Streamlined Appeals and Decision Making for Social Security Disability in Some States

The Social Security Administration continues two parts of its Disability Redesign project, which is otherwise largely defunct.

Streamlined Appeals Process in Ten States

Applicants for Social Security disability or SSI should be aware that under a continuing “prototype test” for the Social Security Administration's (SSA's) Disability Redesign project (which is otherwise largely defunct), there are ten states that still don’t require the reconsideration review as a first level of appeal. In these states, an appeal of an initial claim denial is made directly to an administrative law judge (ALJ). These ten states are:

• Alabama
• Alaska
• California (Los Angeles North and Los Angeles West Branches only)
• Colorado
• Louisiana
• Michigan
• Missouri
• New Hampshire
• New York
• Pennsylvania

In these states and areas, the first step to appeal a disability claim denial is to file a request for an administrative hearing in front of an ALJ.

Streamlined Decision Making in Twenty States

The above ten states as well as ten more states continue testing the “single decision-maker” model from the SSA’s Disability Redesign project. In these states, disability examiners, rather than medical consultants, are allowed to make medical assessments regarding the severity of and limitations imposed by various physical disorders. While claimants with mental disorders are protected by a federal law (Social Security Act, Sec. 221. (42 U.S.C. 421) (h)) that requires “every reasonable effort” be made for claim review by a psychiatrist or psychologist, there is no such protection for the many people with physical problems in the following states:

Questions about specific cases in the above states should be directed to the local SSA field office or the state's disability determination agency.

More information on Social Security disability determinations and appeals in general can be found in Nolo's Guide to Social Security Disability.