Understanding The Disability Appeal Process: What To Expect
It’s a devastating feeling to have waited weeks or months for your application to go through the Social Security Disability review process and receive a letter denying the claim. Knowing that the Social Security Administration denies more than two-thirds of the claims it receives for Social Security Disability Insurance benefits does not lessen the disappointment or the desire to give up.
If you receive an unfavorable decision from the Social Security Administration, challenging it through the disability appeal process could turn a denial of benefits into an approval. The American Disability Action Group handles Social Security disability appeals nationwide, including those in Arkansas, Oklahoma, Mississippi, Tennessee, Texas, and Louisiana. For many people, an SSDI denial appeal results in approval of their claim, so the following explanation of the appeals process gives you an insight into what to expect.
Overview Of The Social Security Administration Appeals Process
A denial of your application for disability benefits may be challenged through the Social Security appeals process. The process has four levels:
- Reconsideration
- Hearing with an Administrative Law Judge
- Request for review by the Appeals Council
- Federal court review
You must request an appeal within 60 days of receipt of an unfavorable decision from the Social Security Administration. It is assumed that you receive the notice of determination within five days of the date printed on it, so do not delay contacting American Disability Action Group to initiate the appeal process.
You could lose the right to appeal by not submitting the written request within the 60 days. If that occurs, you may request additional time by submitting a written request explaining the reason for the delay. Note that when the last day to appeal is on a weekend or a national holiday, the time to appeal automatically extends to the next regular business day.
Reconsideration
The appeal process begins with Social Security reconsideration of your application by someone who did not participate in the original decision. The original application, supporting medical records, and other documentation are reviewed by the new person assigned to conduct the reconsideration. Your disability attorney can submit updated medical records and other new or updated information for inclusion in the reconsideration process.
The Social Security Administration reported the claimant success rate at reconsideration as 15.7%. An unfavorable decision after reconsideration may be appealed to the hearing level.
Hearing Level In The Appeal Process
If reconsideration does not result in an award of disability benefits, you have the right to appeal to the hearing level presided over by an Administrative Law Judge (ALJ). An ALJ is someone who has not participated in the initial determination or reconsideration of your application.
As part of the disability hearing steps, the judge assigned to your appeal reviews the application, the reconsideration, and new evidence presented by your disability attorney. Until the hearing level, review of your claim is based on documents, including medical records. A hearing typically includes records and other documentation, as well as testimony from witnesses, such as medical and vocational experts.
Your disability lawyer has the opportunity to question the expert witnesses to elicit testimony favorable to your claim. Depending on whether it would be helpful to your case, you may have the opportunity to testify at the hearing to provide evidence supporting the claim.
Scheduling a hearing may take several months. During that time, you must continue seeing healthcare providers and following the treatment plan they prescribe for you to keep your medical records current for use at the hearing.
Social Security reports that about 45.4% of appeals to the hearing level result in decisions favorable to the claimant. If your claim is not one of them, you may appeal to the Appeals Council level.
Request for Appeals Council review
An unfavorable decision at the hearing level can be reviewed by the Appeals Council. New evidence may be submitted in support of your claim. The Appeals Council may deny the request for review, or it can grant review and issue its own decision or send the case back to the hearing level for further action.
Review By A Federal District Court
The reconsideration, hearing, and Appeals Council levels of the appeal process take place within the Social Security Administration. When you exhaust the administrative levels of appeal, you may file a lawsuit in federal court for review of the case by a federal judge.
Get Skilled Legal Assistance Throughout The Appeals Process
A denial of a claim for SSDI benefits should not be the end of your pursuit of disability benefits you earned through hard work. You have the right to challenge the denial, but before appealing disability decision on your own, speak to the disability professionals at American Disability Action Group. Find out the difference a disability attorney can make by contacting us for a free consultation.