Social Security Disability: Appealing Denied Claims

How to appeal a denied SSDI disability claim.

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You may want to file a disability appeal if your application for Social Security disability (SSDI) or SSI benefits has been denied. The notice from the Social Security Administration (SSA) denying or terminating your benefits will include information on how to appeal the decision. You must appeal in writing within 60 days of the date that you receive the notice. Here are some things to keep in mind about appealing an SSA decision.

How Long Do Appeal Decisions Take?

The first level of appeal in most states -- reconsideration of a denial by the Disability Determination Service (DDS) -- is the quickest, because your case will simply be reviewed by a medical consultant and examiner (not the medical consultant and examiner who made the original decision). You might get a decision in a few weeks, or you may have to wait a few months, depending on the agency's caseload.

Once you get to the next level of appeal, a hearing before an administrative law judge (ALJ), the decision-making process can really slow down -- you could easily wait for a year or longer for a hearing. On further appeal to the Appeals Council, you'd probably be lucky to get any kind of answer within a year.

If you go to the next level of appeal, appeals to a federal court typically take about a year for a decision -- but several years isn't out of the question. Federal court judges have many kinds of cases on their schedule that have nothing to do with Social Security disability, so your claim will have to wait its turn.

Getting Representation for the Appeal

Some people handle their own Social Security appeal. But you can appoint a lawyer, a friend, or someone else (called your "authorized representative") to help you. The SSA will work with your representative just as it would work with you. At the first level of appeal -- reconsideration by the DDS -- many claimants do not have representation. But this changes as the appeals move further along -- 80% of claimants use a representative when they appeal to an administrative law judge. If you'd like attorney representation during the appeal process, you can use Nolo's Lawyer Directory to find a Social Security attorney in your area.

Alternatives to Appealing

If the SSA has denied or terminated your benefits, there are steps you can take outside of the appeal process. Here's a look at a few options.

  • Reopening your claim. An alternative to appealing your case is to request a reopening of your claim -- which means asking whichever administrative level of the SSA has your claim to take another look at it. After a year has gone by, reopening a claim is only allowed in certain situations. 
  • Filing a new claim. If you lose your appeal (no matter at what level), you have the option to file another initial claim. You would just go to your local Social Security field office and start the process over again. Your chance of being granted benefits will improve if a change in your condition -- such as a worsening of impairments or development of new impairments -- warrants a different disability decision.

Generally, it's a better idea to appeal the decision in your current claim rather than filing a new claim, because you have a better chance of getting approved for benefits after having a hearing, but for more information, see Nolo's article on deciding whether to appeal a disability denial.

Starting an Appeal

To begin your appeal, you can call your local Social Security field office and tell them that you want to appeal a decision that denied or terminated your benefits. They will send you the proper forms and tell you where to mail the paperwork once you've filled it out. The form for getting a reconsideration is Request for ReconsiderationForm SSA-561. The form for getting an appeal hearing is Request for Hearing by Administrative Law JudgeForm HA-501. You can also start your appeal online. To learn more about beginning your appeal, see Nolo's article Social Security Disability: Five Levels of Appeal.

You May Be Able to Receive Benefits While Appealing

If you are receiving benefits and the SSA decides to terminate them, you may be able to continue receiving your benefits while you appeal (up through the ALJ's decision after a hearing) if the SSA decided:

  • you are no longer eligible for SSDI because your condition has improved, or
  • you are no longer eligible for SSI (or that your SSI will be reduced).

To continue getting your benefits in this situation, you must sign and return Form SSA-795 within ten days of receiving the denial of benefits notice. The form should be sent to you with the termination notice from the SSA.

For more information about Social Security disability, including tips on applying for benefits, appealing a denial of benefits, and understanding detailed medical listings, see Nolo's Guide to Social Security Disability: Getting & Keeping Your Benefits, by David A. Morton III, M.D. (Nolo).

by: David Morton

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