced attorney has a limited ability to speed up the process, but having good representation can increase your chances of success considerably.

What Are My Chances Of Winning The Appeal?

Aside from having the necessary medical evidence, your chances may vary depending on the level of appeal and your representation by experienced counsel. According to a study by Martindale-NOLO, only 23 percent of applicants are approved at the initial application stage. For those who present evidence at a hearing, 46 percent end up winning their case. Having a good lawyer really helps, as 50 percent of the respondents in the study with representation won their case after the hearing, compared with 23 percent of those who represented themselves.

Can I Receive Benefits While Appealing A Termination?

If your case is subjected to a continuing disability review and your benefits are terminated (either because your condition has improved or you’re no longer eligible for SSI), you may be able to continue receiving benefits while you wait for an appeal. You must sign and return Form SSA-795 within 10 days of receiving the notice. The form should be included with the denial of benefits notice.

Can A Medical Marijuana Prescription Cause A Problem For My Case?

Even though New York has a limited medical marijuana program for some serious conditions, marijuana remains illegal at the federal level. SSDI is a program of the federal government, and possession of an illegal substance, including marijuana, could not only lead to a denial of benefits, but could lead to arrest and prosecution.

Speak With A New York Social Security Disability Appeals Specialist Today

If you have a long-term disability or illness and you’ve been turned down for Social Security disability benefits, you need an advocate on your side who can guide you through the entire appeals process. It’s extremely frustrating to attempt to focus on recovering from an illness or injury while also worrying about your own health and your family’s financial well-being. Call the SSDI experts at Fusco, Brandenstein & Rada, P.C. right away at 516-496-0400 or fill out our contact form today to get started on your appeal.

Last Updated : January 10, 2022

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