One of the most frustrating experiences you are likely to have if you are unable to work for a long period of time due to a long-term disability or illness is applying for Social Security Disability (SSDI). Unfortunately, more than one-half of the time, your application is likely to be denied the first time which means you will have to have an understanding of your rights to appeal. The process can be very confusing since there are four distinct levels of appeals which are:
- Request for Reconsideration
- Administrative Law Judge (ALJ) Hearing
- Appeals Council
- Federal Court Review
Each of these steps is distinct from the other and what is required is slightly different at each level of the appeal.
Request for Reconsideration
There are two times when you may request a reconsideration of your claim. First, if your initial application is denied you would file a request for reconsideration of the original claim. If you had already been receiving benefits and they were stopped for some reason, you would file a request for reconsideration of continuing benefits. In either event, you must file your initial appeal within 60 days of receiving a letter from the social security office denying your benefits. Typically, you would do this at your local Social Security Office.
The reconsideration is done by someone who was not involved in your initial denial and if this is to restore benefits that have been suspended, you will have to meet with a representative. In other cases, all material that was provided with the application plus any new information will be reviewed before you are notified of the outcome.
If you get a second rejection after filing a request for reconsideration, the next step would be an ALJ Hearing. This second step also allows you 60 days from the receipt of the denial letter. There is an assumption made that you would receive the rejection within five days of mailing.
Requesting an ALJ Hearing
One of the most important things you should know before you start this process is that you have the right to legal representation when you are appearing at an ALJ hearing. If you have been rejected at stage one and your first appeal step (reconsideration) is also denied, an attorney can help you through the next part of the process.
According to the Social Security Administration’s website, along with the formal request for a hearing (Form HA-501) you also need:
You may also need to complete a form SSA-1696, Appointment of Representative if you are appointing a representative.
In general, these hearings will be held within 75 miles of your home and under limited circumstances (such as traveling more than 75 miles), you may be entitled to be reimbursed for the expenses associated with the hearing. The judge will hear from you, your representative and additional witnesses as well as review your entire case before rendering a decision. You and your social security appeals attorney will receive a notification of their determination.
Social Security Appeals Council
If the decision is still not in your favor and you disagree, the next step is to request a review by Social Security’s Appeals Council. Once the council reviews your case, one of two things could occur: (1) they can return it to the ALJ to review again or (2) they could agree with the judge. If they agree with the judge you will get a letter advising you they have decided against you. If the case is referred back to the ALJ you will also be notified that another hearing may be scheduled. However, if your claim is denied once again, your last possible appeal is done through the Federal Court.
Federal Court for SSDI Appeals
The last option if you have exhausted all of your possible appeals is to file a lawsuit in the U.S. district court. This option can be costly and time-consuming and you should discuss this option with your attorney before making the decision to go forward.
There is something important to be aware of: If you have been collecting benefits and the denial was to stop existing benefits, you may have the option of continuing to collect your benefits throughout the appeal process. However, if you lose on appeal, you may have to repay all of the benefits you collected during the appeals process which can be very lengthy.
If you are considering filing for Social Security Disability, have had a preliminary claim denied or you have been informed that your current benefits are going to be stopped, it is imperative you speak with a social security disability attorney who understands the entire appeals process and can help you make the right decisions and ensure that your rights are fully protected throughout the process.