December 27, 2018

YOUR SOCIAL SECURITY | Rock Island, Illinois Office

By Cristina Vital
Social Security Manager
Rock Island Social Security Office

DISAGREE WITH YOUR DISABILITY DECISION? WE WILL TAKE ANOTHER LOOK

Social Security is here to help secure today and tomorrow by providing benefits and financial protection for millions of people. This assistance allows people with severe disabilities and health conditions to take care of the necessities of living, such as food, shelter, and medications. It is imperative that we continue to protect the integrity of the disability program for everyone by ensuring we make the correct decision on each claim. However, if you do not agree with our decision, you can ask us to take another look by filing an appeal.

Generally, there are four appeal levels: 1) Reconsideration, 2) Hearing, 3) Appeals Council Review, and 4) Federal Court Review. At the Reconsideration level, someone who did not make the first decision on your claim will conduct a review and accept any additional evidence. Please note, in some states, appeals may proceed directly to the next step – the hearing.

If you disagree with the reconsideration decision, you can file another appeal and your case will go to the hearing level. You, and any witnesses you bring, may present your case in front of an administrative law judge during this stage. The judge will then make a decision based on the information. If you disagree with the hearing decision, you can ask for a review by the Social Security Appeals Council. The Appeals Council can either make a decision or return your case to the judge for further review.

If you disagree with the Appeals Council’s decision or they decide not to review your case, the last step in the appeals process is filing a lawsuit in a federal district’s court. You will be notified of our decision in every step of the process and the notice will have the information needed should you decide to appeal the decision.

If you receive a denial notice, you have 60 days from that date to file an appeal. There are several ways to obtain the proper appeal forms. The easiestand quickest way is filing online by visiting www.socialsecurity.gov/benefits/disability/appeal.html. You will be able to submit documents electronically to associate with your appeal request. You can also call us at 1-800-772-1213 or visit your local Social Security office to obtain the forms.

Many people wonder if they need a lawyer when filing and appealing disability benefits. Whether you choose to appoint an attorney or authorized representative is completely up to you. However, it is not required that you have one in any part of the process or in conducting business with Social Security. If you decide to appoint a representative, be sure to complete the necessary documents to authorize us to speak to them on your behalf. You can also read our publication Your Right to Representation at www.socialsecurity.gov/pubs/EN-05-10075.pdf.

Social Security takes considerable pride in administering program benefits timely and accurately. The disability program is no exception. This is why we encourage you to contact us as soon as possible if you disagree with our decision. Give us a call, visit the local office, or go online at www.socialsecurity.gov/benefits/disability/appeal.html so we can take another look at your claim.

EXTRA HELP WITH MEDICARE PRESCRIPTION DRUG COSTS

Paying out of pocket for prescription drugs can be a burden that many households can’t afford. The Extra Help with Medicare Prescription Drug Plan Costs program was designed to help people in getting the vital medicine they need to live healthy and productive lives.

Anyone who has Medicare can get Medicare prescription drug coverage. Some people with limited resources and income may also be able to get Extra Help to pay for the costs — monthly premiums, annual deductibles, and prescription co-payments — related to a Medicare prescription drug plan. Extra Help can be worth up to $4,900 per year.

To qualify for Extra Help in 2019, your resources must be limited to $14,390 for an individual or $28,720 for a married couple living together. You can apply for Extra Help at www.socialsecurity.gov/extrahelp. You can also call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to apply over the phone or request an application, or if you prefer, you can apply at your local Social Security office.

To prepare for your application you should:

  • Identify the things you own alone, with your spouse, or with someone else, but do not include your home, vehicles, burial plots, life insurance policies, or personal possessions;
  • Review all your income; and
  • Gather your records in advance to save time.

The records you’ll need are:

  • Statements that show your account balances at banks, credit unions, or other financial institutions;
  • Investment statements
  • Stock certificates;
  • Tax returns;
  • Pension award letters; and
  • Payroll slips.

The program was created because there is a great need for prescription drug assistance. Social Security is here to help. To learn more about the Extra Help program, visit www.socialsecurity.gov/extrahelp.

Filed Under: Retirement

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