Health Insurance Issues
October 24, 2011 - 11:42am
SSDI Appeal to the appeals committee-Has anyone went this far-Need some help ASAP
So I had my appearance before the ALJ in mid July, and 6 weeks later he ruled unfavorably. He ruled my PCP statements as unreliable based on an incorrect date in one of my PCP's letters; and because he used a fill-in-the blank RFC that was provided by my attorney. This is just a very brief run down of his explanations.
Last week my Dr sent me for new MRI's of my entire back, which, as I expected, showed some drastically worsened conditions. Disc extrusion at T6-T7 with mass effect on the sac and cord; C5-C6 left paracentral protrusion with neural compression at the foramen; C6-C7 bilateral foraminal encroachment due to uncovertebral spurring & tight central stenosis with developing myelomalacia of the cord with 5mm AP canal diameter; L4-L5 foraminal narrowing in the setting of disc bulging; L5-S1 left foraminal narrowing due to asymmetric disc bulging.
My attorney is relatively sure that with the now present problems at C5-C6, C6-C7, and T6-T7 I should receive an approval within a few months, IF I REFILE. On the other hand, if I file an appeal to go before the appeals committee based on the new MRI evidence, he is less confident that the ALJ's decision will be over-turned and also stated this process could take up to 2 years.
I have to decide before this Friday if I am going to appeal or refile. If I refile, back pay will only go back to the ALJ's decision date. So, here's my connundrum: Should I file the appeal and prepare for another long haul in the process, with the possibility of getting denied again, at which time I could also reach the end of my work credits; or should I refile with the greater possibility of getting approved rather quickly, but also losing out of about $45000 in back pay.
Anybody want to step in my shoes and make this decision for me? This is one of the toughest decisions I have ever had to make. We could sure use the relief of having that monthly income; but, I also had a lot of needed plans for the back pay.... Which way would you go?
Has anybody appealed to the appeals committee? If so, how long did it take for their decision, and was their decision favorable?
Please, as many opinions as possible, as quickly as possible. If I appeal, I'll have to phone my lawyer Thursday afternoon.
Thanks, Tim
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I am not sure if your attorney told you this or not. But sense you went in front of the judge you can appeal that decision and also submit another application. I know it sounds crazy, but that is the way it works. The second one could come in before the appeals counsel looks at the first decision. Believe it or not all of that information will catch up with both cases. So you can make your new application and still file the appeal. Call SSDI, and ask them and they will tell you the same. So really you don't have to make a decision. The one thing that has to be done is the appeal has to be written first, which your attorney only has 60 days to appeal, then you re-apply even though the appeal is out there. The appeal committee will not look at new evidence only what was submitted to the judge. So now you have new evidence to submit so you make a new application with the new evidence.
Thanks tamtam,
However, a new ssdi ruling in June 2011 prohibits refiling and appealing at the same time. My lawyer informed me of this a few weeks ago. And I just got off the phone with SS and they confirmed this new ruling, an individual may NOT file a new case when a previous case is still open. One cannot refile until after the appeal deadline date of an open case.
Oh, if it were still possible, it would have definitely made things a lot easier on me.
Tim
Also, the appeals committee will now receive and review any and all new evidence. But, if I understood my lawyer correctly, the new evidence has to be filed at the same time as the appeal letter.