If you are unable to work and have recently been denied Social Security disability (SSD) or Supplemental Security Income (SSI) benefits, do not panic. The Social Security Administration (SSA) allows for four levels of appeals.
1. Request for Reconsideration
The first step in the process of appealing your disability benefit decision is to file a request for reconsideration.
A reconsideration of your original claim takes place at the Disability Determination Services (DDS) level. However, the review will be performed by a medical consultant and examiner who were not part of the initial case decision. If appropriate, additional evidence can be introduced to support your request for benefits. This might include lab results, clinical findings, or a statement from your doctor regarding your ability to perform essential work-related activities. The type of evidence that will be most helpful depends on the specific reason why your claim was first denied. Successful evidence must rebut the initial SSA findings.
A re-examination of a continuing disability claim occurs periodically. Being denied benefits at the continuing disability review (CDR) level means your condition has improved enough that you can now work, or you have failed to cooperate with the review process. To appeal a termination of benefits at this level, you must request a reconsideration at a hearing with a disability hearing officer (DHO).
You are not required to be present at the reconsideration, but you may wish to appear if you want to explain to an SSA representative why you believe you qualify as disabled. Between 5% and 10% of claims are successful at the reconsideration stage of the review process.
2. Administrative Law Judge Hearing
If your request for benefits is denied at your initial appeal, the next step is a hearing with an administrative law judge (ALJ). You have 60 days from the appeal decision to request this hearing.
An ALJ is an attorney who works for the Office of Hearings Operations (OHO). The ALJ who hears your case is generally located within 75 miles of your residence, although video conferencing is sometimes used. The ALJ will not have had any part in the original SSD decision or your reconsideration.
The ALJ will ask questions about your disabling condition, physical or mental abilities, medical history, training, education, employment history, and day-to-day activities. The judge will look for answers that are clear, specific, and demonstrate that the person would prefer to be working if at all possible. Collectively, ALJs grant disability benefits in about 50% of the cases they hear.
3. Appeals Council
If you are denied benefits at the ALJ hearing, you can request a review form the Appeals Council. At this level of the appeals process, cases are randomly selected for review.
The Appeals Council will either grant, deny, or dismiss your request for review. Cases can be dismissed without review unless one of the following conditions applies:
- The ALJ committed an error of the law or abuse of discretion.
- The decision was not supported by substantial evidence.
- Your case raises a broad policy or procedural issue.
Less than 3% of people are awarded benefits at this stage of the process. The primary reason people submit their case for review is to exhaust the SSA appeals process, so they become eligible to sue in federal court.
4. Federal Court Review
When someone has exhausted the SSA appeals process, they can choose to sue in U.S. District Court. Then, a judge will hear the case without a jury and make a ruling based on the legal or factual questions raised in the case.
Suing in federal court is time consuming and expensive, which means the vast majority of individuals do not take their disability appeal to this level. Experts estimate that only about 1% of cases make it to federal court.
How Alperin Law Can Help
Although the best course of action is to consult an attorney as soon as you wish to file for benefits, Alperin Law’s dedicated legal team is happy to assist clients who are appealing an SSD or SSI denial. We can gather new medical evidence, cross-examine SSA witnesses, and prepare you for your court hearing.
Have You Or A Loved One Been Denied Social Security Disability Benefits?
If you or a loved on has been denied Social Security Disability Benefits you need to speak with an experienced SSD attorney as soon as possible. Please contact us online or call our Virginia Beach office directly at 757.490.3500 to schedule your free consultation. We have offices throughout Virginia including Chesapeake, Newport News, Norfolk and Suffolk.