SOCIAL SECURITY & DISABILITY OVERVIEW

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A Closer Look at the Social Security Disability Appeals Process

The Social Security Administration (SSA) is a large bureaucracy with complicated guidelines. Too often, people applying for Disability benefits give up out of frustration or after receiving an initial denial of benefits.

If your Social Security Disability claim was denied, you have the right to question, or appeal, this decision. Below is an overview of the four levels of appeal plus information on how an attorney may be able to help you get the results you need.

At the Law Offices of James Scott Farrin, our Social Security Disability team has experience helping clients successfully appeal their denied claims.1 We understand how important a knowledgeable disability appeals lawyer is, and we will fight to try to obtain the benefits you may deserve.

Is It Best to File a New Application or Appeal the Social Security Disability Denial Decision?

For most cases, it’s best to appeal the decision rather than start a new appeal for the following reasons:

  • The majority of first-time Social Security Disability claims are denied, so unless there is significant new information about your case, it may be likely that a new claim will also be denied.
  • When you first inform the SSA of your intention to file for benefits, a protective filing date, which is used to calculate possible back-pay, is established. If you choose to file a new claim, you lose this original protective filing date, which can result in significant loss of any back-pay.
  • If you have new information and evidence for your case, you can still submit it via the appeals process and do not have to start a new claim (and lose your protective filing date).

 

How Do I Appeal a Denial of My Social Security Disability Claim?

There are four levels of appeal available to Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) applicants who are not successful at the initial determination stage. The SSI and SSDI appeal process is as follows:

1. Reconsideration

Reconsideration is a complete case review by a person in the local Disability Determination Services (DDS) office who was not involved in the initial review and decision about your claim. All evidence presented in the initial decision, plus any new evidence, will be considered. In most cases, you do not need to be present. However, if your claim was denied because your medical condition improved, you have the right to meet with a Social Security representative to explain why you believe you should still be considered disabled.

gold monthly calendar iconYou should appeal for a reconsideration in writing or by submitting Form SSA-561-U2 within 60 days of the date on the denial notice.

Tip: The SSA claims that the fastest and easiest way to file an appeal of your SSDI decision is to visit www.socialsecurity.gov/disability/appeal and file online.

2. Hearing

If your claim is denied during the reconsideration level, you can request a hearing before an Administrative Law Judge (ALJ) outside of the DDS office. This is the stage of the appeals process where you may have the best chance of being approved. Before the hearing, you may be asked to give more information about the claim, and you will have the opportunity to review the information you have already submitted and provide more.

At the hearing, you and any witnesses (such as doctors and vocational experts) will be questioned by the judge. You, or your Social Security appeal lawyer or representative, will also be given the opportunity to question the witnesses.

gold monthly calendar iconYou should appeal in writing for a hearing or by submitting Form HA-501 within 60 days after the date on the reconsideration denial notice.

3. Appeals Council Review

If you disagree with the ALJ’s hearing decision, you may request a review by the Appeals Council, which is made up of administrative appeals judges. If a review is granted, the council can uphold, change, or reverse the ALJ’s decision, or return it to the ALJ for further review.

gold monthly calendar iconYou should appeal for a review by the Appeals Council in writing or by submitting Form HA-520 within 60 days after you receive a hearing decision.

4. Federal Court Review

You can file a civil lawsuit in Federal District Court if you disagree with the Appeals Council’s decision or if the Appeals Council decides not to review your case.

gold monthly calendar iconYou must generally file a lawsuit in U.S. District Court within 60 days of the date on the notice of the Appeals Council decision.

Do I Need a Disability Appeals Lawyer to Appeal a Social Security Disability Denial Decision?

While you are not required to have a social security appeal lawyer for the first three stages of the SSDI appeals process, we encourage you to consider enlisting the help of an experienced North Carolina Social Security Disability attorney for your appeal(s).

The following chart is a depiction of the decisions made at each level of the Social Security Disability claims and appeals process in 2020 on a national level. At the initial determination level, 61% of the claims were denied – many because the applicants did not qualify – but some disabled people were likely denied because they did not understand the application process, include all the necessary information, or file on a timely basis.

Social Security Administration disability decision data flow chart for 2019.

86% of the appeals at the reconsideration stage were rejected, and more than half of the appeals at the ALJ hearing were dismissed (14%) or denied (37%) in 2019. We strongly advise you to seek the guidance of a lawyer for Social Security appeals who knows how to:

  • gather and index medical records
  • question the claimant and witnesses
  • obtain detailed statements from treating doctors
  • interpret the complex rules and regulations that govern Social Security programs

And if you decide to appeal your case to the Appeals Council or Federal Court, a skilled Social Security Disability attorney can refer to past case experience and prior rulings when providing the Council or judge with a detailed, issue-focused argument.

Our Disability appeals lawyers understand the processes, timelines, and requirements for filing an initial Social Security Disability claim as well as for appealing decisions at each level. But more importantly, they understand Social Security Disability law and your rights, and they may be able to fight for the financial benefits you need at this point in your life. Contact us for a free evaluation of your potential case.

Contact the Law Offices of James Scott Farrin Today

Our Social Security Disability appeals lawyers understand how to pursue avenues to try and overcome denied SSDI or SSI claims. The head of our Social Security Disability team, Rick Fleming, isRick Fleming is a Social Security Disability appeals attorney at the Law Offices of James Scott Farrin a North Carolina State Bar Board Certified Specialist in Social Security Disability Law, and he and his team have helped many clients successfully pursue their appeals and fight for Disability benefits.1

Contact us today for a free and confidential case evaluation. There is no obligation and no attorney’s fee unless you recover compensation.2 Don’t leave your future to chance. You have the right to representation. Take back control and call us at 1-866-900-7078.

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