Social Security Disability Appeals Process
If your claim is denied, or you disagree with any part of Social Security’s decision, you may appeal the decision. You have sixty days from the time you receive Social Security’s decision letter to file an appeal. Social Security assumes that you received this letter five days after the date on it, unless you can show them that you received it later.
Generally, there are four levels of appeals after the initial decision. They are as follows:
Reconsideration
A reconsideration is a complete review of your claim by someone who did not take part in the first (initial) decision. Social Security will look at all the evidence submitted when the original decision was made, plus any new evidence.
Note : Ten states do not allow a "reconsideration" appeal stage. Social Security has eliminated the "reconsideration" appeal stage in: Alabama, Alaska, California (Los Angeles North and West areas), Colorado, Louisiana, Michigan, Missouri, New Hampshire, New York (Brooklyn and Albany areas), and Pennsylvania. In these states and areas, applicants whose claims are denied at the initial decision can appeal to an administrative law judge within sixty days of the decision notice.
Hearing by an administrative law judge
If you disagree with the reconsideration decision, you may ask for a hearing. This hearing is conducted by an administrative law judge who had no part in the initial or reconsideration decisions of your case. The hearing is usually held within seventy five miles of your home. The hearing office will notify you of the time and place of the hearing.
You and your representative, if you have one, may come to the hearing and explain your case in person. You may look at the information in your file and provide any new information.
The administrative law judge will question you and any witnesses you bring to the hearing. Other witnesses called by the administrative law judge, such as medical or vocational (work) experts, may testify at your hearing. You or your representative may question (cross-examine) the witnesses. It is usually to your advantage to attend the hearing. If you do not wish to do so, you must tell Social Security in writing that you do not want to attend.
In certain situations, Social Security may hold your hearing by a video conference rather than in person, and will let you know ahead of time if this is the case. With video hearings, Social Security can make the hearing more convenient for you. Often an appearance by video hearing can be scheduled faster than an in-person appearance. Also, a video hearing location may be closer to your home. That might make it easier for you to have witnesses or other people accompany you.
Unless the administrative law judge believes your presence is needed to decide the case, he or she will make a decision based on all the information in your case, including any new information given. After the hearing, Social Security will send you a letter and a copy of the administrative law judge’s decision.
Appeals Council review
If you disagree with the hearing decision, you may ask for a review by Social Security’s Appeals Council. Social Security or your representative, if you have one, will help you ask for this review.
The Appeals Council looks at all requests for review, but it may deny a request if it believes the hearing decision was correct. If the Appeals Council decides to review your case, it will either decide your case itself or return it to an administrative law judge for further development.
If the Appeals Council denies your request for review, Social Security will send you a letter explaining the denial. If the Appeals Council reviews your case and makes a decision itself, Social Security will send you a copy of the decision. If the Appeals Council returns your case to an administrative law judge, Social Security will send you a letter and a copy of the order.
Federal Court review
If you disagree with the Appeals Council’s decision, or if the Appeals Council decides not to review your case, you may file a lawsuit in a federal district court. The letter Social Security sends you about the Appeals Council’s action also tells you how to ask a court to look at your case. Your attorney, if you have one, may help you file the lawsuit and represent you in court. A Social Security disability claim can be appealed all the way to the United States Supreme Court.