Important: We updated this article in October 2022 with the most current SSA policy and statistical data available. People with a serious illness or life-altering injury may have to stop working to recover. Whether the issue’s mental or physical, there are a variety of medical reasons that prohibit individuals from full-time employment. When this happens, they may qualify for Social Security disability (SSD) benefits. Before applying for Social Security disability with the Social Security Administration (SSA), talk to an experienced lawyer. We say this because unfortunately, the SSA only approves about 1 in 5 SSD applicants (20%). What’s worse is, only 6% of people filing claims for the first time get approved without a lawyer! If you get a Social Security disability denial letter, don’t give up just yet. You can go through several different appeals if your Social Security attorney thinks it’s worthwhile.
How Many Appeal Levels Are There After a Social Security Disability Denial?
There are four levels of appeals before you must give up or start over.
Appeal Level 1 After Social Security Disability Denial: Reconsideration
The first step after a Social Security disability denial is reconsideration. Reconsideration includes a total claim review by someone not involved in the original decision. You can request a reconsideration appeal within 60 days of your denial. A claims expert will look at all original documents submitted, plus any new evidence. In fact, reconsideration usually occurs without you being physically present.
Appeal Level 2 After Social Security Disability Denial: ALJ Hearing
The second level of appeals is to have a hearing before an administrative law judge. This only happens if you’re denied after first going through a reconsideration appeal. Again, you can request this ALJ hearing within 60 days. The hearing will most likely occur 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.
Appeal Level 3 After Social Security Disability Denial: Appeals Council Review
If your hearing verdict results in another Social Security disability denial, Level 3 is to request an Appeals Council review. 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.
Appeal Level 4 (Final Option): Federal Lawsuit
Finally, your fourth and final appeal option is to file a lawsuit in federal district court. You can only do this after the Social Security disability request is denied by the Appeals Council. You’ll definitely need an attorney’s help if your Social Security disability claim reaches this phase. Be aware that the federal judge will hear your case without a jury present. 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. That means your Social Security disability application gets approved because the SSA didn’t fully take into account your doctor’s opinion, your pain or limitations of your symptoms. (In some cases, this happens because no physician performed an ability assessment.) While it can work out in your favor, it’s important to know that suing the SSA is costly both in time and money. In addition, it can take years to complete.
You May Qualify for Legal Assistance
Still have questions about filing your disability appeal? Those who qualify for legal assistance through our website typically get $12,000 in lump-sum backpay as well as monthly benefits. Click the button below to sign up for a free, no-obligation phone call with a nearby Social Security attorney today. It’s the best way to get the claim help you need for free over the phone!
Lori Polemenakos is Director of Consumer Content and SEO strategist for LeadingResponse, a legal marketing company. An award-winning journalist, writer and editor based in Dallas, Texas, she's produced articles for major brands such as Match.com, Yahoo!, MSN, AOL, Xfinity, Mail.com, and edited several published books. Since 2016, she's published hundreds of articles about Social Security disability, workers' compensation, veterans' benefits, personal injury, mass tort, auto accident claims, bankruptcy, employment law and other related legal issues.