Statistics gathered and maintained by the United States Social Security Administration (SSA) show that the vast majority of claims for Social Security Disability Insurance (SSDI) benefits are denied. Fortunately, the SSA regulations that govern denials of disability insurance claims provide an extensive appeal process that can potentially cure the initial rejection of the application.
The first step: Request for reconsideration
The first appellate step is the submission of a request for reconsideration. The request must be submitted in writing within 60 days of receipt of the notice of denial. The request can also be submitted online.
If a claimant is currently receiving benefits, they will still be able to receive monthly payments as long as the request for reconsideration is submitted within 10 days of the notice of denial.
The next step: Request for hearing
If the claimant’s request for reconsideration is denied, the claimant can request a hearing before an administrative law judge (ALJ). As with the request for reconsideration, the request for a hearing must be filed no later than 60 days after receipt of the notice of denial of the reconsideration request. The SSA will set a date and place for the hearing that suit the claimant’s convenience.
The hearing may be held in person or via video teleconferencing. The claimant may submit any additional evidence that is pertinent to the medical or employment issues in the case. Both sides may include additional testimony, including testimony from expert employment and medical professionals. Both the claimant and the ALJ are entitled to ask questions of any witness. The ALJ will send a copy of the decision to both the SSA staff and the claimant.
The appeals council
If the ALJ affirms the denial of the claim for benefits, the claimant can then seek relief from the internal Appeals Council. A request for review by the appeals council, like the request for reconsideration and the request for a hearing must be submitted within 60 days of receipt of the notice of the Council’s decision. The claimant may submit additional evidence in support of the claim. The Appeals Council may affirm the ALJ’s decision, remand the case to the ALJ for further proceedings, or send the claimant a written notice of its proposed action; after receiving this notice, the claimant may file a written comment on the proposed action.
If the denial of the claim is affirmed by the Appeals Council, the claimant may file an appeal within 60 days in the United States district court having jurisdiction over the claimant. The appeal must be drafted and signed by an attorney authorized to appear in federal court. For this reason, a claimant is usually well-advised to hire experienced counsel at the outset of the appeals process.