If Social Security denied your claim or stopped your benefits for any reason you have the right to file an appeal. What type of appeal you file depends on where you are in the appeals process and what State you are living in.
The appeal process for Social Security is relatively straightforward. The process for appeal is Reconsideration, Hearing, Appeals Council, and Federal Court. If your disability or SSI claim was initially denied by the State, the first step is called Reconsideration.
Request for Reconsideration
Reconsideration means that your claim is sent back to the State disability agency that denied your claim for reevaluation. Your claim will be assigned to a different examiner that had nothing to do with the original decision. The State will reconsider all the medical evidence submitted along with any new evidence have. It takes on average 120 days for the State to evaluate a claim. This 120 day time period applies to initial claims and reconsiderations handled by the State.
Not all states process reconsiderations. There is a pilot program designed to streamline the appeals process that eliminates the reconsideration step and sends your case directly to a hearing. States participating in this pilot program are called Disability Redesign Prototype States. If your initial claim for disability or SSI is denied in one of the Disability Redesign States you will be sent a hearing package to appear before an administrative law judge. These States include:
Alabama, Michigan, Alaska, Missouri, California, New Hampshire, Colorado, New York, Louisiana, and Pennsylvania
Social Security Hearings
If you live in one of the Disability Redesign States listed above or had your request for reconsideration denied by the State agency, your next step in the appeals process is a hearing. Hearings are held in Social Security’s Office of Hearings and Appeals (OHA). At your hearing you and a representative (if you choose one), will appear before an administrative law judge and make your argument as to why you should receive disability and/or SSI benefits.
The administrative law judge you appear before will not have been involved in the prior processing of your claim in any way. After you file the request for a hearing the regional hearing office in your area will contact you to schedule a time for you to appear. This can be a lengthy process; hearing offices are heavily backlogged with cases and it can take over a year to receive a hearing date.
When you attend your hearing you have the right to representation by an attorney and the right to present witnesses on your behalf. You will have the opportunity to review your files and present new information pertinent to your case. Your doctor, relatives, caseworker, and attorney can all attend the hearing and speak on your behalf. It is not required for you to attending the hearing; however, it is in your best interest to go.
After your hearing is held it usually takes the administrative law judge 30 to 60 days to render a decision. You will receive a letter advising you of the decision at that time.
Social Security Appeals Council
If you receive an unfavorable decision at your hearing, the next step in Social Security’s appeals process is review by Appeals Council.
The appeals council will review your request for review. The appeals council may not take your case if they agree with the decision made by the administrative law judge. If the appeals council decides to accept your case for review they will either render a decision or send your case back to the hearing office for another review. You will receive a letter with the outcome of the Appeals Council review usually within 60 days.
If the appeals council refuses to take your case or denies your appeal, the final step in the appeal process is to file your case in Federal Court.
The final step in Social Security’s appeals process is to file against the Social Security Administration in Federal Court. You will need an attorney to assist with your case in Federal Court.
You have the option of filing a new claim at any time after the reconsideration state in addition to your appeal rights. If your new claim is approved and you then receive a favorable decision for your appeal, Social Security will back pay you to your original filing date for the first claim.