Even the Social Security Administration (SSA) admits that most initial applications for Social Security Disability Insurance (SSDI) benefits are denied the first time around. This fact can burden applicants who are already facing financial difficulties with additional burdens that may seem insurmountable without the financial assistance provided by the SSDI program. Fortunately, the SSA has adopted an extensive appeal process that gives every applicant a chance to have a denial of benefits reviewed by an SSA employee who played no part in the denial of the first application for benefits. Understanding this appeal process can provide useful assistance to someone who desperately needs SSDI benefits.
The first step: Request for reconsideration
The first step in the appeal process is a written request for reconsideration. The request can be made in writing – usually a letter or e-mail – addressed to the SSA office that handled the initial application. The request must be filed within 60 days of the date of the initial determination. The applicant can submit any additional medical or employment information that may be relevant to the initial decision and to the applicant’s reasons for seeking reconsideration. The SSA is required to respond to a request for reconsideration within 60 days. If the SSA does not reverse the initial decision, the claimant may seek review before an Administrative Law Judge (ALJ).
Administrative hearings and more
The hearing will be scheduled for a time and place that are convenient for the claimant. Since the advent of remote meetings during the corona pandemic, many hearings are held remotely; the claimant and all witnesses appear remotely. The claimant can submit any evidence concerning the medical situation and ability to work that is deemed relevant. The ALJ will render a decision withing within 60 days. If the ALJ affirms the initial denial of the claim, the claimant can take the case to the SSA’s Appeals Council.
The appeals council is an internal review panel that has jurisdiction over all cases, with the power to reverse or affirm any decision. If the appeals council finds that the decision at the hearing satisfies to satisfy all existing SSA regulations and law. If the Appeals Council finds that the ALJ decision is contrary to SSA laws and regulations, it has the power to reverse the decision and order an award of benefits. It may also send the case back to the ALJ for further consideration. If the Appeals Council does not reverse or modify the original decision, the applicant may seek judicial review in the federal district court having jurisdiction over the applicant.
Filing a federal court appeal requires the applicant to retain an attorney to file the case in court and represent the applicant in all stages of the case. As may be inferred from the descriptions of the earlier stages of appeal, the early assistance of an experienced SSDI attorney can be essential to maximizing the odds for success.