The Four Levels of Appeal When You’ve Been Denied SSDI

When a person becomes injured and is unable to work, Social Security disability insurance (SSDI) can provide benefits that help cover the cost of daily expenses. Unfortunately, the Social Security Administration (SSA) denies thousands of applications every year. When this happens, too many individuals simply give up, thinking there is no way to get the benefits they need. However, all is not lost at this point. There are four levels of appeals in denied SSDI claims, and each provides an opportunity to get the benefits you need.

Request for Reconsideration

Before you attend a hearing to appeal your case, you must first file a request for reconsideration. This is a full review of your original claim, performed by a medical consultant and examiner that were not involved in making the original decision. Anyone involved in denying your original claim is barred from making a decision on your request for reconsideration. Five to ten percent of reconsideration requests result in benefits being awarded.

If a claim is denied after reconsideration, a denial notice is sent in the mail. The notice will provide an explanation for the denial. The next level of appeal, for those that wish to pursue it, is a hearing before an administrative law judge.

Hearing Before an Administrative Law Judge

An administrative law judge (ALJ) is an attorney that works for the SSA’s Office of Hearings Operations. Their work mainly involves overturning or upholding decisions made on SSDI claims. At the hearing you will have to explain why you need SSDI benefits and present evidence to back up your claims, such as medical records. Approximately half of the cases heard in front of an ALJ are overturned, meaning half of the people that take their case to this stage are awarded benefits.

Appeals Council

If an ALJ does not overturn a denial made on a claim, applicants can then move on to the Appeals Council. The Appeals Council randomly selects the cases they will review. They can also deny or dismiss a request for review, so they don’t review every case that is presented to them. If however, an ALJ made an error or their decision was not supported with evidence, the Council must approve a request for review. Only two to three percent of applicants win their case at the Appeals Council stage, largely due to the fact that they review so few cases.

Federal Court

As a last resort, those that desperately need SSDI can file a lawsuit in federal court. If the case goes to court, a federal judge will hear the case. There are no juries present in these cases. Although judges are supposed to only consider legal errors made in a case, they will often consider the facts of the case, too. Federal judges don’t often reverse decisions, but approximately half of the cases they review are sent back to the SSA for reconsideration.

Need Help with Your Appeal? Contact a Pennsylvania SSDI Attorney

If you need SSDI and have been denied, the worst thing you can do is give up. At Haggerty, Hinton & Cosgrove, LLP, we are the Scranton Social Security disability attorneys that can help. We’ll review your case, determine why you were denied, and help you through every stage of the appeal process. Call us today at (57) 354-9731 so we can begin discussing your case.

Resource:

ssa.gov/appeals/

https://www.haggertylaw.net/what-does-age-have-to-do-with-your-ssdi/