Failing to file a Social Security Disability appeal is the biggest mistake you can make when fighting for your SSDI benefits. The Social Security Administration counts on claimants to give up when their initial application for disability benefits is denied – and close to half do. Don’t be part of this group.

The Four Levels of Social Security Disability Appeals

There are four levels of appeal in the Social Security Disability process. The appeal levels are:

  • Request for reconsideration of your claim by Disability Determination Services (DDS);
  • Administrative law judge (ALJ) hearing;
  • Appeals Council review; and,
  • Federal Court review.

The further along you are in the disability appeals process, the more helpful a Social Security Disability attorney may be. If you have any questions or concerns about your claim, call or e-mail us today.

Request for Reconsideration of Initial Claim for SSDI and SSI Benefits

If your initial application for disability benefits is denied, you will receive a letter in the mail telling you why. The most important part of the letter is its date. You have 60 days from the date of this letter to request reconsideration of the denial by DDS – which is the name of your appeal at this letter. If you miss the deadline you may have to start over again – which means you’ll lose valuable time.

To request reconsideration and continue your Social Security Disability appeal, you will need to complete several forms. These forms include:

  • Form SSA-561-U2: Request for Reconsideration
  • Form SSA-3441-BK: Disability Report-Appeal; and,
  • Form SSA-827: Authorization for Source to Release Information to the SSA.

Even though you completed a disability report and authorization to release information when you filed your initial application for benefits, you must do so again to finish your request for reconsideration.

How should I fill out the request for reconsideration form?

Use the SSA’s form when requesting reconsideration of your denial. Make sure that you give the following information when completing the form:

  • Your name and Social Security Number
  • Your claim number, if different from your Social Security Number
  • The reason you are filing your appeal. Keep it short and simple. Write the following – Appealing my denied Social Security Disability claim.
  • Additional reasons you are appealing. State the following: I disagree with the finding that I’m not disabled under the Social Security Act. I do not agree with the finding that I’m capable of performing any past relevant work or other work that exists in significant numbers in the national economy. This protects your Social Security Disability appeal.
  • Also submit any additional medical evidence, including treating source opinions that you may have. This will help you prove you’re disabled and win your Social Security Disability claim.

What happens during the reconsideration appeal process?

DDS reviews your claim at the reconsideration level. Yes, the same DDS that denied your initial application. This is part of the reason why so few cases are approved at the reconsideration level.

Reconsideration is supposed to be a complete review of your claim – from top to bottom. A new DDS claims examiner and new medical consultant will review the evidence in your file and make a new determination.

You are allowed – and should – submit updated medical records and reports to DDS while your claim is pending on reconsideration. You should also complete any other forms that DDS sends you, such as those dealing with your pain level and functioning. Talk to a disability lawyer before completing this forms. You don’t want to say something that inadvertently hurts your case.

If DDS denies your claim again, you will receive a notice in the mail. This denial notice is similar to the letter you received when your initial application for benefits was denied. Again, make sure you note the date on the letter.

Many attorneys think that the SSA should do away with the request for reconsideration level. And I’m one of them. Why? Because this level has become nothing more than a rubber stamp for denials of initial applications. In fact, more than 80 percent of claimants who file a request for reconsideration will receive a second denial. Do not let this denial frustrate you. You should expect the denial and move forward promptly with your appeal.

Appeal to Administrative Law Judge - Request for Hearing before an ALJ

If DDS denies your request for reconsideration and you want to appeal, you must file a request for hearing before an administrative law judge.

We have greater success at the hearing level because, for the first time, an administrative law judge will see you face to face and hear your testimony about how your disabilities affect your everyday life.

To perfect your appeal at this level, you will need to complete what is known as Form HA-501, a Request for Hearing by Administrative Law Judge. This is a short form with several straightforward questions. Make sure you check the box that asks if you wish to appear at a hearing.

What if I don't want to attend a hearing before an ALJ?

I encourage you to reconsider. A hearing is your best chance of proving your SSDI or SSI claim in my opinion.

