If your application for Social Security disability benefits gets denied, you might think you are out of luck. However, that is not the case! You can appeal the Social Security Administration’s decision, and you might be surprised to learn how many appeals are approved. Many applicants get denied on their first try, but they get approved for benefits on appeal. The disability appeals process can be a little complex, and it requires specific documentation and timeframes. If your SSDI application has been denied, then just keep reading. We will tell you exactly how the appeals process works and give you some tips for winning your appeal.
Â
Social Security Disability Appeals Process
The appeals process for disability benefits is quite structured. There are specific steps that you must follow. If your appeal is denied at one level, you can often appeal your case to the next level. There are four main stages of an appeal, and your claim could be approved at any of these stages. Here is how the appeals process works. Remember that this process applies to both SSDI and SSI benefits.
Â
— Request For Reconsideration
The first step in an appeal is to ask the Social Security Administration (SSA) to reconsider your request for benefits. Some states require this step, while other states allow you to skip this step in the process. The reconsideration stage is having the SSA review your request again. The reconsideration review will be performed by someone other than the person who reviewed your initial application.
During reconsideration, all the evidence presented with your original application will be reviewed. In addition, you can also submit any new evidence that you may have. This could include new medical records, doctor’s statements, or expert testimony. Approximately 10% of reconsideration requests are approved, but most requests move on to the next step in the process.
Â
— Hearing By Administrative Law Judge
If your application was denied at the reconsideration stage or you were able to skip reconsideration, you may ask for a hearing by an administrative law judge (ALJ). These judges spend almost all of their time hearing disability appeals. They are attorneys who work for the Social Security Administration in the Office of Disability Adjudication and Review. The judge who hears your appeal will not have participated in the review of your initial application or reconsideration.
The hearing is a way for you to essentially start your disability claim over, and you can present your arguments to the judge in person. These judges are extremely familiar with Social Security disability insurance claims, though they typically rely on expert testimony from vocational experts to determine the types of work you might be able to perform.
The judge will review all the medical evidence you have provided, along with your testimony and the testimony from vocational experts, to issue a ruling in your case. Most people choose to hire a disability attorney before their disability hearing. Having an attorney can greatly increase your odds of winning your appeal. Roughly 50% of appeals that make it to an administrative law judge are won by the applicant.
Â
— Request For Review By Appeals Council
The next level of appeal is a request to the Social Security Appeals Council. If you disagree with the administrative law judge’s ruling, you can request a review by the Social Security Appeals Council. The council may decide to review your disability application appeal or it might deny your request if it determines that all applicable laws were followed. The appeals council has a few options for your case. The council could approve your disability application, it could deny the request altogether, or it could require another administrative law judge to hear your appeal. Only about 2% of applications are approved by the appeals council.
Â
— Federal Court Review
Lastly, your final option for getting SSDI or Supplemental Security Income benefits approved is to appeal your case to a federal court. This process removes the application from the Social Security Administration’s hands and asks a federal district court to review the case. Very few cases make it this far. While about 30% of disability cases that go to federal court are won by the claimant, the process of getting the claim into federal court is often too difficult. The process is both time-consuming and expensive, and most people do not end up moving their case to federal court.
Â
How To File An SSDI Appeal
The process of filing an appeal varies slightly depending on which level of appeal you need to file. Upon your initial disability denial, you will need to submit a request for reconsideration. Remember that the Disability Determination Services office in your state handles your initial application. You may request a reconsideration online, and you typically have 60 days from the date of your initial denial to file your reconsideration request.
If you need to request an ALJ hearing, you can submit your appeal letter online as well. Again, you have 60 days to file this notice of appeal from the date of your denial letter at the reconsideration stage. If your state allows you to skip the reconsideration stage, you have 60 days from the date of your initial denial to submit your request for a hearing. You can also sign up for a My Social Security account at www.ssa.gov to check the status of your hearing request.
