How Does the Social Security Disability Appeals Process Work?
Estimated reading time: 9 minutes
If Social Security denies your disability claim, you generally have the right to appeal the decision. The Social Security Disability appeals process has four levels: reconsideration, a hearing before an administrative law judge, Appeals Council review, and federal court review. Your claim may not need to go through all four levels.
Understanding what happens at each stage can help you know what to expect, what information Social Security may review, and when you need to take action.
What Should You Do After Receiving a Social Security Disability Denial?
The first step after receiving a denial is to carefully review the notice from the Social Security Administration (SSA). The notice should explain the decision and how to appeal if you disagree with it.
Pay close attention to the appeal deadline. In most cases, you have 60 days after receiving the decision to request the next level of appeal. Social Security generally assumes that you received the notice five days after the date printed on it unless you can show that you received it later.
You can file a disability appeal online through SSA, by mail, or by visiting your local Social Security office.
Further Reading: Disability Claim Denied? Now What?
What Are the Four Levels of a Social Security Disability Appeal?
Each level of appeal involves a different type of review. Here is what happens as a disability claim moves through the process. The first is reconsideration. If you disagree with the reconsideration decision, you can request a hearing before an Administrative Law Judge (ALJ). After an unfavorable hearing decision, you may request Appeals Council review. The final level is review by a federal district court.
1. Request for Reconsideration
Reconsideration is generally the first level of appeal after an initial disability claim is denied. When you request reconsideration, you are asking Social Security to review the claim again.
At this stage, a disability examiner and medical team who were not involved in the original determination review the claim. They consider the evidence used in the initial determination along with additional evidence submitted during the reconsideration.
For Ohio residents, disability determinations are handled by the Division of Disability Determination within Opportunities for Ohioans with Disabilities, commonly called OOD. The division makes determinations on Social Security Disability Insurance and Supplemental Security Income disability claims using Social Security laws, regulations, and guidelines.
According to SSA’s fiscal year 2025 disability decision data, 16% of reconsideration decisions were allowed and 84% were denied nationally. These figures describe decisions issued nationwide during that fiscal year and do not predict how an individual claim will be decided.
You should also make sure SSA has current and complete information about your medical treatment. New medical records, test results, treatment information, and medical opinions can become relevant as your claim moves through the appeal.
Further Reading: Can You Submit New Evidence During Your Appeal?
If your claim is denied again at reconsideration, carefully review the new notice. It should explain the determination and provide information about your next appeal rights and deadline.
2. Hearing Before an Administrative Law Judge
If your disability claim is denied at reconsideration, you may request a hearing before an ALJ.
An ALJ is part of the SSA hearing process but was not involved in the initial determination or reconsideration of your claim. At the hearing level, the judge reviews the issues and evidence in your case and makes a new decision.
For the first time in the appeals process, you have an opportunity to explain your conditions and limitations directly to a judge. You may be asked questions about your work history, medical conditions, treatment, symptoms, daily activities, and how your conditions affect your ability to work.
Hearings may take place by audio, agency video, online video, or in person. The judge may also hear testimony from medical or vocational experts.
You and your representative, if you have one, may review the evidence in your file and submit additional evidence. For disability hearings, SSA generally requires written evidence to be submitted or disclosed no later than five business days before the hearing, although exceptions can apply.
SSA’s fiscal year 2025 data shows that at the ALJ hearing level, 50% of decisions were allowances, 33% were denials, and 16% were dismissals nationally. Again, these figures describe national outcomes and do not predict the result of a particular claim.
Further Reading: The Social Security Disability Hearing
3. Appeals Council Review
If the ALJ issues an unfavorable decision or dismissal, you may request review by Social Security’s Appeals Council. The Appeals Council looks for issues such as an error of law, an abuse of discretion, or findings that are not supported by substantial evidence. “Substantial evidence” generally means enough relevant evidence to support the decision.
The Appeals Council may deny or dismiss the request, issue its own decision, or remand the case, meaning send it back to an ALJ for further review or another hearing.
Social Security’s fiscal year 2025 data shows that 80% of Appeals Council cases were denied, 15% were remanded, 3% were dismissed, and 1% were allowed.
