There are four stages in appealing a denied disability claim, but the process stops as soon as you are successful in completing at least one of them.
Beginning the Appeals Process
After your receive a denial letter for disability benefits, the first thing you will need to do is notify the Social Security Administration (SSA) that you would like to file a Request for Reconsideration. You or your attorney can do this by completing and sending Form SSA-561-U2 back to the SSA's office or filing it on the ssa.gov website.
You have 60 days from the date of the denial letter to file a Request for Reconsideration. If you cannot meet this deadline, provide the SSA with a valid reason why in writing, and your deadline may be extended. Otherwise you will need to reapply.
Online resources can begin the appeals process. If your claim has been denied because of:
- Medical reasons: fill out the Appeal Request and Appeal Disability Report (in person or online).
- Non-medical reasons: the SSA requests that you discuss a review of your application with a regional office near you.
Once you have submitted your Request for Reconsideration, you are now in Stage 1 of the appeals process.
Stage 1: The Reconsideration Stage
Once you have submitted a Request for Reconsideration, a representative who has no familiarity with your case will consider all of the evidence and aspects that are affiliated with it. If there are any new developments or pieces of evidence that arise in your case, be sure to submit them immediately.
If your reconsideration is approved, the appeals process ends. You will receive a letter in the mail saying you've been approved.
If your reconsideration is denied, you will need to move onto the next stage of the appeals process, which is a hearing...
How long does the Reconsideration Stage take? This stage can take up to one year, especially if the SSA requires you to get more medical consultations and exams.
Stage 2: The Hearing Stage
If your reconsideration results are denied, you may then request a hearing. To request a hearing, you have two options:
- Filing the appeal online, or
- Submitting an HA-501 form to an SSA office.
You have 60 days from the date of your Request for Reconsideration denial to file your request for hearing. An Administrative Law Judge (ALJ) who was not part of the prior decisions will view your claim and make the next decision. You can expect to see them and the following people at your hearing:
- Your attorney
- Vocational experts (to testify about the claimant's work history)
- Medical experts (to testify about the claimant's health or disability)
- Other witnesses
During your hearing, the ALJ will ask you questions in order to better understand your medical conditions. If you have an attorney, your attorney will also ask you questions that will help the ALJ to understand your medical limitations.
In most cases, the ALJ will hold the hearing within 75 miles of your home. Video-conferencing can sometimes be done in place of a traditional hearing. You will need to provide the judge with any new evidence or developments in your case at least 5 business days before the hearing starts.
Once the judge makes a decision, the decision will be sent to you (the claimant) by mail.
Stage 3: Appeals Council Review
The appeals process becomes even more difficult as it progresses. Most denied claims don't go past the hearing stage. This is mainly because the time and money needed to do so aren't worth the potential benefits. At this level of appeals, the judges are no longer reviewing the claim to make a new decision based off the evidence, but are instead reviewing the decision and the record to determine if the ALJ abused their discretion or made a mistake of law.
The Appeals Council is a section of the Social Security Administration, and consider a case if an appeal is filed past the hearing stage. They may handle your request for an appeal by:
- Agreeing with the prior decision
- Deciding upon the matter themselves
- Or sending it back (remand) to an ALJ for further review.
No matter their decision, the Appeals Council will send you a notification in the mail.
Stage 4: Federal Court
The final step in the appeals process is to file a formal lawsuit in federal court. Claimants rarely reach this final step in the appeals process, but it is definitely an option to consider if you disagree with the decision.
You will need a disability attorney at this stage of the appeals process, but hiring one as early as possible will definitely save you a lot of the time, money, and stress that comes with a lawsuit.
The road to disability can be long and winding. Unfortunately, applying for these benefits and navigating the system on your own can become complicated, and a weak or incomplete claim could languish for a long time before ultimately being denied. If you are considering applying for disability benefits or appealing a denied decision, request a free PDF download of my Disability Special Report today.