You applied for Social Security Disability (SSD) benefits, but your claim was denied. What is your recourse?
Being rejected for SSD isn’t automatically the end of the road for you. In fact, around 70 percent of SSD claims are denied the first time around. After an initial rejection, you have further opportunities to prove your eligibility. Today we provide a brief overview of how the SSD appeals process works:
- Reconsideration: If your initial claim is denied, you can request reconsideration of that claim. When this happens, the Disability Determination Services (DDS) will provide a complete review of your claim again, with one important change: a medical consultant or examiner will be part of the decision. This review, on its own, could result in a reversal of your original denial. If it doesn’t, don’t despair. This set back only allows your appeal to advance to the next stage—where it has a greater chance of being reversed: the hearing.
- Administrative Law Judge (ALJ) hearing: After your request for reconsideration is denied, you have 60 days to request an ALJ hearing. Here, an ALJ—a federal government attorney—will review the details of your case with respect to the guidelines laid out in the law. Your chances of winning your appeal at this stage are good—about 50 percent of appeals are reversed at the ALJ hearing.
- Appeals Council review: If you are unsuccessful in your hearing, and you still believe you have a solid case for SSD, you can file for a review by the Appeals Council. At this stage, the Council has complete discretion in deciding which cases it will consider. In general, there must be some significant issue with the prior decision to deny SSD—e.g., there was unsubstantiated evidence in making the decision or improper legal procedure was followed.
- Federal court review: Once you’ve exhausted all of the above measures, you have one final option to appeal for SSD benefits: you can file a lawsuit in federal court. This is the most complex step in the appeals process. If you haven’t already done so in a previous stage, it’s a good idea to hire an experienced Social Security attorney to represent your interests.
To maximize your chances of winning a disability appeal, it’s critical to provide comprehensive medical evidence and expertise to support your claim. Legal counsel can help you gather such evidence and create the strongest possible case.