A denied Social Security Disability claim can have a significant impact on an individual and their family - especially when it is the main source of income for that family. Many applications are initially denied however, that does not necessarily mean that the applicant is not eligible to obtain benefits.
Our firm has nearly 100 years of litigation experience and the Social Security Disability lawyers in our Appleton office have a comprehensive knowledge of the Social Security Disability application process. From preparing an initial application to re-applying for benefits that have recently been denied, our attorneys can help to navigate the Social Security Disability system on your behalf.
Our main office is located at 303 S. Memorial Dr. and is within minutes from the Appleton Social Security Office. We offer a free, no-obligation consultation and are available today.
For your free consultation, call (877) 888-5201.
Understanding Social Security Disability
If you are unable to work in Wisconsin due to a physical or mental disability, you may be eligible to receive Social Security disability benefits. To qualify, you must have a medical condition that the Social Security Administration (SSA) recognizes as disabling. The Social Security Act’s definition of disability for an adult states that a person must have a severe medical condition or a combination of conditions that have lasted or are expected to last for at least 12 months or result in death.
A child under the age of 18 may also be considered disabled if he or she has a physical or mental condition that seriously limits his or her activities and has lasted or is expected to last at least 12 months or result in death. This means that the SSA will not allow benefit payments for impairments that will not last up to one year.
There are various disability benefit programs offered by the SSA and the State of Wisconsin, that you may be eligible for. These include the following:
- Social Security Disability Insurance (SSDI) – If you have lost the ability to work due to a disabling condition, SSDI is a government program that provides a source of income. You must have worked at least five out of the last ten years to receive SSDI benefits. This includes earning enough work credits where in most instances, you need 40 credits. You will also need to demonstrate that your medical condition meets the SSA’s disability requirements and is expected to last for at least one year or result in death.
- Supplemental Security Income (SSI) – SSI is a financial supplement program that helps pay benefits to disabled adults and children who have limited income and financial resources. These benefits can be paid to any age group as long as the financial requirements are met. You must prove that you can no longer work while suffering from a qualifying physical or mental disability.
- Disabled Widows and Widower Benefits – These benefits provide financial assistance to widows and widowers who are 50 years or older and have lost a spouse within the last seven years, prior to their disability. To qualify, the deceased spouse must have been employed long enough to have contributed to Social Security. The SSA can inform you whether or not your deceased spouse had enough work credits. In addition to these benefits, you may also be eligible for a one-time survivor’s benefit from the SSA as long as you were living with your spouse at the time of his or her death.
- Disabled Adult Child Benefits – These benefits are available to children who are over the age of 18 and have become disabled before they turned 22. To qualify, the child’s parents, if living, must be eligible for disability benefits. If the parents are deceased, they must have been contributing to Social Security long enough for the child to gain benefits.
If you believe that you may be eligible to qualify for disability benefits, contact an Appleton Social Security Disability lawyer from Sigman, Janssen, Sewall, Pitz & Burkham, and learn more about how we can help you.
How We Can Help With Your Application
Ana Burkham - a partner at the firm - has been handling Social Security Disability cases for more than a decade, while as a firm, we have been handling SSD cases in Wisconsin for more than 35 years.
We have a comprehensive knowledge of the application process and can apply that knowledge to your specific claim. For example, when clients contact our office for help with a denied application, we begin reviewing a variety of factors that may have had an impact on their submission. These may include:
Insufficient Medical Evidence
A disability claim may be denied due to insufficient medical evidence to prove a long-term disability. The burden of proof falls on the applicant to demonstrate the severity of the medical condition. This means submitting substantial medical evidence - such as medical records and doctor’s notes - that clearly demonstrate you are unable to work due to a disabling condition. It must be shown that the disability prevents all work activity. Disability under SSA requires that the applicant is unable to perform any substantial gainful work activity.
Failure to Follow Recommended Treatments
You may have a greater opportunity of being approved for disability benefits if you have a strong working relationship with your doctor. However, not following recommended treatments can result in your claim being denied, as the SSA may find it difficult to determine if your inability to work comes from a medical condition or your inability to cooperate with a treatment plan. If the SSA determines you are trying not to get better, it may be justification for denial.
Income Exceeds the Allowable Limit
The income of an applicant cannot exceed the SSA’s substantial gainful activity (SGA) allowance. This means that if you are working and earning more than $1,220 (or $2,040 if you are blind), your disability claim may be denied.
Failure to Cooperate with the SSA
Applications may also be rejected if the applicant refuses to give permission for the SSA to access medical records - or if the applicant fails to show up for a medical exam. A medical exam is generally scheduled when there is insufficient evidence to support that the claim that the applicant has a qualifying disability. A claim may also be denied if the SSA cannot contact you to discuss the status of your application. Be sure to keep all of your contact information up to date.
