Social Security Benefits Appeals Process

A closer look at the appeals process

The Social Security Administration is a large bureaucracy with complicated guidelines. Too often, people applying for benefits give up out of frustration. By going through the appeals process, however, claimants may get the results they need.

For a free case evaluation with an experienced North Carolina disability law firm, call 1-866-900-7078. At the Law Offices of James Scott Farrin, we're on your side.

There are four levels of appeal available to Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) applicants who are not successful in the initial determination stage.

  1. Reconsideration

    A reconsideration is a complete review of the claim by a person in the local Disability Determination Services (DDS) office who was not involved in the initial decision. All evidence presented in the initial decision, plus any new evidence, will be considered. In most cases, the applicant need not be present. If claimants are denied because their medical condition has improved, they retain the right to meet with a Social Security representative to explain why they should still be considered disabled.

    Only about 20 percent of people who were denied in the initial determination are approved during reconsideration. Again, many of the people were denied because they truly didn't qualify for Social Security assistance. However, some disabled people were denied because they didn't include all the information necessary for an examiner to make a favorable decision — or they provided so much information that examiners missed important aspects of the claim. An attorney who is recognized by the North Carolina State Bar as a Board Certified Specialist in Social Security Disability Law can help clients navigate this complex process. Attorney Rick Fleming at the Law Offices of James Scott Farrin is a North Carolina Board Certified Specialist in Social Security Disability Law.

  2. Hearing

    Claimants who are denied during the reconsideration phase can request a hearing before an Administrative Law Judge (ALJ) outside of the Disability Determination Services (DDS) office. Before the hearing, a person may be asked to give more information about the claim. He or she may also examine the information already in the file and provide more information.

    At a hearing, applicants and any witnesses (such as doctors and vocational experts) will be questioned by the judge. The applicant and his/her representative may also question witnesses.

    Currently, there is a nationwide backlog of Social Security cases at the hearing level. As of January 2009, the Social Security Administration (SSA) had a backlog of 765,000 hearing requests, and in some states it takes up to 800 days (2.19 years) to schedule a hearing. Processing time for North Carolina cases currently ranges from 13 to 18 months.

    However, the wait might be worthwhile. Statistically, 60 percent or more of claimants who have a disability hearing win.

    A hearing is tremendously complex, and it is our firm's opinion that it may be highly advisable not to attempt one without an attorney who is recognized by the North Carolina State Bar as a Board Certified Specialist in Social Security Disability Law. A qualified attorney knows how to gather and index medical records, question witnesses and interpret the complex rules and regulations that govern both a court of law and the various Social Security programs. According to the nonprofit National Organization of Social Security Claimants' Representatives (NOSSCR), claimants who employ a qualified attorney to represent them are much more likely to win than those who do not.

  3. Appeals Council

    If claimants disagree with the hearing decision, they may request a review by the Social Security Appeals Council, but it may deny that request. If it decides to review the case, it can either decide the case itself or return it to an Administrative Law Judge (ALJ) for further review.

    Making a case before an Appeals Council is highly complex, and it is our firm's opinion that it may be advisable not to attempt one with out the help of an attorney who is recognized by the North Carolina State Bar as a Board Certified Specialist in Social Security Disability Law. Attorney Rick Fleming at the Law Offices of James Scott Farrin is a North Carolina Board Certified Specialist in Social Security Disability Law.

  4. Federal Court (District Court; Court of Appeals; US Supreme Court)

    Claimants can file a lawsuit in Federal District Court if they disagree with the Appeal Council's decision or if the Appeals Council decides not to review their case.

    Making a case before a Federal Court is highly complex, and it is our firm's opinion that it may be advisable not to attempt one with out the help of an attorney who is recognized by the North Carolina State Bar as a Board Certified Specialist in Social Security Disability Law. Attorney Rick Fleming at the Law Offices of James Scott Farrin is a North Carolina Board Certified Specialist in Social Security Disability Law.

Don’t go at it alone — Contact our law firm today

At the Law Offices of James Scott Farrin, we understand how to pursue appeals of denied SSDI or SSI claims. Contact a North Carolina disability attorney with our firm today for a free initial conversation. There is no obligation. There is no attorney’s fee unless you recover compensation.

Don't leave your future to chance. Take back control. Contact the Law Offices of James Scott Farrin. We're on your side.

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