The Appeals Process

The Social Security Administration is required by law to carefully review all of the evidence and other information regarding your case before making a decision affecting your eligibility or benefit amount. Because the Social Security Administration denies approximately 75% of initial applications, the majority of individuals will require a formal hearing before a Judge to ultimately receive benefits.

If your application is denied, there are generally four levels of appeal:

  • Reconsideration

  • Hearing by an Administrative Law Judge

  • Review by the Appeals Council

  • Federal Court Review


RECONSIDERATION

Reconsideration is a complete review of your claim by an individual that did not take part in the original decision. The majority of reconsideration's involve a complete review of your files without the need for you to be present.

Please note that if you live in one of the following ten states, reconsideration does not apply and you may file your appeal for a hearing directly to an Administrative Law Judge: Alabama, Alaska, Colorado, Louisiana, Michigan, Missouri, New Hampshire, Pennsylvania, and parts of California and New York.


HEARING

If you disagree with the reconsideration decision, or live in one of the ten states that does not require filing for reconsideration, you may file an appeal with an Administrative Law Judge who had no part in the original or reconsideration decision. We will work closely with you and your medical providers to obtain updated documentation of your disability for the Administrative Law Judge to review. At the hearing, the Administrative Law Judge will ask you questions regarding your medical conditions and the limitations you have. A vocational expert will also be at your hearing to inform the Administrative Law Judge of the type of work you have previously done and if any other work exists that you can perform with your medical limitations.


APPEALS COUNCIL

If the Administrative Law Judge denies your claim at the hearing level, you may request a review of the decision by the Appeals Council. The Appeals Council will review the Judge's decision for any errors of law and determine if the decision was correct. The Appeals Council will either deny your request for review or return your claim back to the Judge for another hearing. You must choose between filing with the Appeals Council or filing a new application. We will advise and work closely with you to explain all options and potential outcomes.


FEDERAL COURT REVIEW

You may file a lawsuit in Federal District Court if the Appeals Council denies your claim. This must be decided on an individual basis and referred to an attorney who specializes in this area.