Understanding the Social Security Disability and SSI Claim Appeals Processes

March 15, 2012

Making and continuing to pursue a Social Security Disability (SSD) or Supplemental Security Income (SSI) benefits claim can be a slow, often-delayed and arduous process. A swell of applicants, combined with a shrinking budget, has led to a "tightening" of the Social Security Administration's standards, leading to a decline in approval rates.

By some estimates, as many as 65 percent of disability applications are denied during the first round of review. Often, applications are denied because applicants did not provide sufficient proof of disability. Enlisting the help of an experienced Social Security benefits attorney at the outset of a claim can greatly increase the chances of success.

If your SSD and/or SSI application has been denied, don't give up. The Social Security Administration offers four levels of appeal to contest an initial denial of SSD and/or SSI benefits.

Although an appeal can sometimes be stressful, going though the process can be quite beneficial. Approximately 60 percent of initial rejections are overturned at one of the levels of appeal.

Ways to Appeal an SSD or SSI Denial

The first step in the Social Security Disability appeals process is the "reconsideration" phase. This involves a review of the disability benefits application by a claims examiner for the SSA who was not involved in the initial denial. In addition to the evidence submitted at the time of the original application, the reviewer will also look at any new evidence gathered and submitted after that original application was denied.

If you disagree with the reviewer's decision in the reconsideration phase, you can request to have a hearing in front of an administrative law judge. The applicant (and his representative) will appear at the hearing and will answer any questions the judge may have about the benefits application. You may also want to bring in other witnesses to testify on your behalf. Medical experts, vocational experts, and friends or family who have observed your limitations can all be helpful.

It is usually to your advantage to submit new evidence prior to your hearing. Your SSD/SSI attorney can help you decide if it makes sense to be evaluated by a doctor or vocational counselor before the hearing.

If your location or disability prevents you from attending the hearing in person, the Social Security Administration will usually try to find a way to accommodate you.

If you disagree with the outcome of the hearing, you can request a review by the Social Security Appeals Council. The Council will look at all requests, but will usually not accept for formal review cases it believes were decided correctly. If you disagree with the Appeals Council's decision, or if the Council chooses not to review your case at all, you can take your claim to federal district court.

It's important to understand that the time to file an appeal is limited -- usually 60 days from the date of the decision. If your SSD or SSI claim has been denied, talk to an experienced Social Security Disability benefits lawyer who can help you plan the best course of action.

Article provided by Richard A. Sly Attorney at Law
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