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What is the Appeal Process for Social Security Disability?

If you file a claim for Social Security Disability benefits and it’s denied or your benefits are terminated, you can initiate an appeal to have the decision reversed.

Social Security Disability Insurance (SSDI) benefits can make a world of difference if you’ve recently become disabled or been diagnosed with a medical condition that interferes with your ability to work. Unfortunately, not all requests for Social Security disability benefits are approved. If you believe that your claim was wrongfully denied or that you’re entitled to continued benefits, you can appeal the decision.

There are four steps in the SSDI appeals process, which begins with a request for reconsideration.

Request for Reconsideration

When your request for SSDI benefits is denied, you’ll have 60 days to initiate the appeals process by filing a request for reconsideration with the Disability Determination Services (DDS) department.

To file a request for reconsideration, you can submit an online form or mail completed form SSA-561-U2 to the Social Security Administration (SSA).

Examiners and consultants who were not involved in your initial request for SSDI benefits will review your application along with any new information you’ve decided to submit.

About 10 percent to 15 percent of applicants who file a request for reconsideration have their denials reversed.

If your claim is denied, you can move forward to the next stage of the appeals process and request a hearing with an Administrative Law Judge (ALJ).

Hearing by an Administrative Law Judge (ALJ)

If your request for reconsideration is denied, you’ll have 60 days to request a hearing with an administrative law judge. The ALJ works with the Office of Hearings Operations, and their job is to review decisions to terminate or deny claims for Social Security benefits.

About half of all unfavorable rulings heard by SSA administrative law judges are overturned — meaning that claimants like you end up receiving much-needed benefits.

If your claim is denied by an administrative law judge, you still have the opportunity to appeal the decision.

Social Security Appeals Process

Appeals Council Review

If an ALJ denies your request for Social Security disability benefits, you can ask the Social Security Administration Appeals Council to review your case.

To continue the appeals process, you can request an Appeals Council review online or print and mail completed Form HA-520 to the Social Security Administration.

The Appeals Council will look at every request that’s submitted but personally reviews only a small percentage.

Generally, the Appeals Council will review an ALJ decision if it believes that there was a mistake of law, that Social Security Administration procedures were violated, or that the administrative law judge made an error.

The Appeals Council can review the case itself or remand the case to the ALJ, which means that it’s sent back down to the judge for reconsideration.

You must file a request to have your denied SSDI benefit reviewed by the Appeals Council if you want the opportunity to bring your case to federal court.

Petition to U.S. District Court

The final stage of the Social Security disability appeals process involves filing a civil lawsuit in federal court. Specifically, you would bring an action against the Social Security Administration before a United States District Court.

There’s no jury involved when a disability benefits appeal is heard in federal court. Instead, the district court judge reviews the complaint and decides whether to consider the matter personally or remand the case back to the administrative law judge.

Generally, the federal judge reviews the case to see if there were any mistakes of law, meaning that the law wasn’t interpreted or applied properly. The judge will also consider whether any procedural mistakes were made or that your rights were violated. Judges are human and may also take the facts of your case into consideration during a review, though this is not the standard.

This is the final stage of the Social Security disability appeals process. If your request for benefits is denied, you’ve exhausted every opportunity available to you. Your chances of a successful appeal increase significantly when you hire an experienced Social Security disability attorney to represent you. 

Contact NST Law, the champions for the injured, to speak with a member of our legal team about your SSDI benefits case today. We offer a free consultation and are available to take your call 24 hours a day