Long-Term Disability Appeals: A Four Step Process

Long-Term Disability Appeals: A Four Step Process

6 February 2019
 Categories: , Blog


The last thing that you want to worry about is loss of income after you have sustained a serious accident. Many injured workers are unable to work for an extended period of time due to illness or injury. Disability insurance is designed to help supplement a person's income until he or she can return to work.

Long-term disability specifically serves the needs of those who will be out of work for a long time. The process of applying for long-term disability can be daunting, and receiving a denial can be heartbreaking. An experienced attorney can help you appeal your denial by working through a four step appeal process.

Step 1: Request for Reconsideration

Some people make the mistake of submitting new paperwork after their original claim is denied. This can waste valuable time and resources, and may result in another denial. Instead, you should request that your original claim be reconsidered.

This involves submitting your original paperwork to another Social Security Administration representative for a second opinion. If your attorney identifies any information that was omitted from your original application, you can submit this information as supplemental evidence during the reconsideration phase.

Step 2: Disability Hearing

If the second representative also denies your application, your attorney can request a disability hearing. This puts your claim in the hands of an administrative law judge. The judge will hear your case and use his or her knowledge of administrative rules to determine if you qualify for long-term disability.

The help of an attorney is critical during the hearing phase of your appeal. An attorney will be able to call upon expert witnesses to help prove that your illness of injury has affected your ability to seek gainful employment.

Step 3: Appeals Council

You can still seek an additional opinion as to the validity of your long-term disability claim even if the administrative law judge rules against you. A panel of administrative law judges make up the appeals council.

These judges will focus more on determining if proper laws and procedures were followed in the deciding of your case during the disability hearing. The appeals council can either approve your request for benefits, deny you outright, or send your claim back to the judge who conducted your hearing with their notes and request a new hearing be conducted.

Step 4: Federal Court

When you have exhausted all other avenues for appeal, you can take your claim to federal court. Your attorney can file a lawsuit on your behalf if you feel that you were unfairly denied long-term disability benefits. A federal court judge will review your appeals documentation and make a final ruling on your eligibility for benefits in the future.

Contact a lawyer, like Scott E. Shaffman Attorney At Law, for further assistance.