How Many Times Can You Appeal a Social Security Disability Denial?

social security disability denial

When people have a serious illness or suffer a life-altering injury, they may no longer be able to work. Whether the issue is mental or physical, there are a variety of medical reasons that prohibit individuals from employment, and when this happens, they may be eligible for Social Security disability (SSD) benefits.

If someone decides to file for Social Security disability with the Social Security Administration (SSA), it’s a good idea to hire a lawyer who understands the intricacies of this program and knows what is required in order to gain approval. However, not all applications get approved, and if your claim gets denied, it doesn’t necessarily mean it’s the end of the road. There is an appeals process you can go through if your Social Security attorney thinks it’s prudent.

How many levels of appeals are there?
Depending on what state you live in, there are three or four levels of appeals before you must give up or start over. The first step after a Social Security disability denial is reconsideration. According to the SSA, a reconsideration is a total review of the claim by someone who was not involved in the initial decision, and it can be requested within 60 days of the denial. This person will look at all of the original evidence submitted plus any new evidence, and most reconsiderations can occur without you being physically present.

Unfortunately, Alabama, Alaska, Colorado, Louisiana, Michigan, Missouri, New Hampshire, New York, Pennsylvania and the Los Angeles North and West Branches in California do not allow reconsideration.

Level 2
The second level of appeals is to have a hearing before an administrative law judge if the reconsideration is denied, and this can be requested within 60 days. The hearing will most likely be held within 75 miles of your home, but in some cases, this may be done through video conferencing. You may be asked to provide more evidence, give new information or clarify previous information. During the hearing, the judge will question you and any witnesses included. It’s prudent to attend the hearing with your advocate to explain your case. If you cannot or do not wish to attend, you must provide a written reason.

Level 3
The third level, if your hearing verdict is a denial of Social Security disability benefits, is a review by an Appeals Council. During this phase, the administrative law judge’s decision will be reviewed for any potential technical or substantial errors. The Appeals Council looks at all requests and has a variety of options including reversing the judge’s decision. They can also remand the case if they find a problem with the judge’s decision and order a second hearing, or they can deny the request if they find the judge’s decision was correct.

Level 4
Finally, the fourth and last appeal option is to file a lawsuit in federal district court after the Social Security disability request is denied by the Appeals Council. You will definitely need your attorney’s help if your Social Security disability claim reaches this phase and the federal judge will hear the case without a jury. The judge will review the case for errors, but they might also evaluate the facts that have presented throughout the initial application and appeals process as well. According to reports, about one-third of cases will get a reversed ruling on the Appeal Council’s decision and the Social Security disability application will be approved on that basis that the SSA didn’t fully take into account the doctor’s opinion, pain, and symptoms or there was no ability assessment from a physician. While it can work out in your favor, it’s important to know that using the SSA is a costly experience, both in time and money, and it can take years.

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