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Public benefits

Appeal an SSI or SSDI denial

Amara's disability claim was denied, and the appeal deadline is close.

Amara. Amara can no longer work because of a back injury and depression. Her disability application was denied in a letter she found hard to follow, and the deadline to appeal is approaching. Her medical records are spread across three clinics.

Legal outcome they want
Amara appeals in time with the medical evidence, and gets a hearing.
Life outcome they want
Amara has steady income and coverage. She keeps her apartment.

The problem

People who can no longer work because of illness or injury may apply for disability benefits and receive a denial letter that is hard to follow. The letter sets a deadline to appeal. Medical records are often spread across several clinics, hospitals, and specialists, and gathering them takes time and energy the person may not have. People may believe a denial is final.

The legal outcome

The legal outcome is a timely appeal supported by medical evidence, and a fair hearing before an administrative law judge if the case reaches that stage. That requires understanding why the claim was denied, gathering records and statements from treating providers, and tracking deadlines through each level of review. Back pay can depend on the original application date, so a missed appeal deadline can cost the person months of benefits.

The life outcome

The life outcome is a steady income and health coverage, so the person can keep their home and focus on their health. Without benefits, people can lose housing and fall into debt while they wait. How could people understand a denial, gather their evidence, and stay in the process until their claim is decided on the merits?

One story of how this service works today

Where this story ends todayMany people who would win on appeal give up after the first denial.

  1. Specialized techA denial letter arrives from the agency
  2. Off-the-shelf techSearches online and finds law firm ads
  3. Community, family, or navigatorA friend says everyone gets denied the first time
  4. Non-expert helperClinic staff help request her medical records
  5. The personFiles the appeal form alone, without the records
  6. Expert helperA disability attorney takes the case at the hearing stage

Where people drop offMany people never appeal, and many appeals go in without the medical evidence.

A dashed step is one where people drop out of this story.

This is one story of how the service works today. It is a draft written for people to react to and change, and another place will look different.