Receiving a denial of benefits can be devastating. But you don’t need to give up. Most claims are denied at the initial stage — whether it’s because of a lack of medical evidence or because the application was incomplete. And your chances of obtaining an approval increase upon appeal. At Carmichael Law Group, we can help you with a Social Security disability appeal and give you another opportunity to obtain benefits.
What Are the 4 Levels of a Social Security Disability Appeal?
In your denial notice, you will find instructions regarding how to file an appeal, as well as information about important deadlines. A disability attorney can help you navigate the four levels of appeal:
1. Request for Reconsideration
After receiving a denial, you have 60 days to request a reconsideration from the SSA. If you fail to do so within the time frame, you will have to file a new claim.
You can request consideration through the SSA website or via mail. There are two types of reconsiderations:
- Medical: Claim was denied because SSA didn’t consider you condition to be severe enough.
- Non-Medical: Claim was denied because your income was too high or because you weren’t insured by SSDI.
You can also submit additional medical information along with the request. If you have seen your doctors recently, have a new impairment, or find that your condition has worsened, make sure to include this new information. This level of appeal also gives you a chance to include anything you may have left out of your initial application.
This request is essentially another review by the Disability Determination Services (DDS). A new medical consultant and claims examiner will review your case and make a new decision. They will look at your initial documents as well as any supplementary information you submit.
2. Administrative Law Judge Hearing
If your reconsideration request is denied, you have 60 days to request a hearing from an administrative law judge (ALJ). At this step of the review process, the ALJ will review your medical and vocational documents. They ALJ will also question you, as well as any witnesses you bring with you.
While the hearing does not take place at a court, it is similar to a civil court hearing. It will usually take place within 75 miles of your home, and an attorney can represent you at the ALJ hearing and speak on your behalf.
3. Appeals Council Review
If your claim is denied by the ALJ, you may request a review by the SSA Appeals Council. However, the Appeals Council does not accept every case. They will select only the cases that show the following:
- ALJ abused their discretion or made a legal error;
- ALJ made a decision that was not supported by a majority of the evidence; or
- Policy or procedural issues were raised by the case.
It’s important to remember that if you file late or request a dismissal, the Appeals Council may not review your claim and dismiss it instead.
4. Federal Court Review
If your appeal is not approved at all of the lower levels, you may take your claim to federal court. At this level, you file a lawsuit against the SSA stating that they wrongfully denied your claim.
The federal court review is heard by an actual judge, but not by a jury. You must submit all evidence of your disability, including anything you’ve previously given to the SSA. You must also submit a substantial brief with legal arguments about why previous denials of your claim were invalid.
This level of appeal can be costly and time-consuming. In rare cases, the district court judge may reverse the ALJ’s decision, but more often they will remand the case and send it back to the SSA.
Reconsideration of a Continuing Disability Claim
After your benefits are approved, your claim will be re-examined periodically through a process called the “continuing disability review” (CDR). Your benefits may be terminated if it is determined that you can work or you do not comply with the CDR process. If your benefits are terminated, you may have to appeal that decision with the SSA.
The first step of the CDR appeals process is requesting second review by a different DDS medical consultant and examiner. Then, if your claim is denied again, you may go before a disability hearing officer (DHO). If a DHO denies your appeal, then you will request a hearing before an ALJ. The process may continue in a similar fashion as detailed above.
We Can Help With Your Social Security Disability Appeal
The appeals process can be complex and time-consuming. You need an experienced disability attorney who can help you navigate each level of appeal and ensure that you don’t make costly mistakes that could cost you another chance at receiving benefits. To learn more about filing a successful Social Security disability appeal, contact Carmichael Law Group today.
