What Does the SSA Disability Appeal Process Look Like?

THE FOUR LEVELS OF DISABILITY APPEAL AND WHICH ONE TO PURSUE

The Social Security Administration (SSA) receives millions of SSDI applications every year. And yet, less than 40% of these applications are approved during the application stage.

Appeal Level 1: Reconsideration

If your original SSDI application was denied, you only have 60 days from the date that the SSA made their decision on your file to ask for a reconsideration.

The SSA may grant you an extension beyond the 60-day timeframe in certain situations, but these instances are rare. You should always attempt to submit your request for reconsideration within 60 days, even if incomplete. You can add to the file after you’ve submitted the request for reconsideration paperwork.

When you ask for a reconsideration, you’re essentially asking for SSA to look at your initial application with fresh eyes. It’s also an opportunity for you to include any additional information that may not have made it into your first application, such as results of tests or additional medical reports. Your case will be assigned to a different case examiner to review the entire file.

It can take anywhere from four to six months for reconsideration to take place. 

Appeal Level 2: Hearing Before an Administrative Law Judge (ALJ)

If the SSA denies your application after completing the request for reconsideration, you have 60 days to request an appeal hearing. You will actively participate in the hearing and have the opportunity to explain why you feel your application for SSDI benefits should be approved.

Once scheduled, an Administrative Law Judge (ALJ) will review your case and decide on one of the following outcomes:

• Your SSDI claim will be approved
• Your case will be sent back for additional review
• Your SSDI claim will be denied

You can request a social security disability appeal hearing in one of three ways:

• Online
• In a letter written to SSA
• By completing and submitting Form HA-501 | Request For Hearing By Administrative Law Judge

It’s important to remember that an appeal hearing is a legal environment. Many people with a Social Security disability appeal benefit from having an attorney present to help them navigate the legal proceedings and ensure they get the best possible results.

Appeal Level 3: Appeals Council

If your SSDI application is denied after a hearing with an ALJ, you can escalate your claim and submit your request to the Appeals Council within 60 days of the decision at the Appeals Hearing level. 

At this level, it can take anywhere from six to twelve months for the Appeals Council to hear your appeal. Unfortunately, the Social Security Appeals Council doesn’t guarantee they will hear every appeal request.

The Appeals Council does not review your claim’s medical validity. They review the legality of the decision rendered by the judge at the Appeal Hearing stage. The council will either uphold the ALJ’s previous decision or send your case back to level 2 for another appeals hearing. 

The council can overturn the previous decision if they determine the judge did one of the following:

• Made a technical error in your case
• Failed to consider valid medical information
• Made the decision in error

If, at the end of this stage, your SSDI application is still denied, to escalate your appeal you will need to file a new appeal with the Federal District Court.

Appeal Level 4: Federal Court

As with all other levels, you have 60 days to file in federal court. Having a disability lawyer represent your claim at this stage is important. 

Your lawyer will file your case, called a “complaint.” This will outline your reason for appealing the SSDI decision and detail why you should be entitled to receive the benefit. 

A judge will be assigned to your case and will review your file. The judge can make a decision strictly on the documents you provide, or they can request that your SSDI lawyer argue your case. At this point, your attorney will argue the ways in which you meet the eligibility and how that aligns with current laws.  

The judge will typically make one of the following decisions:

• The court will agree with the Appeals Council and uphold their decision (you don’t receive benefits)
• The court will send your case back to the SSA for additional review and consideration
• The court disagrees with the Appeal Council and overturns their decision (you receive benefits)

COMPLETE YOUR SOCIAL SECURITY DISABILITY APPEAL ONLINE ON THE SSA WEBSITE

If you recently received a denial on your SSDI application, you can submit your appeal request online. To submit online, you’ll be asked to provide specific information to the SSA. 

REPRESENTATIVES WHO CAN HELP YOU WITH AN SSA DISABILITY APPEAL

Because a disability lawyer has a comprehensive understanding of the law and your rights within the law, they can argue persuasively — citing exact laws or relevant precedents — to help you get the benefits that you deserve.

Social Security Disability Lawyers

A disability lawyer can help determine why your initial SSDI application was denied. They can also advise ways to strengthen your reconsideration or appeal application, giving it an improved likelihood of being accepted.

Your disability lawyer can also help you complete the complex forms, get additional medical records and determine what information you should include with your application for disability benefits.

Non-Lawyer Representatives

Non-lawyer representatives can also help with your appeals process.

However, because non-lawyers don’t have an extensive and specialized understanding of SSDI and the law, it can be challenging for this type of representative to make a significant impact on the outcome of your appeal. They can, however, provide considerable personal support.

CONTACT THE SAM BERNSTEIN LAW FIRM TO GET THE DISABILITY COMPENSATION YOU DESERVE

Successfully filing an appeal can be challenging. There is a lot of information out there to help you, but sometimes the nuances of each individual’s case make it hard to be sure you’re taking all the right steps to get the SSDI income you deserve. That is why we encourage you to contact us today if you are interested in filing an application, or if your application or request for reconsideration were denied.

Social Security Disability Law is complicated, but finding the right Michigan disability lawyer is simple.

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