How To Appeal a Denial
Many individuals simply accept the Social Security Administration’s first denial of their claims without realizing that the majority of initial disability applications are rejected — sometimes solely on the basis of a technicality. That’s why it’s important to understand that the SSA’s initial claim denial doesn’t automatically mean you have reached the end of your application process.
Here are the four stages for appealing your denied Social Security benefits claim:
- Reconsideration
- Administrative Hearing
- Appeals Council Review
- Federal Court
After Disability Determination Services has issued an initial denial, you must file a “request for reconsideration” within 60 days. This first stage of appealing your claim is conducted internally by the DDS. An examiner for the DDS that didn’t work on your initially denied claim will evaluate your new entry file to determine if your prior claim’s denial was made in error. However, statistics show that claims are rarely reversed at the reconsideration stage.
If you receive a denial of your reconsideration, you have another 60 days to file for an administrative hearing. This hearing is where you’ll present your disability claim to an administrative law judge. The hearing date may be set for any day from three months to one year after your filing date. On that date, the judge will have already reviewed your claim before the court’s proceedings begin, so the hearing’s focus will be determining your residual functional capacity. This is a very typical court proceeding where you’re given an opportunity to make your case while the judge asks you questions to further evaluate your claim. Witnesses may also be called to testify on your behalf. Occasionally, experts are called to submit their opinions to the court based upon their evaluation of your claim. The judge will conclude the hearing once all supporting evidence has been submitted for review. After closing your hearing, the judge will make a determination and typically notify you of the court’s decision within two months.
If your appeal is denied at your administrative hearing, you still have an additional 60 days after receiving the judgment to file another appeal with the Appeals Council. Then, the Appeals Council must review the judge’s decision and evidence presented at your administrative hearing before submitting your case to the United States District Court. You can expect one of four possible outcomes in this third stage of the appeals process:
- Refusal of your claim
- Request for additional information
- Reevaluation of the claim by your administrative hearing judge
- Reversal of the decision
Once you’ve begun the process of reconsideration, getting legal help from attorneys and disability appeals advocates is highly recommended. These professionals are exceptionally familiar with helping claimants navigate their way through the SSA’s extensive bureaucracy, its processes and the practices involved with issuing claims denials. Without an attorney to represent your interests or the help of an experienced advocate to help you with appealing your claim’s refusal at the administrative hearing, it’s extremely difficult to establish evidence of your eligibility for Social Security Disability benefits.