Appealing a Denial of SSDI

Appealing a Denial of SSDI

If you have applied for Social Security Disability Insurance or Supplemental Security Income and your claim is denied for any reason, you have the right to appeal the decision. However, this right is conditional upon you taking action within the stipulated amount of time and following the appropriate steps. If you believe that you deserve SSDI benefits and have been denied, here is what you need to know about your right to appeal the decision:

Make Your Appeal Request Within 60 Days’ Time

If you want to appeal a decision handed down by the Social Security Administration, you must make this desire known by submitting an appeal request within 60 days’ time from the date that you receive notice from the Social Security Administration informing you that your SSDI claim has been denied. If you do not make your request known with 60 days’ time, your appeal will likely be denied. You must send a written appeal form, or you can file your appeal online.

The Four Levels of Appeal

There are four levels of appeal. These are:

  1. Reconsideration;
  2. Hearing;
  3. Appeals council review; and
  4. Federal court review.

The first step is asking the Social Security Administration for a reconsideration about the decision made in regards to your Social Security disability claim. A reconsideration refers to a complete review of your claim, essentially a ‘do-over.’ All of the medical evidence that was originally submitted with your claim and any additional evidence developed will be reviewed by an individual who was not involved in denying your claim as part of the original decision. Usually, you do not need to meet with anyone during the reviews process, unless special circumstances dictate otherwise.

If a reconsideration results in the same decision as did your original claim (a denial of disability benefits), then you have the right to appeal the decision a step further by requesting a hearing with an administrative law judge (ALJ). During the hearing, you will have the right to present any new medical evidence that may substantiate your claim, and you can also call witnesses to the stand to testify on your behalf. Good witnesses that can be used to corroborate your case are usually vocational and medical experts, although you can also bring non-expert witnesses (such as a family member) to testify about your disability. When all evidence has been presented, the judge will issue a decision about your case. If you do not agree with the decision, you can yet again appeal – the next step is bringing your case before an appeals council.

Note that
The Appeals Council is not obligated to hear your case unless it believes that the decision made during the hearing was possibly incorrect; if it believes that the hearing decision was correct, and that your hearing was fair and just, it will not hear your case. If the appeals council decides to review your case, you will be notified of the decision.

Finally, the last step in the appeals process if appealing to a federal district court. Like the Appeals Council, the federal district court does not have to review your case; they can choose not to hear it if they believe that the decision issued by lower courts (Appeal Council, ALJ) were correct.

Throughout all steps of the appeals process, it is important that you have an experienced attorney guiding you. The goal is to get your claim approved during the reconsideration, if not the first time that you apply. You do not want to have to deal with the headache of filing an appeal with a federal district court.