Termination of Disability Benefits: Evidence Requirements

December 7, 2023

By Steve Fields
Principal Attorney

If your disability benefits have been terminated by the Social Security Administration (SSA), you have the right to file an appeal. However, the technical and medical evidence required to win an appeal may be complicated for most people to understand.

In general, the Social Security Administration requires that you submit new evidence with your appeals application. In fact, if the paperwork in your appeals application is the same as the one included in your initial claim, then your application will likely be rejected.

Continue reading below for more information on what evidence you need to win an appeal.

The Social Security Administration Appeals Process

Reconsideration and a hearing are the two steps in the appeals process. However, if your appeal is rejected at the hearing level, you may take your case to federal court. 

Request for Reconsideration

When compared to the hearing stage, your prospects of getting Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) at the reconsideration stage are pretty low. 

By filing for reconsideration, you can request that the Social Security Administration conduct an additional review of your application. The Social Security Administration will typically take around six months to assess your request for reconsideration. 

ALJ Hearing

If you are unhappy with the outcome of your request for reconsideration, the next thing you need to do is arrange a hearing in court with an Administrative Law Judge (ALJ) for your appeal. 

This hearing normally starts approximately a year and a half following the reconsideration, and it takes roughly a month for the court to issue a decision. Social Security hearing appeals have a better chance of success than reconsideration appeals.

Federal Court Review

If you are unsuccessful at the appeal hearing, you have the option of taking your case to the federal court. 

On the other hand, the likelihood of successfully appealing your SSDI claim in federal court is relatively low. The important thing to remember is that any chance, no matter how little, is better than none at all.

Evidence Requirements for Successfully Filing an Appeal

The Social Security Administration may reject your initial SSDI claim if they determine that you do not actually qualify for these payments. They may have come to this conclusion for any one of the following reasons:

  • They could assume that you did not follow the recommended medical treatment for your disability, injury, or illness as closely as you should have in order to recover from it.
  • They could assume that your disability, injury, or illness will not persist for more than 12 months.
  • They could assume that your disability, injury, or illness won’t prevent you from retaining employment.
  • They could assume that your disability, injury, or illness was brought on by a misuse of alcohol or drugs.

Consequently, if you want your appeal to be successful, you will need to present sufficient information that challenges the initial conclusions drawn by the Social Security Administration. 

To put it another way, you will want to demonstrate that you actually meet the requirements for Social Security Disability Insurance benefits so that they will reconsider their decision. 

A statement from your physician in which they describe the nature of your injury, illness, or limitations and how it affects your capacity to work is a significant piece of evidence. However, your doctor will need to provide you with some extra information, which might include the following:

  • Your doctor should explain your medical diagnosis in detail.
  • Your doctor should describe the details associated with your medical diagnosis, sometimes known as the symptoms linked to your diagnosis.
  • Your doctor ought to go over the details of testing outcomes, which are the laboratory test results related to your diagnosis.
  • Your doctor should provide a detailed account of your medical history prior to making a diagnosis.
  • Your doctor should explain the medicine or other treatment they gave you, how you responded to it, and what their final prognosis is.

Procedure for Submitting New Evidence During Appeals

If the Social Security Administration denies your initial claim for Social Security disability benefits, you can file an appeal by submitting a Request for Reconsideration. 

If you decide to submit your request for reconsideration to the Social Security Administration, you should include any new or revised medical documentation that would be helpful for overturning the SSA’s decision. 

If your Request for Reconsideration was turned down, you will have to request a hearing to have your case reviewed. 

The lengthy wait times between when an application is submitted and when a hearing date is finally set means that new medical evidence is frequently discovered while an applicant waits for their turn in court. 

You must provide the administrative law judge who will be hearing your case with all of the additional medical evidence that pertains to your condition as soon as you receive notification that the date of your disability hearing has been set.

You have ten days from the day you received notice of your Social Security Disability hearing to provide this documentation. If you need more time to gather the evidence and submit it to the court, you can apply for it by requesting an extension from the judge.

Should I Contact a Disability Lawyer?

If you are going to provide additional evidence to the administrative law judge who is to be hearing your case, it could be in your best interest to hire an attorney or advocate to present the documentation on your behalf. 

It’s possible that you won’t need an attorney or advocate until your reconsideration request is denied, but that doesn’t mean you shouldn’t get help now. When you consult with a disability advocate or lawyer, they can examine your case and point out any errors in your Social Security disability application. These experts in the field of disability law know exactly what the Social Security Administration wants to see in a claim in order to grant benefits.

Conclusion

Most Social Security disability applications get denied due to a lack of medical evidence. So, when filing an appeal, you want to make sure you don’t make the same mistake again. And for that, it’s essential to know the kind of evidence required when filing an appeal.

Author

Steve Fields is the founder and managing attorney at Fields Law Firm. Since founding the firm in 2001 he quickly established a reputation with his Personal Injury clients for being a lawyer who truly cares.

Together with his experienced team of legal professionals, Steve ensures clients win their case, maximize their recovery while also looking out for their long-term interests, all backed with the firm’s Win-Win Guarantee®.

Fields Law currently handles cases for Personal Injury, Workers’ Compensation, Long Term Disability, Social Security Disability and Consumer Rights and has grown to be one of the largest injury and disability law firms in the nation.

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