Social Security Disability Benefits: The Appeals Process
At Julie A. Rice, Attorney at Law, & Affiliates, we have handled hundreds, if not thousands, of people successfully appeal decisions from the Social Security Administration (SSA), so if you have been initially denied your application for disability, as most people are, then you may Contact Us for your free legal consultation about your Rights to an Appeal. If you are eligible for Social Security Disability Insurance (SSDI) Benefits or Supplemental Security Income (SSI) Benefits, we want to make sure that you get these benefits on time and in the right amount.
If the SSA decides that you are not eligible for disability benefits under either SSDI or SSI, or if the SSA decides that they are going to stop paying benefits to you or alter the benefit amount payable to you, then the SSA will send you a letter explaining this decision. If you do not agree with the decision of the SSA, then you have the Right to Appeal the decision.
Before you decide to appeal the SSA’s decision, it is important that you review and become familiar with the following information:
Before you can appeal, you need to have your Notice of Decision from the SSA.
You should review the Video: Preparing to File Your Disability Appeal Online, and the Checklist: Information You Will Need such as:
- Your Current Name, Social Security Number, Address, and Phone Number.
- If you have a Representative, your Representative's Name, Address, and Phone Number.
- Name, Address, and Phone Number of any Friends or Relatives who Know about your Medical Condition.
Medical Information since you last filed a disability claim or appeal:
- A Detailed Description of any Changes and New Medical Conditions.
- A Detailed Current list of the Name, Address, Phone Number, Type of Treatment, and Visit Dates for all Doctors, Hospitals, and Clinics.
- A Detailed and Current list of the Names of Medicine (over-the-counter and prescription) you are currently taking, Who Prescribed Them, and Any Side Effects.
- A Current and Complete Name, Location, and Date of all Medical Tests you have had and Who Sent you for them.
The following are very useful Tips for Using this Website that you should become familiar with before you appeal. Furthermore, the following are Instructions for Blind or Visually Impaired Users that you will want to review before you appeal.
Four steps of appeal
There are four (4)steps in the disability appeals process and each step must be completed in the order listed below, and this is an overview and each level will be described in detail herein below:
|Type of Appeal||Appeal Process|
If you recently applied for SSDI or SSI, and you were denied for medical reasons, then you may request an appeal online using the SSA’s Internet Appeal application . If you want to appeal any other kind of Social Security decision, you can call the SSA's toll-free number 1-800-772-1213 (TTY 1-800-325-0778) or contact your local Social Security office .
You should also complete a Request for Reconsideration and an Appeal Disability Report; Both forms can be completed on the Internet, and submitted electronically to Social Security, or you can complete paper versions and send them to your local Social Security Office . Whether you complete the forms on line or send the forms into the office, the SSA will then send your case to the State Disability Determination Services (DDS) office where a representative there will review your medical records and make a new determination about your disability. Please note that the person who reviews your reconsideration will not be the person whom made the last determination on your case. After the DDS representative has reviewed your medical records, then you will be notified in writing of the decision.
If your Reconsideration is denied, then you should complete a Request for Hearing by Administrative Law Judge and an Appeal Disability Report . As with the Reconsideration forms, both forms can be completed on the Internet, and submitted electronically to Social Security, or you can complete paper versions and send them to your local Social Security office . Either way that the completed forms are submitted to SSA, SSA will send your request to the Office of Disability Adjudication and Review . If you would like to meet face-to-face with the judge, then an appointment will be made for you . After talking with you and your representative, then the judge will notify you in writing of his/her decision on your case.
|Appeals Council Review||If you are not satisfied with the decision of the Administrative Law Judge (ALJ), then you should complete a Request for Review of Decision/Order of Administrative Law Judge. This cannot be done on the Internet, and it must be signed and sent to your local Social Security Office, and they will send your request to the Office of Disability Adjudication and Review and a representative there will review your medical records and notify you in writing of the decision on your case.|
|District Court Case||If you are not satisfied with the Appeals Counsel Review, then you must have an attorney at this level of appeal, and he or she must file a case against Social Security in District Court, and your case will be heard by a district court judge who will notify you in writing of the decision on your case.|
You May Have a Representative
If you have a representative, and you may or may not have to pay his or her fees. For more information about representation see Your Right To Representation (Publication No. 05-10075). You can have a representative, such as an attorney, help you when you do business with Social Security. The SSA will work with your representative, just as they would with you.
