Appealing the SSA’s Decision About Your Eligibility After a Routine Medical Review

The initial process for getting approved for Social Security Disability Insurance (SSDI) benefits can take a significant amount of time and effort, and in order to be approved, you must provide detailed evidence proving your medical eligibility. Once you are approved, it can be a relief for benefit checks to begin coming in, but it can also be frustrating to realize that you will need to undergo medical reviews in which your eligibility may be at issue. If your eligibility is denied after a scheduled medical review, can you appeal?

You can certainly appeal if you are denied eligibility for SSDI benefits after a medical review takes place. Our national SSD eligibility lawyer can assist you with your appeal, and we can provide you with more information about what to expect in this appeals process below.

Understanding the SSA’s Medical Review Process

The frequency with which you will need to undergo a medical review from the SSA will depend on the details of your case. The frequency of reviews after approval for SSDI benefits is based on medical expectations for your improvement. If your condition is expected to improve, your first medical review will occur anywhere from 6 to 18 months after the date of your disability. If medical evidence suggests improvement is possible but is not definite, you can expect a medical review every three years. Finally, if you have a condition in which improvement is not expected, you can anticipate a medical review every seven years.

At the review, your medical evidence will be assessed, including new medical records and information after your initial eligibility was approved. What can you do if the examiner decides you are no longer eligible for SSDI benefits after a medical review?

Appealing the Decision from the Medical Review

In short, if you disagree with the decision made after a medical review of your case, you can appeal. Similar to the appeals structure after an initial eligibility denial, there are four levels of appeal that you can go through, and you should expect to only have 60 days to appeal from the medical review decision and through each of the following levels:

• Reconsideration, in which your information will be re-reviewed by parties who did not make the decision in your most recent medical review;
• Hearing, where you will appear before an administrative law judge (ALJ) if you do not agree with the reconsideration outcome to ask that you retain eligibility for SSDI benefits;
• Appeals Council review, where you will ask the Appeals Council to review the ALJ’s decision if you do not agree with it; and
• Federal court appeal, where you will bring a civil lawsuit in federal court if you disagree with the Appeals Council’s decision.

Contact Our National SSD Eligibility Attorney for Assistance with Your Appeal 

Was your eligibility for SSDI benefits denied after a medical review by the Social Security Administration? If so, you can appeal, but you will need to act quickly. Contact one of the experienced national SSDI eligibility lawyers at the Law Offices of Stephen Barszcz today to begin working on your appeals case.

Source:

ssa.gov/pubs/EN-05-10053.pdf