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How does the SSDI and SSI appeals process work?

On Behalf of | May 1, 2024 | Disability Appeals |

A person who applies for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits may be denied at first. This opens the door for an appeal.

Appealing an SSDI or SSI decision must be done quickly. The instructions for appeals are included in the denial notification. These must be followed precisely.

Reconsideration phase

The first step in the appeal process is to file for reconsideration. This must be done within 60 days from the date of the denial notice. During reconsideration, a new reviewer from the Social Security Administration (SSA), who wasn’t involved in the original decision, reevaluated the application. The applicant can submit additional evidence and documentation to support their claim.

Administrative law judge hearing

If reconsideration results in another denial, the next step is to request a hearing by an administrative law judge (ALJ). This hearing is more formal and allows the applicant, who may be represented by an attorney, to present their case in person.

The judge will review all evidence, and witnesses, including medical experts, may be called to testify. The ALJ will ask questions to understand better the applicant’s disability and its impact on their ability to work.

Appeals Council review

If the ALJ also denies the claim, the next option is to request a review by the Social Security Appeals Council. The Appeals Council doesn’t review every request but selects cases based on potential errors of law, conflicts with SSA policy or the broad need for review to ensure consistent application of the law.

If the Appeals Council decides to review a case, it may either settle the case itself or return it to an ALJ for further review. If the Appeals Council declines to review the decision, or if it reviews and upholds it, the applicant can take their case to the final level of appeal.

Federal court review

The final step in the appeal process is filing a lawsuit in a federal district court. The federal court reviews the administrative record to determine whether previous decisions were based on substantial evidence and legally correct.

Anyone who is going through the appeals process should ensure they have a legal representative who can protect their interests. This process can become rather complex, so having someone to assist with it can make all the difference to its outcome.