It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Health Insurance Issues Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 07-27-2010, 05:08 PM   #1
Junior Member
(male)
 
Join Date: Jun 2010
Posts: 46
billj HB User
Unfavorable after alj hearing. What next?

I finally spoke to my attorney today. She said I had a new judge at hearing. He's a nice guy she said but he has over a 50% denial rate at his hearings lucky me. She said that she feels that he turned facts around to deny my case. She said she is going to show the misfacts the alj wrote in the denial letter and send it to the next level. Its so hard to be optimistic because I was told I may have to face the same judge again. Things were in the letter I didnt even say. Can someone tell me how the next level works. I believe my lawyer said its the federal level. They look at the case either deny and go along with the judge or send it back to the same alj or a different one. Does anyone know how long by your experience or another case experience how long this may take. I had a really good conversation with my lawyer. I want to believe in her but she said things went well at the alj hearing my hopes were up then. How long before the next hearing may be? She said all this may take 1 year and 4 months. Thar is so discouraging I dont know if I will make it. Thanks for any feedback

 
Sponsors Lightbulb
   
Old 07-27-2010, 08:32 PM   #2
Veteran
(female)
 
Join Date: Mar 2008
Location: USA
Posts: 355
sickofpain2 HB Usersickofpain2 HB User
Re: Unfavorable after alj hearing. What next?

I think your attorney needs to file an appeal and you need to write a letter of complaint listing all of the things that are wrong in the denial. things he did not address that is critical--that was a big one for me.

I wrote a letter of complaint (info should be on denial letter where to send letter) and my attorney filed appeal. The complaint letter was "dealt" with according to the response I got and my case was sent back to alj per appeals council--I got a different judge. I believe it was due to my complaint letter.

My second hearing was about 20 months after the 1st hearing and I was awarded at the 2nd hearing. This is not pleasant to hear--you have to keep fighting, somehow, someway!

 
Sponsors Lightbulb
   
Old 07-28-2010, 05:00 AM   #3
Junior Member
(male)
 
Join Date: Jun 2010
Posts: 46
billj HB User
Re: Unfavorable after alj hearing. What next?

20 months after the hearing. It is terrible the nightmare you went through. Im curious. Did you feel like I did reading the denial letter did it seem like the judge twisted everything around to make it easier for them to deny you? Also speaking to my attorney she said she would file the appeal. You are saying you sent the letter of complaint and I shouldnt just leave it in the lawyers hands? Thanks for responding.

 
Old 07-28-2010, 05:10 AM   #4
Junior Member
(male)
 
Join Date: Jun 2010
Posts: 46
billj HB User
Re: Unfavorable after alj hearing. What next?

Great advice. I am going to send a letter. When you sent in your letter did you send it to the office that denied you or somewhere else I think not sure she is filing the appeal at the federal level. Do you have the address where you sent your letter if you sent it elsewhere? Thank you so much.

 
Old 07-28-2010, 07:42 AM   #5
Veteran
(female)
 
Join Date: Mar 2008
Location: USA
Posts: 355
sickofpain2 HB Usersickofpain2 HB User
Re: Unfavorable after alj hearing. What next?

I will see if I can find the address for you for the letter of complaint. The attorney did not participate in that AT ALL! He just handled the appeal.

Yes, the first judge twisted things and did not cover many of the documented health issues. Medication side affects are huge with me and always has been--he never mentioned anything about that in his denial letter.

You will need to go over the letter and document every twisted detail. More details the better. I would think using bullet points should make it easier for you when putting the letter together.

Is there anything in the letter stating anything about where to send complaints? Not just appeals, but complaints.

 
Old 07-28-2010, 07:45 AM   #6
Veteran
(female)
 
Join Date: Mar 2008
Location: USA
Posts: 355
sickofpain2 HB Usersickofpain2 HB User
Re: Unfavorable after alj hearing. What next?

I did a google search--type in ssa letter of complaint for alj--it brought it right up. It has several Q&A's type things. Go and take a look.

It is called how to file an unfair treatment complaint. It even says it is different than appeals process.

Last edited by Administrator; 01-16-2014 at 08:42 AM.

 
Old 07-28-2010, 08:37 AM   #7
Member
(female)
 
Join Date: Aug 2007
Location: WILMINGTON,DE
Posts: 94
daph10 HB User
Re: Unfavorable after alj hearing. What next?

