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Understanding the Social Security disability appeals process

Understanding the Social Security disability appeals process is important for disabled individuals and their families who rely on resources made available to those suffering with a disability that results in an inability to work. In general, Social Security disability (SSD) benefits are available to individuals suffering from a medical condition that lasts longer than 12 months, or is expected to result in death, which renders them unable to work or perform gainful activity. In addition, to qualify for SSD benefits, the disabled individual must meet the work history requirement, however, additional options, such as Supplemental Security Income, may be available to disabled individuals who do not meet the work history requirement.

A large number of applications for Social Security disability benefits are initially denied. Following a denial, the applicant has 60 days to make an appeal so it is important to promptly respond to a denial of a claim for benefits. There are generally 4 steps in the appeals process. The first step is the reconsideration process. During the reconsideration process, a party not involved in the initial review of the claim for benefits reviews the entire application again. New evidence may also be submitted at this time so it is important to have complete medical records to provide.

Following the reconsideration process, if the claim is still denied, the SSD appeals process provides for a hearing before an administrative law judge. The hearing process may involve the questioning of witnesses and experts and a representative for the applicant can also question witnesses. In some circumstances, the applicant may not be required to attend the hearing but it is important to communicate with the Social Security Administration concerning an inability to attend. If the claim is not approved following a hearing, the applicant can request the Appeals Council review the claim and denial, however, the Appeals Council can decline to review the application for benefits. Finally, if the claim for benefits remains unapproved, the applicant can appeal by filing a lawsuit in federal court.

The SSD application and appeals processes can seem overwhelming to individuals already struggling with a disability and the challenges that brings. Because of the importance of disability benefits to many individuals and their families, it is vital that they are familiar with the application and appeals processes and how to navigate them in order to receive oftentimes badly needed benefits.

Source: Social Security Administration, “The Appeals Process,” Accessed June 30, 2016


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