After sustaining a disability, people can rely on Social Security Disability (SSD) insurance to cover their basic needs. Unfortunately, not all claims lead to approval. Sometimes, issues involving the process or eligibility standards can arise, possibly causing denial. In these situations, claimants can ask the agency to reconsider the decision, which usually involves various people who can help paint a clear picture and contribute to the outcome, such as medical experts (MEs).
The SSD appeals process typically involves hearings with an administrative law judge (ALJ). When reviewing the case, the ALJ consults MEs responsible for providing impartial professional insight and opinion, serving as evidence for the claim. An ME is often necessary to fulfill the following duties:
- Verifying if the involved impairment or disability is eligible based on the agency’s standards
- Giving further information about the impairment, especially if combined with other health issues
- Providing unbiased information to reflect the actual challenges faced by the claimants, considering their circumstances
- Answering questions the ALJ may have about the case, potentially impacting their decision
- Confirming if the claimant’s testimonies are accurate and have a factual basis
As a valuable resource, an ME may need to perform other tasks based on the situation. Their expertise could be necessary to clarify inconsistent information. By fulfilling these duties, the ALJ can make reasonable decisions, considering the case details and other facts presented during the hearing.
Knowing how to navigate the appeals process
The SSD appeals process can sometimes be straightforward, but it is usually complex. There is no way to guarantee a favorable decision, especially since the outcome significantly depends on what happens during hearings. Still, it can be beneficial to understand the situation and the steps that will follow fully. By doing so, claimants can make necessary preparations and determine other appropriate options.
