The initial review process denies benefits to 62% of those applying for Social Security disability benefits. Although some people give up, the appeals process offers four ways to challenge an unfavorable decision.
The appeals process consists of four levels or steps, starting with a reconsideration appeal. If you choose to handle the reconsideration appeal without lawyer representation, first get advice and guidance from the disability benefits team at Sackett and Associates.
The Disability Appeals Process
The Social Security appeals process has four levels:
- Reconsideration
- Disability hearing with an administrative law judge.
- Appeals Council review.
- Federal court review.
You need only go as far in the appeals process as it takes to win disability appeal. If reconsideration approves your claim for benefits through the Social Security Disability Insurance program, you will not continue to the hearing level.
The results vary at each level of the appeals process. According to the most recently available data from the Social Security Administration, 16% of Social Security denial appeal cases at the reconsideration level resulted in an approval of benefits. Outcomes at the other levels of the appeals process included:
- Hearing level: An allowance of benefits in 51% of the cases.
- Appeals Council review: A 1% allowance rate with 16% of the cases remanded to the hearing level for further action by an administrative law judge.
- Federal Court: While only 1% of the cases resulted in an approval of the claim for disability benefits, 63% were remanded to the hearing level for additional consideration by an administrative law judge.
The high success rate at the disability hearing level, where administrative law judges approve benefits in more than half of the cases, could make you want to skip the reconsideration appeal level. Appeals must proceed in sequence through the four levels, starting with reconsideration.
Reconsideration Level of The Appeals Process
The first step in the Social Security denial appeal process is a second look at your claim during the reconsideration level. A claims examiner who did not take part in the original review of your claim looks at the file.
You may submit new evidence in support of your claim, such as updated medical records, or to address issues raised during the original review. Although the 16% rate of approval of claims at the reconsideration level is lower than the 51% rate at the hearing stage, you cannot skip reconsideration.
To avoid a gap in your medical records, continue with the treatment of your condition and keep appointments with your doctors after submitting the initial application. This ensures that your medical records reflect any changes that may have occurred in your medical condition.
The average time from submission of a request for reconsideration and a decision is 183 days. This is in addition to the six to eight months it generally takes to receive a decision after the initial review of your application.
If reconsideration does not result in an approval of benefits, you have the right to appeal it to the disability hearing level of the appeals process. An administrative law judge conducts the hearing where witnesses present evidence in the form of sworn testimony. Consult with a Sackett and Associates disability lawyer if you receive an unfavorable decision after reconsideration to discuss your options.
Appeals Process Deadlines
Complying with deadlines has to be at the top of any list of SSDI reconsideration tips. You have only 60 days from receipt of the notice of denial of your claim to request a reconsideration.
As soon as you receive the notice, take note of the date printed on it. Social Security assumes that you receive the notice five days from that date. If you miss the 60-day deadline because it took more than five days for the denial notice to reach you, the burden of producing evidence that it was delayed is on you.
Avoid problems by requesting reconsideration within the allotted time. You have two ways to request reconsideration:
- Online at the Social Security Administration’s Appeal a Decision
- Mail or Fax completed forms to your local Social Security office. Download a Request for Reconsideration form, fill it out, and fax or mail it.
You have the right at all levels of the appeal process to submit current medical documentation that was not submitted as part of your original application.
Consult A Disability Appeals Attorney
Individuals with disabilities have relied on Sackett and Associates for more than 45 years for trusted advice and outstanding representation for disability appeals. Sackett Law does not charge legal fees unless you win your claim for disability benefits. Contact Sackett Law today for a free consultation and claim evaluation. Learn how our disability benefits team makes a difference.
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