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Appeals process for Social Security Disability Insurance

If you have a long-term health condition that prevents you from returning to work, Social Security Disability Insurance is a valuable federal resource that can help you financially stay on your feet. Even though you may be eligible to apply for SSDI, not every applicant is accepted upon their initial application. Therefore, it's important to understand the appeals process within the Social Security Disability system and understand your rights within that system as well.

SSDI decisions are sent through the mail and are in letter form. If your letter explains that your application for SSDI benefits has been denied, the letter will also contain information on how to appeal the decision. All appeals must be in writing and must be requested within 60 days from the date the letter was received. The Social Security Administration assumes you receive the letter five days after the date on the decision letter. The letter also explains information on how to appeal. In general, there are four levels of appeals for SSDI benefits.

Reconsideration

The first level of appeal is referred to as "reconsideration." A reconsideration is essentially a review of your initial application by a different person within the SSA; however, you are allowed to provide additional medical evidence that you did not submit with your initial application. The majority of reconsiderations occur without requiring an interview of the applicant. If you are denied SSDI benefits after you receive your reconsideration decision, you may appeal that decision.

Hearing

If you appeal the reconsideration decision, you may request a hearing in front of an administrative law judge who will review your case. The administrative law judge who reviews the case will not have previously seen your information. If you request a hearing, the SSA may request additional evidence regarding your condition, such as medical information, and the time and place of the hearing will be issued to you by letter.

While it is a good to consult a Social Security attorney when applying to and initially appealing an SSDI case, it's especially important to consideration representation for a hearing. At the hearing medical and vocational experts will likely be present to provide information regarding your condition and case. You and your representative will also be able to question the expert witnesses and question your own witnesses to bolster your case. After the hearing is concluded, the judge will finalize his decision based on the information obtained at the hearing, previous information, and additional information provided before the hearing. The SSA will send a letter containing the judge's decision. If you disagree with the judge's decision, you may seek a third appeal.

Appeals Council and federal court

If you seek a third appeal, your case will be reviewed by Social Security's Appeals Council. The letter containing the judge's decision will outline the steps necessary for such an appeal. The Appeals Council takes all requests for review, but it will deny a request if it agrees with the judge's decision. If the Appeals Council agrees to review your case, either the Council will review your case or the Council will forward your case to a different administrative law judge for review.

A letter will be sent to inform you whether the Appeals Council denied or accepted your request. If the Council accepted your request the letter will also contain a copy of its decision, and if the Council sent your case to a judge for review the letter will also contain a copy of the judge's determination.

If you disagree with any of the Appeal Council's decisions, you have a fourth and final change to appeal by filing a lawsuit in federal court. The letter from the Appeal Council will outline relevant information to initiating a federal suit.

Since the Social Security Disability appeals process is complicated and lengthy, it's important to consider obtaining legal representation from the outset. An experienced Social Security attorney can provide guidance throughout the application and appeals process and help ensure you have the greatest chance to obtain needed benefits.

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