How to Appeal

Most people who apply for Social Security Disability benefits are denied initially.  The day you receive the denial letter is usually not a happy day.  However, fortunately, a large percentage of denials are eventually reversed on appeal.  SSA and Disability Determination Services (the state agency that processes claims for SSA) frequently make mistakes.  Disability judges, called Administrative Law Judges, “ALJ”s, make their own decisions and are free to disregard the earlier denials.  Moreover, medical evidence often gets stronger over time.  The point is that, if you are truly disabled, then you should timely appeal any denials and not give up.

What are the different levels of appeal?

Request for Reconsideration: This is where the Disability Determination Services, or DDS, the state agency which denied your claim initially, looks at your updated information and medical records and makes a new determination.  At this level, the case will be processed by a different case worker than the one who handled your claim at the initial level.  Last we checked only about 11% of all cases are approved at this level.

Request for Hearing Before an Administrative Law Judge:  This is where an Administrative Law Judge conducts a hearing, reviews all the medical evidence, and makes an independent decision.  This is the level at which claimants have the greatest chance of winning.  However, SSA will generally not gather new medical evidence at this level, so it will be your responsibility to do so.

Appeals Council:  The Appeals Council (“AC”) is in Falls Church, Virginia.  Here a panel of reviewing ALJs will determine if the decision contains legal error and if either the payment of benefits or a remand back for a new ALJ hearing is warranted.  AC review usually takes 12-16 months.  It is the final level of administrative (non-court) review. Chances of prevailing at the AC level is only about 20%.  Moreover, winning at the AC level usually only means that you are entitled to a new ALJ hearing, not that you are entitled to benefits.

Federal Court:  If the AC denies your case, your last chance is filing a lawsuit in federal district court.

Social Security Disability Topics

The Social Security Disability Process

Types of Social Security Disability Benefits

How Social Security Determines if You Are Disabled

Improving Your Chances of Winning

Do I really need to get an attorney?

Your Hearing Before An Administrative Law Judge (ALJ)

Appealing a Denial of Benefits