Unfortunately, many applications for disability benefits are denied the first time through the application process.

If you have received a Social Security Disability decision that denies you benefits you rightly deserve, you don’t have to accept that denial as a final answer. You have the right to the appeals process.

What is the first step in the appeal of a Social Security Disability decision?

Most of the time denied individuals must ask the Social Security Administration to reconsider their decision. This request for reconsideration is the first step in the appeals process in nearly every state in the U.S.

What is a reconsideration?

A reconsideration is a second full review of the claim you submitted. Social Security assigns your claim to a different examiner who will determine if the initial examiner missed something or should have decided differently. Anywhere from 5 to 10 percent of reconsidered claims receive a reversed decision.

What can I do to strengthen my Social Security Disability decision appeal?

Application rules are tightening. An important part of making a strong case for disability benefits, and a strong case for appealing a decision that was not in your favor, is having proper documentation available. 

The Social Security Administration explains that you can submit two kinds of appeals, or reconsiderations. One type, a request for reconsideration for a medical determination, would apply if you believe that your claim was denied for medical reasons. For instance, if the SSA determines that you are not disabled but have medical evidence to prove that you are, you may want to submit an appeal.

During a medical reconsideration appeal, the Social Security Administration will examine all evidence submitted in the original claim, as well as any new evidence that is available. If you can provide extensive documentation of your medical records, as well as testimony from your doctors, you may be able to strengthen your existing claim for reconsideration of benefits.

If your request for benefits was denied for non-medical reasons, you can also appeal your case. Some non-medical reasons why your benefits were denied may include overpayment of benefits, your income, additional resources you have that may disqualify you from benefits, or living arrangement.

If you can provide additional evidence and documentation showing that the non-medical reason for your denial was invalid, you may be able to make a successful appeal. This could include providing more detailed or updated information about your income, new information if your living arrangements have changed, or other information. 

How long does it take to hear the decision on a reconsideration appeal?

You should usually receive a letter in the mail that will provide notification that your appeal was or was not successful within three to six months of submitting the paperwork.

What if my Social Security benefits are denied on appeal?

If your request for reconsideration ends in another denial, you have the option of seeking a hearing by an administrative law judge. You and any witnesses who accompany you will be questioned regarding your disability. Witnesses often include medical and vocational experts who will speak on your behalf. You must request the administrative law judge hearing within 60 days of receiving your reconsideration denial.

What are my chances the administrative law judge hearing will end in a decision favorable to me?

Statistics show that about half of the appeals that are heard in an administrative law judge hearing end with the applicant receiving Social Security disability payments. It can take up to a year before a hearing is scheduled.

What if I am extremely ill?

Some people who are suffering from serious medical conditions are able to have their claims process expedited if they have an illness on the Social Security Administration’s Compassionate Allowance List. Metastatic cancers and some genetic ailments are among the types of illnesses on the list.

If I lose the administrative law judge hearing, do I have another recourse for an appeal?

If the hearing is not favorable, you are allowed to request an Appeals Council look over your case. However, the Appeals Council chooses cases to review randomly and is allowed to dismiss the request to review any case. Very few people win disability benefits at the Appeals Council level of review.

Why would an Appeals Council rule in my favor?

The Appeals Council might find an error was made by the administrative law judge or that evidence does not support the administrative law judge’s denial of your Social Security Disability benefits. If the administrative law judge failed to notify you that an expert witness would go forth at your hearing, the Appeals Council may see that as a procedural concern in your case.

What is the final step of the Social Security Disability decision process?

If all else fails, you may wish to file a lawsuit in a U.S. district court to appeal the Social Security Administration’s ruling. A federal judge will hear your case, and there will not be a jury present.

A lawyer who is well-versed in Social Security disability cases can help you navigate the court system, but less than one percent of all disability claims cases are taken to court. An experienced disability lawyer can also help you ensure that your initial application, or your subsequent appeals, are as complete as possible, including all required documentation and giving you the best chance at a successful application or appeal.

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This article is not legal advice. It is presented
for informational purposes only.