Understanding the appeals process for Social Security Disability claims

Many claims for Social Security Disability are initially denied, but through the appeals process people may still obtain the benefits they need.

As a result of ailments, illnesses and injuries, people throughout New York may be left unable to work. When these conditions are permanent, people often seek Social Security Disability Insurance. Unfortunately for many, these requests for benefits are often denied. There are steps in place, however, for people to appeal these decisions and potentially obtain SSDI benefits.

According to Social Security, there are four general levels of appeals – reconsideration, hearings before administrative law judges, appeals council reviews and federal court reviews. Appeals must be made within 60 days of receiving a denial letter.

Reconsideration

Through reconsideration, someone who was not involved in the original decision reassesses a person’s claim. The reviewer will go through all of the evidence that was submitted with the initial filing, as well as any new evidence. In most cases, the person seeking benefits does not have to be present for the reconsideration review.

Administrative law hearing

When people do not agree with the decisions resulting from reconsiderations, they may ask for a hearing before an administrative law judge. The judges who preside over these hearings will not have had any role in the initial decision or the reconsideration of a case. In some cases, people may be asked to provide additional evidence or to clarify information prior to such hearings.

During administrative law hearings, the judge will question the claimant, in addition to any witnesses that he or she brings. Based on this testimony and a review of the included information, the judge will decide whether to approve or deny the claim. Claimants are informed of these decisions by letter.

Appeals Council

If a hearing still results in a SSDI claim denial, people may ask Social Security’s Appeals Council to review their case. The council does not review every case it is asked to look at, however. If it determines the decision reached at the previous level was correct, then the council may deny the request. In these situations, a letter will be sent to the claimant advising him or her of the council’s decision.

There are two options for reassessing cases when the Social Security Appeals Council determines that a review is warranted. Sometimes, the council will review the case and evidence itself. In other situations, the council will send the case to an administrative judge for review. In either case, a letter is sent to the claimant explaining the result once a decision is reached.

Federal court

The final option for appealing SSDI denials is to file an appeal in the federal court. According to the U.S. District Court for the Southern District of New York, this may only be done once the options through Social Security have been exhausted and a final decision issued. Once a lawsuit has been filed in these cases, a judge will hear evidence from both sides and make a determination.

Obtain legal counsel

For people in New York, and elsewhere, with disabilities, the process for obtaining SSDI is often challenging. This can make an already difficult situation all the more arduous for them, as well as their families. As such, those seeking such benefits may find it of benefit to work with a legal representative. An attorney may help them to understand their rights and options, as well as guide them through the process.