The Social Security Appeals Process

My Claim Has Been Denied! What do I do now?

You have the right to appeal a denial of your  claim.  If you wish to appeal, you must make your  request in writing within 60 days from the date you receive your  denial letter. The SSA will assume you receive the letter five days after the date on it, unless you can show them you received it later. Call your  Social Security office if you need help with your  appeal.

How Many Appeal Levels Are There?

There are three levels of appeal. They are (1) reconsideration, (2) hearing by an administrative law judge, (3) review by the Appeals Council and (4) federal ctheir t review.

When the SSA  sends you a letter about a decision on your claim, the SSA will tell you how to appeal the decision.

Request for Reconsideration:

A reconsideration is a complete review of your claim by someone who didn't take part in the first decision. The SSA will look at all the evidence submitted when the original decision was made, plus any new evidence.

Most reconsiderations involve a review of your  files without the need for you to be present. But when you appeal a decision that you are no longer eligible for disability benefits because your  condition has improved, you have a choice of a file review or meeting with a Social Security representative to discuss your  case. You can meet with a disability hearing officer and explain why you believe you still have a disability.

Request for Hearing:

If you disagree with the reconsideration decision, you may ask for a hearing. The hearing will be conducted by an administrative law judge who had no part in the first decision or the reconsideration of your  case.

The hearing is usually held within 75 miles of your  home. The administrative law judge will notify you of the time and place of the hearing.

You and your  representative, if you have one, may come to the hearing and explain your  case in person. You may look at the information in your  file and give new information.

The administrative law judge will question you and any witnesses you bring to the hearing. You or your  representative also may question the witnesses.

It is usually to your  advantage to attend the hearing. If you don't wish to do so, you must tell the SSA in writing that you don't want to attend. Unless the administrative law judge believes your  presence is needed to decide the case, he or she will make a decision based on all the information in your  case, including any new information given.

After the hearing, the SSA  will send you a letter and a copy of the administrative law judge's decision.

We strongly advice that you get a representative or lawyer to assist you if your claim reaches the hearing level.

Appeals Council:

If you disagree with the hearing decision, you may ask for a review by Social Security's Appeals Council. The SSA will show you how to ask for this review.

The Appeals Council looks at all requests for review, but it may deny a request if it believes the hearing decision was correct. If the Appeals Council decides to review your  case, it will either decide your  case itself or return it to an administrative law judge for further review. You will receive a copy of the Appeals Council's decision or order sending it back to an administrative law judge.

Federal Court Review:

If you disagree with the Appeals Council's decision or if the Appeals Council decides not to review your  case, you may file a lawsuit in a federal district court.

You will likely need an experienced lawyer to successfully appeal your claim to the Federal Court.

Will My Benefits Continue?

In some cases, you may ask the SSA to continue paying your  benefits while the SSA  make a decision on your  appeal. You can ask for this continuation of benefits when:

1. you are appealing their decision that you are no longer eligible for Social Security disability benefits because your condition has improved.

2. you are appealing their decision that you are no longer eligible for SSI payments or that your  SSI payment should be reduced.

If you want your  benefits to continue, you must tell the SSA within 10 days of the date you receive their  letter. If your  appeal is turned down, you may have to pay back any money to the SSA you weren't eligible to receive. 

Can Someone Help Me?

Yes. Many people handle their own Social Security appeals with free help from Social Security. But you can choose a lawyer, a friend or someone else to help you. Someone you appoint to help you is called your  "representative." The SSA will work with your  representative just as the SSA  would work with you.

See YOUR RIGHT TO REPRESENTATION

Your  representative can act for you in most Social Security matters and will receive a copy of any decisions the SSA  make about your  claim.

Your  representative cannot charge or collect a fee from you without first getting written approval from Social Security. If you want more information about having a representative, contact the SSA. The SSA  can give you the free factsheet, Social Security And Your  Right To Representation.