When you apply for Social Security Disability, there is a 65% chance your claim will be denied. Yet, more than 70% of claimants who were denied at first are awarded benefits at the administrative appeals level of the SSD process.
Does this mean that the claims were not justified when they were first filed? No – it means do not give up.
Where does your claim go, if you appeal a denial?
Click on the infographic to follow 1000 example applicants as they go through each stage of the Social Security Disability appeals process – from the initial review stage, to an appeal in Federal Court.
Throughout the appeals process, if the SSA denies your claim at any level, you must appeal to the next level. Otherwise, your file will be closed and you must start the process over.
Many claimants will be awarded disability benefits during different stages of the process. Many others will give up, and drop their claim along the way.
Five Steps of the Social Security Disability Appeals Process
Step 1: Initial Determinations (120 days)
Most claims are denied at the first two stages of the process: the Initial Determination and the Reconsideration stages. If your claim is denied at the initial filing, you should promptly appeal the decision.
Step 2: Reconsideration (90 days)
The Reconsideration stage becomes the first level of appeal. This entails a complete review of your claim by a different examiner, and you may include new evidence.
Step 3: Administrative Law Judge (ALJ) Hearing (530 days)
Often, the biggest mistake claimants make after a denial at reconsideration is not appealing to the next level, the ALJ hearing. This hearing is your chance to argue your case to the judge, and present additional details and evidence including how your circumstances have changed since the previous decision. You have the opportunity to present your own witnesses, and question any SSA vocational or medical experts who may be present at the hearing.
If you do not have legal representation by this point, it is to your definite advantage to retain an attorney. Most claims are won at the ALJ hearing with the aid of an experienced Social Security Disability lawyer who understands how to fortify your case and work successfully with administrative law judges.
Step 4: Appeals Council (270 days)
Claims denied in the ALJ hearing may be appealed next to the Social Security Appeals Council. At this level, we can introduce new evidence for consideration; otherwise, the Appeals Council will review the ALJ’s decision for procedural error.
Your claim may follow one of three paths at this point. The Appeals Council may:
- Overturn the denial and award benefits;
- Return the disability claim to the ALJ for a new decision;
- Deny the request for review, or refuse benefits. If the Appeals Council denies the request for review, you must file an appeal in federal district
court within 60 days.
Step 5: Federal Court (540 days)
If you do not agree with the decision from the Appeals Council, the final step in the Social Security Disability appeals process is filing a lawsuit in federal court. It is essential to have a lawyer representing you who knows the federal courts and is accomplished at arguing disability appeals at this level.
Begin the Process
If your claim for Social Security Disability benefits is denied, expert help is available. I encourage you not to give up, but to continue to seek the benefits you deserve through the appeals process.
If you have questions, give us a call. We’re here to help you throughout the entire process as needed, from preparing your initial application, handling all aspects of administrative hearings, to arguing your case in federal court.
Learn more about what’s involved in a Social Security Disability appeal.