You can appeal an SSDI denial for an autoimmune disorder by filing a request for reconsideration within 60 days of the date you received your denial letter. The SSA assumes it will take 5 days for you to receive your letter. Update and submit medical evidence to show how your symptoms limit your ability to work.
If your request for reconsideration is denied, you can request a hearing before an Administrative Law Judge. If you are still dissatisfied with a ruling, you can appeal, and if the appeal fails, you may file a federal lawsuit as a last resort.
What to Do After Receiving a Denial
Your denial letter will explain why your application was turned down. To successfully appeal the decision, you must address these points. For example, the SSA may have declined your application because you provided insufficient medical evidence or because it implies you are still able to work.
Use Form SSA-561. If you wish to appeal a medical decision, you must also submit Form SSA-827 to authorize access to your medical information.
How to Strengthen a Claim For Autoimmune Conditions When You Appeal
The debilitating symptoms of autoimmune conditions fluctuate, sometimes from day to day, making it difficult for the SSA to determine whether you are eligible for disability assistance. To improve your chances of a successful appeal, it may be necessary to submit more comprehensive evidence. It may include:
- Updated test results and reports from medical specialists
- A letter from your doctor stating your physical limitations
- A symptom diary showing how frequent your flare-ups are and how they affect you
- Ask your doctor for support. They may be able to help with evidence to assess your residual functional capacity (RFC)
Residual Functional Capacity (RFC) is an administrative assessment of what a claimant can still do despite limitations. You can find a detailed account of how the SSA assesses RFC in 20 C.F.R. § 416.945.
There Are Four Levels of Appeal for an SSD Denial for Autoimmune Disorders
Applying for SSDI when you have an autoimmune disorder can be difficult because of the variability of your symptoms. However, you need not take an initial denial, or even a denial of your initial appeal, as final. You can escalate your appeal through four levels, each of which must be executed in order:
- Appeal for reconsideration
- A hearing before an Administrative Law Judge (ALJ)
- Appeal an ALJ’s ruling through the appeals council
- File a lawsuit in federal court
An SSDI attorney may be able to help you get approval. The National Bureau of Economic Research found that having representation may increase the chance of initial approval by 23%. Disability attorneys generally work on a contingency basis, charging fees only if they win applicants’ cases.
Following Your Treatment Plan May Strengthen Your Appeal
Apart from getting support from your doctor and representation by an attorney, your actions can contribute to a successful application. Follow your treatment plan closely. By doing so, you not only show that you are compliant with doctors’ orders but also continue to build medical evidence to support your claim.