If your application for Social Security benefits is denied, you may not be out of luck. A substantial percentage of denials are reversed on appeal. For example, almost half of all Social Security disability appeals, which are by far the most common type of appeal, are favorably changed during the appeal process.
Read on to learn about appealing the denial of your Social Security claim -- including when and how to appeal.
When to Appeal
If you truly don't qualify for benefits, you shouldn't waste your time by filing an appeal. But Social Security has been known to make errors or to be overly strict in its judgments (for example, over whether your illness is severe enough to prevent you from working). The appeal is your chance to correct such errors or persuade Social Security or the courts to judge your case differently.
You must send in the completed appeal form(s) within 60 days after you receive written notice of the Social Security office's decision to deny you benefits (65 days if you received the notice by mail).
Time Involved in an Appeal
In many situations, the appeal will require little more than your taking another opportunity to explain why the information you already presented should qualify you for a benefit. In other cases, it will involve presenting one or two more pieces of information that better explain your situation to Social Security personnel.
How to Appeal
To appeal a denial of an initial claim, complete Form SSA-561-U2 (Request for Reconsideration). If you are appealing the denial of disability benefits, you'll also need to complete Form SSA-3441-BK (Disability Report -- Appeal).
If you have been receiving disability benefits and you wish to appeal a decision to stop your disability benefits, you'll need to use a different form. In that case, you'll complete Form SSA-789-U4 (Request for Reconsideration -- Disability Cessation) and Form SSA-3441-BK (Disability Report -- Appeal).
The forms ask you for basic information, such as your name and Social Security number. You will also need to state the reasons why you think you were unfairly denied benefits. When you submit your forms, you can attach other material for the administrators to consider, such as recent medical records or a letter from a doctor or employer about your ability to work. All of the forms are available at your local Social Security office or from the agency's website at www.ssa.gov.
What to Include in Your Appeal
Think strategically about what other information to include in your appeal. Put yourself into the shoes of whoever denied your claim, figure out why they were led astray, then consider what new evidence might back up your version of things. Psychologically, having new evidence to look at seems to help government workers change their minds.
The most convincing evidence usually comes from an outside authority -- for example, an employer who writes a letter confirming the months that you worked, or a specialist explaining your physical limitations and why they keep you from working.
Levels of Appeal
There are four possible levels of appeal following any Social Security decision.
- The first level is called reconsideration; it is an informal review that takes place in the local Social Security office where your claim was filed.
- The second level is a hearing before an administrative law judge; this is an independent review of what the local Social Security office has decided, made by someone outside the local office.
- The third level is an appeal to the Social Security National Appeals Council in Washington, D.C.
- The final level is filing a lawsuit in federal court.
To learn about appealing a denial of retirement benefits, see Social Security, Medicare & Government Pensions, by Joseph Matthews and Dorothy Matthews Berman (Nolo). To learn about appealing a denial of disability benefits, see Nolo's Guide to Social Security Disability: Getting and Keeping Your Benefits, by David A. Morton III, M.D. (Nolo).