There are four levels of the SSDI appeals process:
Reconsideration
If your initial application has been denied by the SSA you have 60 days to file an appeal for a reconsideration of your claim. In general, about 10-15% of requests for Reconsideration are granted.
A disability claim can be denied due to the applicant's age, lack of work, because too much time had passed since the applicant had worked, or the applicant's earnings had exceeded the statutory limit. These denials are known as technical denials and often cannot be appealed unless the denial was due to missing paperwork or information or it can be shown that the SSA had miscalculated the applicant's earnings. If the denial of SSDI benefits is based on the SSA's medical determination, this is known as a medical denial in which case the decision can be appealed. If you filed your initial claim on your own it could be much to your advantage to seek legal assistance for your appeal.
Administrative Law Judge Hearing
The second level of appeal is to bring the case before an Administrative Law Judge (ALJ). As with the initial denial of a disability claim, the request to bring the matter befor an ALJ must be filed within 60 days from the Reconsideration denial. Getting a date for a request to go before the ALJ can take anywhere from 9 months to 2 years
Among the issues that may be argued before the ALJ could be proving that the applicant is unable to to do their past work and/or that the applicant does not have the skills or experience to perform a different type of job. Roughly 50% of cases that go before an ALJ are granted.
Appeals Council
The third level of appeal is to request a review by the Appeals Council. The appeal as with the Reconsideration and ALJ Hearing must be filed within 60 days of the ALJ's denial of benefits. The Appeals Council reviews the ALJ's decision to see if there were any errors or if the decision was not supported by the evidence presented.
Most requests for review brought before the Appeals Council are denied and in some cases dismissed. Only 1% of cases that go before the Appeals Council are granted and roughly 10% are remanded, or sent back, to the ALJ for a second hearing. Given the likelihood of a case being denied or dismissed by the Appeals Council, legal representation is highly recommended.
Federal Court
The fourth and final step in the appeals process is to file a claim in federal court. These cases go before the U.S. District Court and must be filed within 60 days of the Appeals Council's denial of an applicant's claim. The District Court hears the case without a jury and generally reviews the Appeals Council decision for legal or procedural errors but may sometimes consider the facts and evidence presented before the Appeals Council
Few cases brought before the District Court are reversed and roughly 50% are remanded back for review. By this stage of the appeals process legal representation is all but essential for a successful outcome.
Social Security Disability Attorney
Having an experienced Social Security disability lawyer for your appeal can increase your chances of a successul outcome for your disability appeal. Disability attorneys know how the SSA works and why they often deny claims from applicants who are disabiled and need their benefits. Also, there is never any money up front for a consultation or legal services. If you have applied for Social Security Disability and have been denied, contact Forrest Jackson today.