The request for a review by the Appeals Council may also be submitted online. Online requests are the quickest and easiest way to get your appeals submitted. Finally, an appeal to the Federal Court is the only hearing level that cannot be requested online. This request will need to be filed in federal district court, and it will need to follow the filing rules of the court.
Â
How Long Does A Disability Appeal Take?
The length of time that your appeal takes depends on a few different factors. The first factor is how many levels of appeal you need to go through. If your application gets approved at the reconsideration stage, your appeal may only take a couple of months. However, most appeals take much longer than this. When you request a hearing before an administrative law judge, you could wait more than a year in some cases for the hearing alone. The judge’s decision could take another two to three months. So, in some states, your appeal could take 18-24 months just for a decision from an administrative law judge.
If your appeal goes to the Appeals Council, you can expect to wait another nine months before the council reviews your case. If they decide to send it back for another hearing, you might be waiting another year for that new hearing. Finally, an appeal to the Federal Court could create months or even years of additional wait time.
The average Social Security appeal is completed in about 18-24 months. However, some appeals can take three years or more to complete. This means that it could be three or four years from the time you apply for disability until the time you get approved. If your application is ultimately approved, a long appeal time will mean a large amount of back pay for you. So, you can expect a big lump sum once your application is finally approved.
Â
Tips For Winning Your SSDI Appeal
The first step in winning your appeal is to determine why your initial application was denied. The Social Security Administration may deny your application for medical or non-medical reasons. If your application was denied for non-medical reasons, like not having enough work credits, you would need to find a way to prove that you are eligible for benefits. This evidence should be enough to approve your benefits application on appeal.
If your application was denied for medical reasons, then the Social Security Administration did not find that your impairment met their definition of a disability. To win your appeal, you will need to provide enough evidence about your medical condition to convince the judge that you qualify for benefits. This might include getting statements from your medical providers, updating medical records with new lab results or other test results, getting expert testimony from a vocational expert, or other things. The more evidence you can provide to prove your disability, the better your odds of winning your appeal.
Finally, you can increase your odds of winning your appeal by hiring an attorney. Claimants with an attorney typically have a much higher chance of success during the appeal than those without an attorney. You should also remember that these same tips apply to winning your SSI appeal.
Â
The Bottom Line
If your application for disability benefits is denied, don’t fret! The SSDI appeals process exists so that you can appeal the initial decision. Many people who initially get denied benefits end up getting approved during the appeals process. The four stages of the appeals process include the request for reconsideration, a hearing before an administrative law judge, a review by the appeals council, and a review by the Federal district court. Typically, more than half of claims that are appealed end up getting approved.
Â
Frequently Asked Questions
Â
What are the chances of winning an appeal from Social Security?
The chances of winning your Social Security appeal are quite high. In fact, more than 50% of applications that go through the appeals process end up getting approved. Most of these approvals happen during the administrative law judge hearing process. Very few applications are approved by the appeals council, and only a handful of appeals make it to federal court. However, about one-third of appeals that make it to federal court get approved.
Â
Should I appeal my SSDI denial?
If you believe that your SSDI claim has been wrongfully denied, you should appeal the decision. A disability attorney can help you decide whether you have a good chance of success at appeal. Disability attorneys can help you evaluate your case, and they can help you determine whether you should appeal the decision. However, if you believe that you are entitled to benefits, you should almost always appeal at least to the ALJ hearing stage.
Â
What happens at a Social Security hearing?
At a Social Security hearing, the judge will typically ask you questions about your work history, medical condition, and ability to perform certain tasks. If you have an attorney, they can help you present your case to the judge. In most cases, a vocational expert will also be present. The judge will ask this expert witness questions about their opinion of your ability to perform certain job-related tasks. In rare cases, the judge may approve your application at the hearing. However, in most cases, you will have to wait 30-60 days to get the judge’s decision.
Â
What are the most common reasons for an SSDI denial?
The most common reason for an SSDI denial is that you do not have a medical condition that qualifies for disability benefits. If your claim does not meet this requirement, then your application will be denied. In that case, you will need to present additional medical evidence during your appeal that shows the judge that you are unable to work due to your disability.