If you still don’t want to attend a hearing, you will need to sign a Form SSA-773. That form states:

I have been advised of my right to have a disability hearing. I understand that a hearing will give me an opportunity to present witnesses and explain in detail to the disability hearing officer, who will decide my case, the reasons why my disability benefits should not end. I understand that this opportunity to be seen and heard could be effective in explaining the facts in my case, because the disability hearing officer would give me an opportunity to present and question witnesses and explain how my impairments prevent me from working and restrict my activities. I have been given an explanation of my right to representation, including representation at a hearing by an attorney or other person of my choice.
Although the above has been explained to me, I do not want to appear at a disability hearing, or have someone represent me at a disability hearing. I prefer to have the disability hearing officer decide my case on the evidence of record plus any evidence that I may submit or which may be obtained by the Social Security Administration. I have been advised that if I change my mind, I can request a hearing prior to the writing of a decision in my case. In this event, I can make the request with any Social Security office.

Will I have a prehearing conference?

Some ALJs will hold a prehearing conference to narrow the issues in your case or to make a quicker decision. I have not had an ALJ request a prehearing conference in any of my clients’ cases in the past four years. So they appear to be out of favor in the Richmond, Norfolk, and Charlottesville ODAR offices.

A prehearing conference may also be held with an attorney advisor. But we don’t see much value in these. Most attorney advisors do not have the authority to grant a case after a rehearing conference, so we’ve found it to be a waste of time in most cases.

Who schedules the ALJ hearing?

The ALJ’s office, or more specifically, the scheduler for the Office of Disability Adjudication and Review (ODAR) where your ALJ is located, will notify you or your representative of your hearing. With the new rules going in place later this year, you will receive at least 75 days notice of the time and place of your hearing.

If you can’t make your hearing due to transportation problems or an important doctor’s appointment, let the ALJ know as soon as possible. His or her telephone number should be listed on your notice of hearing.

Some ALJs make a decision on your case at the hearing. Others take several more months to issue a written decision.

If you win your case, great! You can focus on having your approval processed. If your claim is denied after a hearing, you should learn more about the next step.

Appeals Council Review - The Last Step of the Administrative Process

When the ALJ denies your claim for SSDI benefits or SSI, you may file a final administrative appeal with the Appeals Council. Recent reports show that more than 150,000 requests for review are filed with the Appeals Council each year.

The Appeals Council’s main office is located in Falls Church, Virginia. The Executive Director of the Office of Appellate Operations, which has more than 1,000 support staff, serves as the Deputy Chair of the Appeals Council. The Deputy Chair is responsible for the Appeals Council’s day to day operations.

Roughly 70 administrative appeals judges and more than 50 appeals officers work within the Appeals Council.

The Appeals Council has three options when it receives your appeal. It can:

  • Deny your request for review and affirm the ALJ’s decision;
  • Reverse the ALJ’s decision and approve your claim for benefits; or,
  • Remand the ALJ’s decision with instructions.

If your case is remanded, you will have another hearing before an ALJ. The Appeals Council’s instructions may tell the ALJ to obtain additional evidence or to change the weight given to certain medical opinions.

Getting the Appeals Council to reverse or remand the ALJ’s denial of your claim is difficult. It requires support from at least two judges. An administrative appeals judge does not have the ability to reverse or remand an ALJ decision single-handedly. For you to win your appeal, at least two administrative appeals judges must think your denial was wrong.

It does not, however, take two administrative appeals judges for you to lose your appeal. A judge may single-handedly deny your appeal.

The Appeals Council process takes time. Usually it takes six to eighteen months for a claimant to receive a written decision from the Appeals Council. This is why it sometimes makes more sense to file a new application for SSDI benefits instead of requesting review by the Appeals Council.

Sue the SSA in Federal Court

If you disagree with the Appeals Council’s decision, you can file a civil action in U.S. district court. You have 60 days from the date of the Appeals Council’s denial to file suit.

Juries do not hear disability cases. Most federal judges will make a decision based on motions for summary judgment.

We do not recommend filing suit in federal court without the help of a disability attorney. A Social Security Disability appeal at the federal court level requires knowledge of civil procedure.

Denied Social Security Disability Claim Lawyer in Richmond Virginia

Were you denied benefits? Call or email Corey Pollard today for a free consultation regarding your denied Social Security Disability claim.