The SSD Appeals Process
Updated: Mar 30, 2021
Most people who apply for Social Security Disability benefits will be denied on their initial application. In the event that this occurs, the Social Security Administration has established procedures for those who wish to appeal a disability denial.
When you appeal, your chances of approval for benefits increase, and your best chance at getting approved happens at the hearing level.
There are 4 levels of appeals within the Social Security Disability process:
Administrative Law Judge Hearing
Appeals Council Review
Should you choose to appeal a SSD denial, an attorney can file these appeals and submit all the paperwork on your behalf, so nothing gets overlooked. While we recommend hiring an attorney for appeals, we also think it is important for claimants to understand each step of the process.
If your initial application for disability benefits is denied, you may request reconsideration by completing form SSA-561. You have 60 days from the date on the top of your decision letter to file this appeal. This reconsideration will be performed by Disability Determination Services (as was your initial application), but it will be reviewed by a different medical consultant and examiner than your initial claim.
Should you hire an attorney at this level of the appeal process, they will file all of the appeal paperwork, as well as request additional medical records to be evaluated in the reconsideration. Unless you submit new medical evidence that shows a severe worsening of your conditions, you will likely not receive approval for benefits at this level. In fact, about 87% of cases are denied at the reconsideration level. And it is unlikely that your medical records will show that because a reconsideration review typically takes place only weeks after your initial decision.
If you are denied, you will receive another denial notice, and you can move forward with the next step in the appeals process.
2. ADMINISTRATIVE LAW JUDGE HEARING
To request a hearing before an administrative law judge, you need to file form HA-501. As with a reconsideration, you need to file the appeal within 60 days. Your claim will be assigned to a judge, and your hearing will be held at the SSA Office of Hearing Operations (OHO).
At this level, you may have to complete medical exams with evaluators contracted with SSA, your judge may ask certain witnesses to attend your hearing to testify, and all evidence must be submitted 5 business days before your hearing date.
Again, should you hire an attorney, they can file this appeal for you. At Kapor | Davis & Associates, not only will we do that, but our attorneys will inform you of any scheduled appointments, order all of your medical records, meet with you directly to get a handle on your disabilities, build a strong case to present before your assigned judge, and meet with you about 10 days before your hearing to walk you through the process and answer any and all of your questions.
At the hearing level, the approval rate for benefits is about 35% for people who go to hearing without an attorney. That goes up to 62% when you hire an attorney, and 73% when you hire an attorney at Kapor | Davis & Associates.
Again, if you are denied, you will receive another denial notice, and you can move forward with the next step in the appeals process.
3. APPEALS COUNCIL
If you are denied at hearing level, you may file another appeal by filing form HA-520, and it must be filed within 60 days of your decision. This appeal will be sent before the Appeals Council, which has the discretion to grant, deny, or dismiss your request for review. Note, if you file your appeal late, the Appeals Council may dismiss your claim without reviewing it.
The Appeals Council will usually look for a flaw in the Judge’s decision before granting a review. When you hire a SSD appeal attorney, he or she will pick apart the judge’s decision to find flaws and will write a brief for the Appeals Council pointing out needs for review. Your claim at this point may be approved, denied, or remanded back to hearing level. In a remand, your case will go back before an administrative law judge for reevaluation.
There is one last appeal that can be conducted should your claim be denied.
4. FEDERAL COURT REVIEW
If the Appeals Council denies your request for review or denies your claim, you can file a civil action with the US District Court.
Need Help with Your Upcoming SSD Appeal?
At Kapor | Davis & Associates, we do not do Federal Court Appeals. However, should your case get that far, we will refer your case to a trusted attorney who files our federal court cases.
If you have been denied Social Security Benefits at any level, our team would be happy to help you out. We know that this process can be long and exhausting, but with over 30 years of experience, we can guide you through it one appeal at a time.