Understanding the Four Levels of Disability Appeals

by | May 21, 2016 | Lawyers

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When your Social Security disability claim has been denied, it can seem tempting to give up – however, you can feel heartened knowing that this isn’t the end of the road. The SSA has an appeals process set up whereby you can request that your case be reviewed again under different circumstances, especially if you believe that the original decision was unfair or you have acquired new evidence that will strengthen your claim.

But before you file an appeal with the Social Security Office in Washington, D.C., you should understand that there are four different levels of appeals you can go through while trying to get the benefits you deserve from the SSA. To help you prepare for this, take a look at the following details of each level and what you need to know to move forward.

1. Request for Reconsideration

The first level of appeals after your initial claim has been denied is to file an official request for reconsideration, which allows your case to be reviewed by a medical consultant and examiner who were not involved in the original decision to deny your claim. You can request a reconsideration after your initial denial, or if your benefits have been terminated after a continuing disability review (CDR).

2. Administrative Law Judge Hearing

If your initial request for reconsideration is denied, you can request a hearing before an administrative law judge, an attorney who works for the SSA’s Office of Disability Adjudication and Review (ODAR). The judge will hear from you and your attorney and review medical records that are presented in order to come to a decision on your claim. You must request the hearing within 60 days of being notified of your denial.

3. Appeals Council

The hearing is the end of the road for most appeals cases; however, if you feel that there has been a serious breach of justice in that the judge didn’t consider all of the evidence, didn’t follow procedure, or if your hearing was cut short, then you have the option to appeal your case to the Appeals Council if the administrative law judge denies your claim. The Appeals Council can reject any case without reviewing it, so it’s really up to chance whether you will get in; if you do, you need to present a strong case that the administrative law judge made an error in order to win your claim.

4. Federal Court Review

The final option for those appealing their SSDI or SSI claims is a federal court review, which seeks to overturn the decision of the Appeals Council by filing a lawsuit in a federal district court. A federal judge will hear your case without a jury, which means that you need to present strong evidence that your case has merit but that the initial review, appeals review, administrative law judge and Appeals Council all made mistakes.

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