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What Happens if I Am Denied?

Your Right to Appeal

If your claim for Social Security Disability (SSDI) or Supplemental Security Income (SSI) is denied, you have the right to appeal the agency’s decision. In Vermont appeals are first sent back to Disability Determination Services (DDS) in Waterbury to be reconsidered. Since DDS is the same agency that denied benefits in the first place, it rarely sees things differently the second go around. However, if DDS changes its mind, Social Security awards benefits and starts processing the claim for payment. If the claim is denied after reconsideration, then the claimant has a right to request a hearing before an Administrative Law Judge (ALJ) for the Social Security Administration. Neither New Hampshire nor New York go through the reconsideration stage. If a claim is denied in one of those two states, then the claimant must appeal for a hearing directly.

Hearings before an Administrative Law Judge

Most of the claims handled by Jarvis & Modun go to a hearing in front of an ALJ. The ALJs who hear claims from Vermont and New Hampshire work out of Social Security’s Office of Disability Adjudication and Review in Manchester, New Hampshire. For northeastern New York, they work out of Albany. Most hearings in Vermont, northern New Hampshire, and northeastern New York are conducted by video conference. In these regions, Social Security maintains video-conferencing offices in Burlington, St. Johnsbury and Brattleboro, Vermont and Plattsburgh, New York. Although may hearings are done by video, you have a right to a hearing in the presence of a live judge. If you prefer being in front of a live judge, then an ALJ will travel to one of the remote hearing sites to hear your claim.

In New England, all medical evidence must be submitted to Social Security at least five business days prior to the hearing, or it might not be considered at all. These days, most claims files are completely electronic. You have a right to an electronic copy of all the records in your claims file so that you can review everything Social Security has.

Although disability hearings are informal, testimony is given under oath. You have a right to have a representative with you at the hearing. In addition to the ALJ and your representative, a clerk is always present and is responsible for recording the proceedings. You have the right to call witnesses on your behalf. Social Security frequently calls experts to testify. It’s common for Social Security to call a vocational expert to testify about vocational issues related to your claim. Sometimes Social Security may call a medical doctor or psychologist to testify as a medical expert. The ALJ listens to the testimony of the witnesses and considers the document evidence in your file. He or she then issues a written decision that either approves your claim completely, approves it in part, or denies it completely. Sometimes an ALJ may give an indication at the hearing of whether he or she intends to approve the claim. However, this is not always the case, and even when it happens, nothing is final until the ALJ issues his or her written decision. If the case is approved, then the claim is sent back to your local Social Security office to process for payment.

Vocational and Medical Experts

Vocational and medical experts can make or break a claim. Medical experts may offer opinions about what medical impairments you have and whether your impairments meet or equal listing level conditions. They may also offer opinions about your residual functional capacity. The ALJ then consideres these opinions when he or she decides whether you are disabled because of the medical listings or whether you have the functional capacity to work.

Vocational experts classify your past work in accordance with the U.S. Department of Labor’s Dictionary of Occupational Titles. The ALJ may also use the vocational expert as a resource to understand the physical and mental demands of particular occupations as they are typically performed. During the hearing, the ALJ almost always poses hypothetical questions to the vocational expert about whether you could do to your past work or other work assuming you have certain limitations. You may not always agree with the limitations the ALJ chooses to use. If the ALJ denies your claim, subsequent appeals almost always focus on whether the limitations posed by the ALJ to the vocational expert adequately reflect the limitations you would face at work.

Appeals after the Hearing

If the ALJ denies your claim completely or in part, you have the right to appeal your claim further. The next level of appeal is to Social Security’s Appeals Council in Virginia. It considers all appeals of all ALJ denials from around the country. If it does not reverse or remand the ALJ’s denial, then you have the right to file a civil action in the U.S. District Court where you live. The final right to appeal is to the U.S. Circuit Court of Appeals. The U.S. Supreme Court very rarely hears appeals of Social Security claims, and it chooses the cases it wants to hear.

How Jarvis & Modun Helps You through the Appeals Process

Social Security’s disability claims process can be long and frustrating. From the outside looking in, the Social Security Administration can seem like a huge, faceless bureaucracy. If you are fortunate as a claimant, you’ll face it once. The disability lawyers at Jarvis & Modun have guided clients through the process hundreds of times. We have handled cases from initial applications all the way through to the U.S. Circuit Court of Appeals. We know the process. If you hire us, then you rely on us to shepherd you and your claim through it. We give you legal advice at each stage about the strengths and weaknesses of your claim and how to make it stronger.

We also deal with all of the deadlines you face. After each denial there is a deadline for appealing your claim to the next level. There is also a deadline for submitting evidence into your claims file. Jarvis & Modun worries about these deadlines so you don’t have to.

Jarvis & Modun knows the questions to ask vocational and medical experts that will help your case. Most claimants have no experience dealing with the opinions of a vocational expert or doctor. Sometimes claimants have a hard time even understanding what the experts are saying. We have years of experience handling experts. We have questioned experts in hundreds of cases. We know what works and what doesn’t.

Finally, we advocate vigorously for you at all levels of the process. We argue why the evidence and the law show you are disabled. Put our experience and expertise to work for you. Call Jarvis & Modun at (802) 540-1030 to discuss your SSDI or SSI claim.