The SSI/SSDI Appeals Process


One thing that any new applicants for disability benefits will hear about shortly after submitting their application is the disability appeals process. It can sound like a daunting and difficult process filled with claimant participation, occasionally making the claimant feel responsible for keeping the process moving. However, most times, while the claimant will be asked to fill out some paperwork, go to an interview, or a doctor’s visit, the process for claimants can be relatively seamless. This post (and the parts that come after it) will take readers through some brief descriptions of the steps in the appeals process and what the roles of the claimant and representative are at each stop.

The Application

The application is actually the first step in the appeals process. Most people think of the application as only beginning their claims for benefits. However, even the best compiled application can fall into the 60-65% of applications that are denied. Well thought out applications and supporting documents will lay the foundation for any subsequent appeals that may be necessary.

At this stage of the process a claimant should gather everything that they can to provide to SSA either directly or through their representative. This information is going to include doctors’ names, addresses, and dates of treatment; former employers and dates employed, education history, bank account information, and more. It is a lot of information to provide, but the more of it you have on hand, the more complete your application will be; the more complete your application is, likely means the quicker the response from SSA will be and with a greater chance of success.

For the application, the representative will have the responsibility of compiling the information from the claimant in a way that makes sense to SSA. This is going to mean several things. First is literally organizing the information. When completing an application for a claimant a representative will be required to enter this information in a certain order for an online application and then mailing, faxing, or both the packet of information collecting from the claimant to the Administration. The representative will have to find out which office it goes to, to whom the case has been assigned, and whether to request that SSA take certain actions such as requesting a consultative exam.

They will also be responsible for pointing SSA to the locations of the claimant’s medical records so the agency can procure everything relevant to the claim. Many representatives will do more to develop the record such as collecting medical source statements, collecting letters from collateral witnesses, and drafting briefs. The representative may also work closely with an SSA case worker on more detailed cases or SSI cases which are dependent upon the confirmation of detailed information and subjective valuations (i.e. blue book value vs. true car vs. eBay auction value) of assets such as homes and cars.

In a nut shell, it benefits the claimant to present as much information as possible when submitting a disability application. So, the representative’s role is generally to assist them in collecting it and communicating it to SSA in a manner that is easily digested by the agency.

Stay tuned for the next part of our discussion of the roles of the representative and the claimant during the appeals process! If you have questions about this before our series is done please do not hesitate to contact us!