What are the appeals options when denied Social Security?

by Oct 16, 2015

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When people in Knox County believe they meets the requirements to receive Social Security disability benefits and the claim is denied, many wonder what they should do next. While it is a setback to be denied Social Security, there are options to try and have the decision overturned. The perception for most appeals of federal decisions is that it will almost automatically be upheld. That, however, is not the case. There is a chance that a denied Social Security claim will be overturned on appeal. It’s important to know how the appeals process works.

The idea behind Social Security is to provide benefits to those who meet the requirements. If there is a denial, the claimant has to request an appeal within 60 days of the date of the letter of denial from the Social Security Administration. There are four different levels of appeal when denied SSD benefits. These are reconsideration, having a hearing by an Administrative Law Judge, having a review by the Appeals Council and having a Federal Court review the case.

With a reconsideration, the entire case will be reviewed by someone who had no role in the initial decision. All evidence from the first case will be examined as well as any new evidence. In most instances, the claimant doesn’t have to be present for the reconsideration, but depending on the circumstances, it is possible to meet with a SSA representative to explain why a medical condition hasn’t improved sufficiently to be denied benefits. After a reconsideration, a hearing is possible. This will be overseen by the ALJ who didn’t have a role in the initial decision or the reconsideration. This hearing is held within 75 miles of the claimant’s residence. The ALJ will ask questions and hear new evidence.

The Appeals Council will hear the next appeal. All requests for a review will be heard, but if the Appeals Council views the decision as accurate, they can deny to hear the case. Either there will be a review by the Appeals Council or it will be returned to an ALJ. If the Appeals Council rejects the appeal or refuses to hear it, the final option is to appeal to the Federal Court. Claimants who have been rejected need to remember their options. With all levels of appeal an experienced legal professional can help.

Source: Social Security Administration , “The Appeals Process,” accessed on Jan. 4, 2015