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Understanding the SSDI appeals process

As many people in Missouri can attest, a large percentage of Social Security Disability Insurance claims are denied. Fortunately for disappointed claimants, the Social Security Administration provides an extensive SSD appeals process that such claimants can use to obtain further review of their claims. The appeals process comprises four levels: request for reconsideration, review by an administrative law judge, review by the internal SSA appeals council and, finally, federal court review.

A request for reconsideration is the first step; it is a written request to the SSA to submit the disability claim to an SSA employee who was not involved in making the initial decision to deny the claims. The claimant can submit new medical or employment evidence with a request for reconsideration. The claimant is not required to be present for the reconsideration review. If the reconsideration request ends with a denial, the claimant can ask for a review by an administrative law judge. The ALJ's review is similar to a court trial. The ALJ takes testimony from the claimant and any other witnesses the claimant may call, including medical professionals and employment experts. The claimant is expected to attend, but the SSA will allow attendance by video conferencing if the appellant is physically unable to travel to another city for the hearing.

If the ALJ rejects the appeal, the claimant can seek review by the SSA's Appeals Council. The Appeals Council will render one of three decisions: reject the appeal and affirm the denial by the ALJ, return the case to the ALJ for further hearing, or reverse the ALJ and award benefits. If the Appeals Council chooses either of the first two options, the applicant can seek judicial review by filing a lawsuit in federal court. The federal court will not accept new evidence and will only determine whether the decision of the ALJ or Appeals Council was contrary to the evidence or the law.

The SSD appellate process becomes more complex at each higher level of review. Anyone whose application for benefits has been denied may benefit from a consultation with a lawyer who handles such cases. Such a review can provide a helpful evaluation of the facts and law that apply to the case.

Source: Social Security Administration, "The Appeals Process," accessed on Feb. 26, 2017

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