Im so sorry to hear this for you. It is a very long and trying situation. I filed in July05 finally got to the judge in Sept 07. Got a denial letter in Jan08. It was a terrible hearing my lawyer and judge fought for 20 minutes over something in my file. I knew it wasnt a good outcome then. So we appealed to the Appeals council and they remanded it back to the same judge. We appealed in Jan 08 and I am finally going back to the same judge who denied me in Sept 29, 2010. So for me it took over 2 years to go back to her. After we filed the Appeal my lawyer told me it could take years so we filed a new claim and I was awarded on the first try in July 08. So for me it was bitter sweet. Even though I collect ssdi now I have to go back to same judge for appeals on backpay from 05-08. And yes I am sure she will deny me again. I dont even want to go back.
It is a very long process once the judge denies you and if your lucky you get your appeals case remanded back to judge. Filing my second claim did not hurt the first one. But only file a new claim once you are denied by judge and not before then.

 
Old 07-28-2010, 12:21 PM   #8
Junior Member
(male)
 
Join Date: Jun 2010
Posts: 46
billj HB User
Re: Unfavorable after alj hearing. What next?

Thank you both for responding. Sickofpain2 I feel that will help me so much. Im going to do it without letting the lawyer know. I believe thats what you did? This gives me hope. How all of you have gotten through this is beyond me. You have incredible strenghth. I dont know if I do but im going to give it my best shot. Daph10 thats what I asked my lawyer. I asked do I have to see the judge again? When she said possibly yes my heart sank. As far as seeing the same judge I talked to my lawyer and she said that when there is alot of inconsistencies the judge probably got repremanded a slap on the wrist. I feel confident for you the judge probably doesnt want any more problems with your case.

 
Old 07-29-2010, 06:43 PM   #9
Senior Veteran
(female)
 
BB07's Avatar
 
Join Date: Feb 2010
Location: Lower Alabama
Posts: 1,001
BB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB UserBB07 HB User
Re: Unfavorable after alj hearing. What next?

bill you CAN and will make it-you should start a new claim alot of people on these forums did just that and won thier second filing while waiting for the federal appeal so you should talk to your atty about starting a new claim in the mean time if she says not to i would get a second opinion- but you keep pushing on and quitting is NOT an option!! pulling for you-God bless
__________________
constant companion pain

Last edited by BB07; 07-29-2010 at 06:44 PM.

 
Old 07-29-2010, 08:31 PM   #10
Veteran
(female)
 
Join Date: Mar 2008
Location: USA
Posts: 355
sickofpain2 HB Usersickofpain2 HB User
Re: Unfavorable after alj hearing. What next?

Get the letter written and off in the mail asap! Be as thoughtful and detailed as you can be but lay all of your complaints out! It can not hurt one bit! And yes, I did not involve my attorney in my letter of complaint--they would have just complicated all of the wording where a normal person would not understand.

Also, Do you have copies of all of your medical records? If not, get them for yourself and keep them all together and keep them forever. Did you look at your file when you had your hearing? Was it missing anything? Sometimes records or parts of records get misplaced. If there is something missing--get it resolved asap. My file was about 10" thick if that tells you anything.

I believe to this day that that letter of complaint made all of the difference in EVERYTHING!

Last edited by sickofpain2; 07-29-2010 at 08:33 PM.

 
Old 07-30-2010, 09:56 AM   #11
Senior Veteran
(female)
 
Join Date: Jul 2008
Location: Texas
Posts: 626
gayle428 HB Usergayle428 HB Usergayle428 HB Usergayle428 HB Usergayle428 HB Usergayle428 HB Usergayle428 HB Usergayle428 HB Usergayle428 HB Usergayle428 HB Usergayle428 HB User
Re: Unfavorable after alj hearing. What next?

Agreed! That is exactly where I am right now. My first case is waiting for a Fedreal Court date, and my second case has been started.

Quitting is never an option! That is what they want ... for you to give up.

Last edited by Administrator; 09-09-2010 at 06:16 PM.

 
Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
Unfavorable - From ALJ Hearing, Now What Emmettk Health Insurance Issues 25 12-06-2011 04:52 AM
received unfavorable today billj Disabilities 5 07-27-2010 07:01 PM
Hearing In Ohio wishing4good Disabilities 4 07-27-2010 10:29 AM
rcv'd notice of unfavorable decision fibrofoggie Disabilities 10 06-24-2010 08:13 PM
Received SSA Unfavorable Letter Today Tjunea Disabilities 16 12-15-2009 03:56 PM




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 11:20 PM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!