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Should I appeal my SSI denial or start a new SSI Claim?

This is a tough question which really depends on the situation of your Supplemental Security Income (SSI) claim and why you were denied SSI benefits by the Social Security Administration (SSA).

Why was I denied SSI benefits?

• Your income or Resources were too high

The SSI program requires you to meet certain income and resource limits, in addition to meeting the disability criteria. If you do not meet the income and resource criteria you will be denied SSI benefits, regardless of whether you meet the other medical criteria (aged, blind or disabled).

• You were considered not disabled

The SSA will determine you are disabled using the same criteria they use for Social Security Disability Insurance. You must have a severe mental or physical health condition which is so serious that it does not allow you to perform substantial work for at least 12 continuous months or is expected to result in your death.

• Your mental or physical health condition is not expected to last for 12 continuous months

If your condition is not expected to last for at least 12 continuous months you will be denied SSI benefits, regardless of the severity of your current health condition.

• You are performing substantial gainful activity

If you are working and making too much money, the Social Security Administration will deny Supplemental Security Income benefits. Work does not have to be full-time and you do not have to be realizing a profit to be considered “substantial.”

Proving that you are disabled

If your claim was denied because your income and resources were too high or you are working too much, you can appeal the denial, but unless something has changed, (i.e. you have stopped working) the SSA is likely to deny you a second time.

The other two denials can be more easily challenged. For instance, whether or not your condition will last 12 continuous months or whether your are disabled can be a subjective decision the SSA made after studying your medical records. If you were able to get more objective medical information that your condition is more severe and will last at least 12 continuous months, you may be able to prove you are disabled and unable to work.

Should I appeal my SSI denial or file a new SSI claim?

Most disability advocates or lawyers would probably argue that it is better to appeal the initial SSI denial rather than applying a second time. The reason is very simple; appealing the denial allows you to get to the administrative hearing faster which generally gives your best opportunity to win your SSI claim.

The administrative hearing is not the first level of appeal; in fact, you will have to appeal for a reconsideration before you can appeal a second time for a hearing, but the hearing will allow you for the first time to plead your case before the decision maker who has the authority to award you SSI benefits.

The best thing to do is talk to a disability lawyer. They can review your initial SSI application, your medical records and your SSI denial letter. They should be able to tell you what additional information you need to add to your medical file to improve your chances for winning SSI benefits at the administrative hearing.