How Do I Appeal the Denial of Social Security Benefits?

Most initial Social Security disability claims are denied. If Social Security denies your disability claim, you can file an appeal. An appeal is a chance to have your disability claim reviewed so you can get the benefits you need. However, you only have limited time to file an appeal.

Don’t give up after Social Security denies your claim. A Social Security disability lawyer can help you file an appeal. For more information about your disability appeal options, talk to a Social Security disability lawyer.

When Can You Appeal a Social Security Disability Decision?

If the Social Security Administration (SSA) denies your benefits claim, you have the right to appeal. You have the right to appeal a Social Security denial for both of these disability benefit programs:

• Social Security Disability Insurance (SSDI)
• Supplemental Security Income (SSI)

SSDI is a monthly benefit payment for people who can’t work because of a qualifying medical condition. To get SSDI benefits, you have to have enough work credits and pay into the Social Security system with payroll taxes.

SSI is a monthly benefit for disabled people with low income and few assets. While there is no work history requirement for SSI, there are income and asset limits to qualify.

When you go through the application process, the SSA will refer your case to a state Disability Determination Service (DDS). The DDS reviews your medical records, work history, and other information to determine if you qualify for benefits. It can take three to five months before hearing back from the SSA.

According to the SSA, about 67% of all disability claims are denied. The SSA will explain the denial when they respond. There are medical and non-medical reasons for denial, which could include:

• Not enough recent work credits to qualify
• Continuing to work
• Impairment is not expected to last 12 months
• Impairment is not severe
• Can do other work
• Not enough medical evidence
• Failure to cooperate
• Impairment results from drug addiction or alcoholism

The SSA notice will also include information about the appeals process. At each level of the appeals process, claimants must file a written request for appeal within 60 days from the date of notice of denial.

What Are the Social Security Appeals Options?

There are different options for filing an appeal. The four levels of appealing a Social Security disability decision include:

• State DDS reconsideration (Form SSA-561)
• Administrative law judge hearing (Form HA-501)
• Appeals Council review (Form HA-520)
• Federal U.S. District Court review

Filing for Reconsideration

A request for reconsideration is generally the first option for appealing your denial. The Disability Determination Service will reconsider your initial claim. However, it will go to a different examiner and medical team. You can also present more evidence to support your claim. The DDS team will review all the medical evidence submitted. They can request more medical exams or testing.

A legal representative can help you request reconsideration. Your lawyer can file the reconsideration request and help you gather new evidence to support your claim. A lawyer acting as your representative can also work directly with the SSA on your behalf.

During the reconsideration process, you should continue with your doctor’s treatment plan. The DDS may contact your doctor for more information about your medical condition. After reviewing all relevant information, the SSA will notify you about its decision. If approved, you can start getting payments for your Social Security disability benefits.

Administrative Law Judge Hearing

An administrative law judge (ALJ) is a legal professional who decides administrative government matters. You can request a hearing with an ALJ to review your disability claim. The ALJ will consider the evidence and any new evidence. The ALJ can also use medical and vocational experts to review the case.

Your Social Security disability lawyer can represent you in the disability hearing. While you wait for your hearing date, they can prepare you for the court date. You can appear by phone, in person, or through an online video hearing. Your lawyer will explain the process and tell you what you can expect from the ALJ.

After the ALJ hearing, you’ll get notice of the hearing decision. If the ALJ approves your disability claim, you will start getting benefits. If the ALJ denies the claim, you can file a request for an Appeals Council review.

Appeals Council Review

If you aren’t satisfied with the ALJ decision, you can request a review by the Appeals Council. Administrative appeals judges make up the Appeals Council. The council can grant, deny, or dismiss a review request. If the Appeals Council grants a review, they can review the ALJ’s decision based on all the evidence submitted and any additional evidence. The council can uphold or reverse the ALJ’s decision. They could also send it back to the ALJ for a new decision.

Federal Court Review

Within 60 days of the Appeals Council decision, you can file a civil action in federal court. The U.S. District Court can review the Appeals Council’s decision. If the federal District Court finds in your favor, they can approve your disability award so you can get benefits.

What Is the Appeals Deadline for Social Security?

You have limited time to file an appeal. Generally, you must file an appeal within 60 days from the date of the decision letter from the SSA. Sometimes, you can file a late appeal for good cause. If you file a late appeal, you have to submit a good cause for late filing request to the SSA. Examples of good cause can include:

• Serious illness or death in the family
• Misleading SSA actions
• Mental limitations preventing timely appeal filing
• Fire destroying employment records

Can a Social Security Disability Lawyer Help With an Appeal?

Your chances of getting your disability claim approved increase if you file an appeal. According to the SSA, appeals increase the approval rating for disability awards from 20% to 30%. A lawyer can explain your appeal options and represent you in court. Contact a Social Security lawyer to file an appeal in your disability case.