Disability is Related to Drug or Alcohol Abuse
If drugs or alcohol are the main contributing factor(s) to your disability, your claim may be denied. However, you may still be able to obtain disability benefits if you have a medical condition in addition to a drug or alcohol addiction. For instance, a blind person is still eligible for benefits even if they have an alcohol problem, because his or her vision deficit prevents them from being able to work, regardless of whether they struggle with alcohol abuse.
In addition to these reasons, even prior claim denials can affect the outcome of you receiving disability benefits. Many people assume that filing a new claim is a better alternative than filing an appeal, but this is not the case. When the claims representative reviewing your claim sees that you have been previously denied, it may be enough justification to deny your claim again.
If you are unsure about your eligibility, contact a qualified Appleton Social Security Disability attorney with experience in appealing SSD denials at Sigman, Janssen, Sewall, Pitz & Burkham, today. We can help to answer any questions you may have about eligibility for benefits and if you qualify, assist you with the entire application process.
Complete our Free Case Evaluation form today.
Appealing a Denied Disability Claim
If your application for disability benefits is denied, you have the right to appeal the decision. Typically, you only have 60 days after you receive notice of the SSA’s decision to file an appeal. Your request must also be in writing.
Our Appleton Social Security Disability lawyers can help with this process and ensure that:
- Your appeal is filed within the deadline
- The appeal is completed correctly
There are four levels to the appeals process:
Request for Reconsideration
A reconsideration is a complete review of your claim by someone other than the examiner who initially denied it. He or she will look at all the evidence submitted in the initial claim as well as any new evidence. A decision should be determined within two to three months. At this stage, approximately 19 percent of Wisconsin residents get approved compared to a 13 percent approval rating nationwide.
Hearing by an Administrative Law Judge
If your disability claim is again denied after reconsideration, you can request a hearing before an administrative law judge (ALJ). The hearing is generally held within 75 miles of your home. The average wait time for a disability hearing is about 16 months.
Once your hearing date arrives, you have the opportunity to speak directly with the ALJ about why you deserve to have disability benefits. He or she will ask questions to decide whether or not you are eligible for SSD benefits. A witness - such as a medical or vocational expert - may also take the stand and provide an opinion on your disability. After the hearing, the ALJ commonly issues a decision in writing within 30 days.
Request an Appeals Council Review
If you do not agree with the ALJ’s decision, you can ask the SSA’s Appeals Council to review your disability claim. The Appeals Council may deny your request if it believes the hearing decision was appropriate and in accordance with Social Security law. If the Appeals Council does decide to review your case, one of two things will happen: it will either decide your case on its own or return to another ALJ to review your case further.
Federal Court Review
If that is unsuccessful, the last option is to file a lawsuit in federal district court. You will be sent a letter from the Appeals Council detailing how to ask the court to look at your case. No new evidence or documents will be considered. The federal judge will review the transcript of your hearing and examine the same medical evidence provided to the ALJ for that hearing in order to make a determination in your case.
The appeals process can be complicated and quite frustrating to do on your own. If you want a fighting chance for a positive outcome, it is highly recommended to obtain legal representation. An experienced Appleton Social Security Disability attorney at our firm can assist you on all aspects of the appeals process.
Our team is here to help. Call (877) 888-5201.
Documents Required For an SSD Application
The Social Security Administration also offers a Disability Starter Kit, which can help to explain the necessary information you need to begin completing an application.
Some of these documents may include:
- Your Social Security number
- Your birth certificate or other proof of birth
- Proof of U.S. citizenship or lawful alien status
- Information about your work, including the amount earned this year and last year
- Detailed information about your medical condition or disability
- Contact information from your treating doctor, hospital or clinic
- Medical records, including doctor reports, medications you are taking and recent test results
- Recent W-2 forms and/or self-employment tax returns
After your application is received, a claims representative from the SSA will be assigned to your case. He or she will review your application and reach out if they need more information. If you are eligible, your application will then be sent to the Wisconsin Disability Determination Bureau (DDB) for a medical determination of disability.
The DDB will be responsible for making the initial decision on your disability claim. In other words, the SSA processes disability applications while the DDB decides to approve or deny disability claims.
Submitting incorrect &/or incomplete information to the SSA can be a reason that your application is denied.
Applying for disability benefits is a detailed and time-consuming task, which is why many applicants make the decision to hire an attorney for help. At Sigman, Janssen, Sewall, Pitz & Burkham, we charge no upfront fees and your initial consultation with an Appleton Social Security Disability lawyer from our law firm is free. We understand the process, have many years of experience and help to gather the information that is needed for your specific application.
Contact Our Appleton Social Security Disability Attorneys
If you need assistance applying for disability benefits or appealing a denied claim, our Appleton Social Security Disability attorneys can help. We have decades of experience handling SSD claims and a proven record of success.
We welcome the opportunity to review your claim during a free, no-obligation consultation. There are no upfront costs or fees to you. We do not get paid unless our clients receive benefits. We are ready to help you today.
Call our team today at (877) 888-5201.