How to Request a Hearing or Appeals Council Review
As discussed above, you must fill out the necessary forms, and your request must be in writing.
Generally, you have 60 days after you receive the notice of the SSA's decision to ask for any type of appeal.
- If you do not appeal on time, the Administrative Law Judge or the Appeals Council may dismiss your appeal and you may not be eligible for the next step in the appeal process and that you may also lose your right to any further review.
Administrative Law Judge hearing
Before the hearing:
- Submit any additional evidence you want the Administrative Law Judge to consider as soon as possible.
At the hearing:
- The Administrative Law Judge will explain the issues in your case and may question you and any witnesses at the hearing, and the answers to the questions presented by the Judge will be under oath and recorded.
- You may bring witnesses to your hearing. The Administrative Law Judge may also ask other witnesses to come to the hearing.
- You and the witnesses answer questions under oath. The hearing is informal but is recorded.
After the hearing:
After reviewing and studying all the evidence, the Administrative Law Judge issues a written decision and will send you a copy of the decision or dismissal.
It is very Important that you Appear at the Hearing if a Hearing is Scheduled, And When the SSA can Pay Travel Expenses
Under certain circumstances, such as you having to travel more than 75 miles to the hearing, then the SSA may pay your travel expenses but you must request this in writing to the ALJ at the time or the hearing or as soon as possible thereafter.
Appeals Council review
If you think the Administrative Law Judge’s decision or dismissal order is wrong, then you may ask the Appeals Council to review your case as set forth herein above.
United States District Court Action
If you do not agree with the Appeals Council’s decision or denial of your request for review of the Administrative Law Judge’s decision, then you may file a civil action in the United States District Court for the area where you live and you must have an attorney to file this action.
If you have any questions, please call, write, or visit any Social Security office. The toll- free number is 1-800-772-1213 (for the deaf or hard of hearing, call our TTY number, 1-800-325-0778). Or you can go to the SSA's website at www.socialsecurity.gov/appeals.
Please include your Social Security Number in letters you write to any Social Security office or have it ready when you call.
If you prefer not to complete an appeal request or a Disability Report on the Internet, you can use any of the following ways:
- Call the SSA's toll-free number, 1-800-772-1213. Explain that you don't want to use the online appeal process but do want to appeal the decision made in your case. Representatives are available Monday through Friday from 7 AM to 7 PM. If you are deaf or hard of hearing, call the SSA's toll-free "TTY" number, 1-800-325-0778.
- Contact your local Social Security Office and tell the SSA's representative that you want to appeal the decision made on your case.
- Refer to your denial notice to find out the kind of appeal you need to request. You can print the form you need from the SSA's Forms Page . In addition to the appeal request form, you will need to print and complete a paper Appeal Disability Report (SSA-3441) and an Authorization to Disclose Information to SSA (SSA-827). After you print out and complete all three forms, you should mail them to your local Social Security Office. The SSA will be able to take action more quickly if the SSA receives all three forms at the same time.
Note: You must have Adobe Reader on your computer to read and print the forms. If you do not have a current version of Adobe Reader, use this link to get a free copy of Adobe Reader.
- If you live outside the United States, see Service Around the World.
For more information and to find copies of the SSA publications, visit the SSA website at www.socialsecurity.gov or call toll-free, 1-800-772-1213 (for the deaf or hard of hearing, call our TTY number, 1-800-325-0778).
As you can tell from this information, appealing a disability decision is a complex process. We at Julie A. Rice, Attorney at Law, & Affiliates, have successfully represented hundreds, if not thousands, of people obtain disability benefits so please feel free to Contact Us for your free legal consultation. We look forward to hearing from you soon.