If you have already been denied Social Security Disability Insurance or Supplemental Security Income (SSI) disability benefits at an Administrative Law Judge hearing in Delaware, it may be too late to obtain an Attorney at the Appeals Council Level of the disability process. I normally recommend that most people that are applying for Social Security in Delaware, or any State, should obtain an attorney to help them with the process as early as possible (before you even apply). The Social Security Disability process is difficult, and part of what an attorney can do is advise you of the requirements of the program. If you wait to consult with a lawyer until after you have been denied 3 times or more by the Social Security Administration in Delaware, even with the help of an attorney, it will be very difficult to be approved for benefits.
The Social Security Administration allows Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) claims to be reviewed de novo at the Initial Application Stage, Reconsideration Appeal and at the Administrative Law Judge Disability Hearing stage. This means that at each of these disability levels, the person deciding whether you are disabled can disregard the prior denials. They do not have to explain why it was wrong that you were previously denied Social Security disability benefits.
At the Appeals Council stage (normally the fourth step of the disability process in Delaware), the Appeals Council can only determine if the Administrative Law Judge had substantial evidence to support the conclusion that was made that you were not entitled to Social Security Disability benefits. This means that even if the Appeals Council would have made a different decision, if there is any support in the record for the ALJ’s conclusion that you are not disabled, and the ALJ did a good job of documenting why the particular decision was made, Appeals Council cannot reverse the ALJ decision, and you will not be found disabled by the Social Security Administration.
Typically, new evidence of your disability is not considered at the Appeals Council level. This means that even if you or an attorney can get an opinion from your doctors indicating that you were disabled (and met all the rules of the Social Security Administration), if this same opinion could have been obtained prior to the disability ALJ hearing, it would not be considered when the Appeals Council reviews your disability claim. Appeals Council is normally stuck with just the same evidence that the Delaware ALJ had to rely on when it was determined that you were not disabled. (The rare exception is when Appeals Council determines that the evidence is new and material).
If someone contacts me after they already have been denied at the Administrative Law Judge Hearing level in Delaware, it is normally very difficult for me to help with their Social Security Disability case. I consistently find that when the Delaware ALJ issued the decision, the potential client had not obtained supportive medical evidence indicating a basis for their disability, and there a very few (if any) medical opinions in their Social Security file. This is why it is important that you obtain an attorney at the earliest point possible (even before you apply for disability benefits). When I represent someone at an ALJ hearing, I work to get the most supportive evidence in the file before the Delaware disability hearing. This allows me to rely on this evidence even if an ALJ ultimately denies their claim for SSDI/SSI during an Appeals Council Disability Appeal.
If you are applying for Social Security Disability in Delaware, I would highly recommend that you contact an attorney immediately to discuss these issues. Don’t wait until after you have already been denied disability benefits by a Delaware Administrative Law Judge.
Even if you have a statement from one of your doctors indicating that you are disabled, these statements have little value in a Social Security disability proceeding if they are not well explained. Disabled is a legal term in Social Security Disability Law. The finding of being disabled is reserved for the Social Security Administration. A conclusion from your Delaware doctor that you are disabled, has no meaning unless the doctor explains what it means for you to be disabled.
For example, for a physical condition, your doctor needs to explain how you are limited in sitting, standing, walking, lifting, bending, crouching, using your arms, using your legs, and concentrating. There should be a detailed explanation of these limitations in any disability opinion from your physician, with references to the diagnosis that causes the limitations, and citation to test results that show your medical condition and disability exists.
This article was written by Steven Butler. Steven is a partner at Linarducci & Butler, PA and his practice is limited to Social Security Disability/SSI claims. Steven offers free initial consultations for Social Security Disability/SSI claims to residents of Delaware, Maryland, New Jersey and Pennsylvania. To schedule a consultation with Steven, please use the Linarducci & Butler Contact Form or call 302-613-0707 to schedule an appointment. If Steven determines that you have a qualified disability claim, he can even help you apply for Social Security Disability Benefits in his office.