The Three Levels of the Social Security Appeals Process
It can be frustrating and disappointing when you are denied Social Security Disability, but a denial does not have to be the end of the story. You can appeal the adverse decision. In fact, you can appeal three times within the Social Security system. The three levels of appeal within Social Security’s system are reconsideration, hearing, and Appeals Council review. You could be approved at any of these appeals. However, if you are not, you still have the legal right to pursue your claim in Federal court.
Expert Legal Assistance for your Social Security Appeal
If you did not have a Social Security lawyer help you with your initial claim and you have been denied, now is a good time to hire an attorney who is experienced in Social Security Disability to help you determine what is necessary for a successful appeal. For more information on how a Social Security lawyer can help you appeal, please see our articles “How Can a Social Security Disability Lawyer Help Me Get Social Security Benefits?” and “Do I Really Have to Hire a Lawyer for My Social Security Disability Claim?”
Reasons for a Social Security Disability Denial
If you are indeed disabled according to Social Security rules, your claim could have been denied for any number of reasons. For example, perhaps you forgot to include or didn’t know to include some aspect of your medical history. Or, maybe your doctor’s report didn’t address everything Social Security needed to fully understand your condition. In these cases, having an expert representative review your claim can help you identify the additional information that you or your doctor needs to submit.
Payment Continuation During Appeal
If the Social Security Administration has notified you that your Social Security Disability benefits are being terminated because they have found that you are no longer medically disabled, you can have your benefit payments continued while the appeal is decided. To get payment continuation, you must appeal and request payment continuation within ten days of receiving the termination notice. One thing to consider when deciding to request continued benefits is that, if the claim-closure decision is upheld, you may have to repay the continued benefits.
Social Security Request for Reconsideration
The first level of appeal is a reconsideration. At this level, your claim file, your statement of why you disagree with the denial and any new evidence that you submit with your appeal will be reviewed by claims examiners and physicians who were not involved in reviewing your claim the first time. If they now find that you meet the requirements for disability, your claim will be approved. For more information about reconsiderations, visit our article “What Is a Social Security Request for Reconsideration?”
Social Security Disability Hearings
If you are denied a second time, you can appeal again, this time requesting a hearing. Once you file the hearing request, it typically takes about fifteen months to get your hearing scheduled.
Hearings are usually held in person within seventy-five miles of your home, but, in some circumstances they may be held by video conferencing. At a hearing you, or you and your attorney, will present your case to an Administrative Law Judge, sometimes referred to as an “ALJ.” You can submit affidavits and call witnesses at the hearing. Sometimes the ALJ will ask a medical or vocational expert to testify, and you or your attorney will have the opportunity to question these experts. For more information about Social Security Disability hearings, please see the several articles we offer on hearings, starting with our article “What Is a Social Security Disability Hearing, and What Can I Expect When I Request a Disability Hearing?”
Social Security Appeals Council Reviews
If your claim is denied at the hearing, you can request an Appeals Council Review of the Administrative Law Judge’s decision. See our article “What Is a Social Security Appeals Council Review, and What Can I Do If the Appeals Council Denies My Claim?” for more information about Appeals Council Reviews.
Federal Law Suit
Finally, if the Appeals Council Review does not result in an approval, you have the right to file suit in Federal court.
This can all sound a bit discouraging, but keep in mind that a significant number of people who have been denied Social Security Disability are approved at one of the levels of appeal. So, if you believe you are disabled, it is worth your time and patience to appeal.