Types of Appeals

Social Security Disability Lawyer Discusses Types of Appeals

We recommend that you consult with an experienced disability lawyer before appealing a Social Security Administration decision. If you have filed a claim for disability benefits and the Social Security Administration has denied it, you can appeal denials of Supplemental Security Income (SSI)or Social Security disability (SSDI) claims, or both. The first step is to file a request for reconsideration. If that fails, the next step would be to request a hearing. A Social Security disability lawyer can help you through the lengthy process of appealing your Social Security disability case.

Request for Reconsideration

If your application is denied, the next step is a request for reconsideration. It asks the Social Security Administration to review the unfavorable determination that they made in your case. In your denial or termination letter, you will find information about how to appeal the decision. You can file an appeal online at www.ssa.gov, or you can contact a local office of the Social Security Administration to begin this process. Social Security will review all aspects of your original claim. In this review, medical professionals and an examiner who were not part of your original claim will review your medical records. This reconsideration process takes place at the Division of Disability Determination (DDD), a State agency. Statistics show that the DDD reverses the decision in less than 20% at the reconsideration level. If Social Security denies your claim at this level, they will send a letter to you called a notice of reconsideration explaining why you were denied. The letter will also tell you how to begin the appeals process. We recommend that you schedule a consultation with a Social Security disability lawyer if you have been denied disability benefits by Social Security.

Termination of Disability Benefits

If you have been granted disability benefits, Social Security will periodically review your case. Social Security may determine that you are no longer disabled and terminate your benefits. Benefits may be terminated when there has been medical improvement and/or work activity above certain levels for extended periods of time. A request for reconsideration of this unfavorable determination, as discussed above, can be filed.

Request for Hearing with an Administrative Law Judge (ALJ)

If your case is denied at the reconsideration stage, the next step is to request a hearing. It asks to have your case re-decided by an ALJ. While ALJs work for the Social Security Administration, they are independent decision-makers. At this level, there is an expectation in most cases that you will appear at a hearing and answer questions about your work history, medical conditions and your treatment for them, symptoms, limitations, and activities. About half of claimants’ claims are granted at this level. Unfortunately, there is a long wait for hearings, usually longer than 12 months from when a claimant asks for a hearing until the hearing is actually held. A claim can be expedited only in special cases, most commonly because of lack of shelter or when the claimant’s condition is terminal.

Request for Review (Appeals Council) and Federal Court

If an ALJ denies your claim, the next step is to file a request for review, which is decided by a part of Social Security called the Appeals Council. The Appeals Council does not re-decide your case. It evaluates whether the decision issued in your case has an “error of law” (failed to follow the law, regulations, and other rules) and whether there was “substantial evidence” (enough that “a reasonable mind might accept as adequate to support a conclusion”) that supports the decision’s conclusions. The Appeals Council rarely reverses decisions made by ALJs. More often, it will “remand” your case for a new hearing with specific instruction, when it has found an error of law or conclusions that are not supported by substantial evidence. The average time between filing of the request for review and a decision from the Appeals Council is about 12 months.

If your claim is denied by the Appeals Council, there are no further appeals to the Social Security Administration. Your last recourse is to file a complaint in Federal Court, alleging that Social Security has failed to make a legally adequate decision under the law in your case. The federal court also only rarely reverses decisions. Like the Appeals Council, it will more often “remand” a case to Social Security when it agrees that the decision contains errors of law or conclusions that are not supported by substantial evidence. This is a complicated process and usually takes more than a year to obtain a decision.

Contact an experienced disability lawyer from Roose & Ressler today at (800) 448-4211. Roose & Ressler has dedicated lawyers who will help you fight to get the best results from your disability case.