Additional evidence may sometimes be considered at this stage, but different rules apply. In general, the evidence must be new, material, relate to the period at issue, and meet other SSA requirements.
4. Federal Court Review
If you disagree with the Appeals Council’s decision, or if the Appeals Council declines to review the ALJ’s decision, the next level of the Social Security appeals process is filing a civil action in federal district court. This is the final level of the Social Security appeals process.
Federal court review is different from the earlier stages. The court reviews the administrative record and the final agency decision rather than holding another disability hearing and starting the claim over.
A federal court can affirm SSA’s decision, reverse it, or remand the case to SSA for further proceedings.
SSA’s fiscal year 2025 data shows that 65% of the federal court decisions reported by SSA were remanded, 30% were denied, 5% were dismissed, and 1% were allowed. SSA notes that its federal court data also includes appeals involving Continuing Disability Reviews, so these percentages should not be interpreted as the odds of a particular disability application being approved in federal court.
In general, a civil action must be filed within 60 days after receiving notice of the Appeals Council’s action.
Why Is Medical Evidence Important During a Disability Appeal?
Medical evidence remains important throughout the Social Security Disability appeals process. As your claim continues, there may be new treatment records, test results, diagnoses, changes in symptoms, or medical opinions that were not available when SSA first reviewed your application.
SSA needs evidence that helps document your medical conditions and how they affect your ability to function. Consistent medical treatment can also create a record of symptoms, examination findings, testing, treatment, and how a condition changes over time.
Attorney Jon Ressler explains why that documentation matters in a Social Security Disability claim by comparing subjective symptoms, such as pain or fatigue, with objective medical evidence, such as X-rays, lab testing, and other documented findings. The medical record helps SSA evaluate both the condition itself and the limitations the person reports.
Keeping SSA informed about your medical providers and new treatment can help make sure the people reviewing your appeal have a more complete record.
Further Reading: Can You Submit New Evidence During Your Appeal?
Do You Need a Lawyer to Appeal a Social Security Disability Denial?
You are not required to have a lawyer to appeal a Social Security Disability decision. You may handle the appeal yourself or choose an attorney or another qualified representative. SSA allows people to choose a representative at any stage of the appeals process.
Some people decide to speak with a Social Security Disability lawyer after a denial because they have questions about why the claim was denied, what information may be missing, or what happens at the next stage. A lawyer can review the denial notice and explain the appeal options and deadlines that apply to the claim.
Frequently Asked Questions About Social Security Disability Appeals
In most cases, you have 60 days after receiving a decision to request the next level of appeal. SSA generally assumes you received the notice five days after the date printed on it unless you can show otherwise. Review the notice you received carefully because it explains your appeal rights and deadline.
You can request a disability appeal online through SSA.gov, by mail, or through a local SSA office. The notice you received should explain which type of appeal applies to your decision.
Not necessarily. If you disagree with SSA’s decision, the appeals process allows you to request further review of the existing claim. The next step depends on where your claim is in the process and the notice you received.
Yes. Additional evidence can be submitted during parts of the appeals process, although the rules and deadlines depend on the stage of the claim.
At reconsideration, new evidence may be considered along with the evidence from the original determination. At the hearing level, Social Security generally requires written evidence to be submitted or disclosed at least five business days before the scheduled hearing unless an exception applies. The Appeals Council has additional requirements for considering new evidence.
The next step depends on the stage of your claim. A denial at reconsideration may be appealed by requesting a hearing before an ALJ. An unfavorable hearing decision may be taken to the Appeals Council, and some cases may proceed to federal court after Appeals Council review.
Each decision or notice should explain the available appeal rights and applicable deadline.
Understanding What Comes Next After a Disability Denial
A denial does not necessarily end a Social Security Disability claim. Depending on where the claim stands, the next stage may be reconsideration, a hearing before an administrative law judge, Appeals Council review, or federal court.
For an example of how a disability claim can move through several stages of the appeals process, read Kate’s Story, a fictional example based on circumstances Roose Ressler & Green regularly sees in Social Security Disability cases.
Download Kate’s Story to Learn More
If your Social Security Disability claim was denied and you have questions about your next step, Roose Ressler & Green can review your situation and discuss whether representation may be appropriate. Contact us through our online form or call 800-448-4211.