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Supplemental Security Income and Social Security Disability Appeals Process

It is not uncommon for claimants to be denied Supplemental Security Income (SSI) or Social Security Disability benefits when they first apply. In fact, Disability Determination Services, a state agency funded by the federal government, reports that 62 percent of initial claims are denied. However, all is not lost:  Some of the denials are actually overturned through the appeals process.

If you receive a letter from the Social Security Administration (SSA) denying your application for SSI or Social Security Disability benefits, you can appeal that decision. It is important to remember that you must respond within 65 days from the date on the letter, or 60 days from the date you actually received the letter.

Four levels of appeals

The four levels of appeals are described below:

• Level 1 – Reconsideration: All of the documentation will be reevaluated by a disability examiner who was not part of the initial determination. You will be given an opportunity to explain your case in person and to provide new information about your claim for disability benefits.  The examiner will take into consideration the evidence presented at the hearing and notify you by mail of the decision.  Approximately 14 percent of appealed cases are overturned at this stage.

• Level 2 – The Hearing: If reconsideration is denied and you wish to appeal, the next step is a hearing before an administrative law judge (ALJ).  The judge will make a decision based on information from the reconsideration level and any new information that may be provided. At this level about 60 percent of the cases are overturned.

• Level 3 – Appeals Council Review:  The role of the Appeals Council is to review the ALJ’s decision and examine documentation.  They will either make a decision or send it back to the ALJ for a second hearing. About 27 percent of the cases appealed at this level are sent back to the second level for further action.

• Level 4 -- Federal Court Action: If the appeal was again denied, a lawsuit can be filed in federal district court.  The court will review all the information and make a decision without any future hearings.  Federal court is essentially the end of the road in the appeals process, and if your claim is denied at this level, your only recourse would be to start over and file a new disability benefit claim.

At each level of appeal, you should request a copy of your file, review all information to understand why you were denied Social Security benefits and check to see if the information is complete and accurate. You can submit additional information on your disability that might be relevant to your case.

When should I see an attorney?

Statistics show that claimants represented by Social Security Disability attorneys have a much higher success rate than people without any representation – 40 percent higher.  In fact, the best time to hire an attorney is at the earliest stage of denial.

If you have been denied a disability claim, the experienced Social Security Disability lawyers at Berry & Associates can help.  You can contact us via email or call us at 1-888-330-7874.