Appealing a Social Security Decision
Once the claimant files for social security benefits, the Social Security Administration (SSA) makes a decision as to the party’s eligibility for benefits and sends a letter explaining their verdict. If the claimant does not agree with the decision, then the person has the legal right to ask SSA to review the matter. When an appeal is filed, the SSA will reverse the judgment if they find an error or mistake was made.
The claimant must file a written request for appeal within sixty days from the date of receiving the SSA’s notification letter. An appeal may be handled through procedures at various levels:
- Hearing before an administrative law judge
- Review by the SSA Appeals Council
- Review by a federal court
When notifying the claimant of the decision, the SSA will provide information about how to appeal the decision, and at what level the appeal will be heard. Individuals themselves can handle Social Security appeals, or they may appoint a friend, lawyer, or anyone else, who will be called the “representative”. The representative will receive a copy of any decisions made by the SSA pertaining to the party’s claim. The representative cannot charge or collect fees from the claimant unless written approval is obtained from the SSA.
Reconsideration is a total reanalysis of the claim by a person who didn’t participate in the original verdict. All of the initial proof of the claim, along with any additional evidence, will be examined during reconsideration. This process does not require the presence of the party. An explanation can be provided to a Social Security representative if the claim was denied due to an improvement in the party’s medical condition.
The claimant can request a hearing on the disability issues of the claim if he or she contests the initial verdict of the SSA. An administrative law judge, not part of the initial judgment in the case, will conduct the hearing. The judge will inform the party of the date and venue of the hearing. Typically, the hearing is held within a 75-mile radius of the claimant’s residence. The claimant and the representative may appear for the hearing and explain the case in person. It is generally advisable to attend the hearing; however, if the party doesn’t want to attend, a written notice should be sent to the SSA. The SSA will then send a letter and a copy of the administrative law judge’s verdict to the claimant after the hearing.
If the claimant isn’t satisfied with the judgment after the hearing, the party may seek a review by the SSA’s Appeals Council. The Appeals Council will entertain all review requests, unless it finds that there was no mistake or error in the verdict made at the hearing. If the Council decides to review the case, it may either settle the case by itself or send it back to the administrative law judge for further review. The claimant will receive a copy of the Appeals Council’s verdict or order transferring it back to an administrative law judge.
If the claimant disagrees with the verdict of the SSA Appeals Council, or the Appeals Council declines to review the case, the party can file a suit in federal district court. This is the final level of appeal in the social security appeal process.
A party’s choice to appeal must be based on the debilitating nature of the disabilities, whether the impairment will exist longer than a year, the age, education level, and work experience of the party, and most importantly, whether the appeal is in the best interest of the party. It is advisable to get the assistance of a disability lawyer who can analyze the denial notice and give an opinion on the likelihood of an appeal’s success.