When you appeal a denial of Supplemental Security Income (SSI) or Social Security disability (SSDI) benefits, you will have to follow the instructions that are written in the denial form issued to you by the SSA (Social Security Administration). In most states, the first step that you can take in this regard is filing the request for reconsideration. You will have to consider taking the case to the next stage of appeal if your plea is denied upon reconsideration.
Request for Reconsideration
The appeal starts with your request that the initial termination of benefits or denial has to be reviewed once more. There are four states, namely, Alaska, Alabama, Missouri, and Michigan, where this step is not applicable. Go to the next step if you belong from any of these states. Reconsideration might be added back to the process even in these four states by April 2020.
Reconsidering The Original Claim
Reconsidering your original claim means a total review of the claim, and this takes place at the DDS (Disability Determination Services) level. You will get an examiner and a medical consultant who were not there at the time of the first decision.
Reconsidering The Continuing Disability Claim
CDR (Continuing Disability Review) starts after your disability benefits begin. Under CDR, there will be a periodic review of your condition to understand if you’re still eligible to receive benefits. You can appeal for reconsideration even if your benefits were terminated after review.
The Administrative Law Judge Hearing
You need not give up yet if the appeal for reconsideration is denied. You can request a hearing in front of an administrative law judge within sixty days from receipt of the denial. If you are a resident of any of the four states mentioned above, then you can make the request within sixty days of the initial denial.
Administrative law judges are attorneys that work at the Office of Hearings Operations of the SSA. The job is basically to overturn or uphold the decisions made in terms of disability benefits, including hearing appeals about other social security cases. Statistically, about half of the disability claims that reach administrative law judges are granted by them.
Request at the Appeals Council
You can request the Appeals Council to review the case. Cases are selected randomly by the appeals council for reviewing. It can deny, dismiss, or grant your request for review depending on whether there has been An error of law or misuse of discretion by the administrative law judge There was no substantial evidence to support the decision of the administrative law judge.
There has been any procedural or policy issue related to the case
Cases might also be dismissed by the appeals council if the appeals are filed late or if the claimant dies. The appeals council, usually, only pays attention to a case if there is a flaw in the judgment of an administrative law judge.
It is one of the last resorts, and the chances of winning are about two to three percent. Before you end up suing the SSA in a federal court, you will have to go through the appeals council.
Request a Federal Court Review
The final step of appeal is filing the lawsuit in a federal district court. If you have gone through the appeal process without an attorney, at this stage, you will definitely need one.
There are no juries present when federal judges hear disability cases. The judges review cases for legal errors. The decisions of the appeals court or the administrative law judges are usually not reversed by the federal judges. They might send back the case to the SSA for further assessment, saying that they might not have considered all the relevant facts.
There is a fair chance that you will win the appeal that reaches the federal court, but it is not an excellent option for other reasons. Going against SSA is time-consuming and expensive. It takes years to reach this level of appeals, and thus, claimants usually are not willing to take this step.