Social Security Denial: The Appeals Process

June 25, 2010 · by admin · in

When someone applies for Social Security Disability Insurance (SSDI), the Social Security Administration (SSA) will review their application and then send a letter informing them of their decision to approve or deny the request. The SSA receives many applications for SSDI and it is possible that they deny a perfectly legitimate claim. Common reasons for a denial include:

  • Insufficient application, including missing personal information about the applicant, incomplete paperwork, or missing paperwork
  • Insufficient proof of medical disability; the SSA requires applicants to provide medical documentation proving their inability to work because of a qualifying disability.

Individuals who are initially denied SSDI have the right to appeal the decision. They must send a written request to the SSA within a certain period of time. If they miss the window of opportunity, they must file an entirely new application.

There are different levels to the appeals process:

  1. Hearing – an administrative hearing will be held before a judge who has no prior knowledge of the case; the applicant will try and prove the nature of their disability, when it began, and why they can no longer work. They can present new information in addition to their original application and call witnesses to help their case. It is not imperative that the applicant be present at the hearing, but it almost always will help their case to be there in person.
  2. Appeals Council – if the request for benefits is denied after the administrative hearing, the applicant may then ask for a review from the Social Security’s Appeals Council; however, the Council has the right to deny the review if they agree with the decision from the administrative hearing. The Council can review the case itself or send it back down to a different administrative judge.
  3. Federal Court – the final appeals step is to file a lawsuit in federal district court.

The appeals process can be long and frustrating. Most people chose to appeal with the help of a social security lawyer  law. This is because having legal representation will increase the chances for a successful appeal.