Appeals
(For Disability Claims In The Following Areas: Alabama, Alaska, Colorado, Louisiana, Michigan, Missouri, New York, Pennsylvania, North And West Los Angeles, California click here)
Social Security wants to be sure that every decision made about your Social Security claim is correct. They carefully consider all the information in your case before they make any decisions that affect your eligibility or your benefit amount. When they make a decision on your claim, they will send you a letter explaining their decision. If you do not agree with their decision, you can appeal—that is, ask them to look at your case again. When you ask for an appeal, they will look at the entire decision, even those parts that were in your favor. If their decision was wrong, they will change it.
If you wish to appeal, you must make your request in writing within 60 days from the date you receive their letter. They assume you receive the letter five days after the date on the letter, unless you can show them you received it later. Call our Social Security representatives if you need help with your appeal. If you filed for Social Security disability benefits and your claim was denied for medical reasons, you may request an appeal here.
Generally, there are four levels of appeal. They are:
•Reconsideration;
•Hearing by an administrative law judge;
•Review by the Appeals Council;
•Federal Court review.
A reconsideration is a complete review of your claim by someone who did not take part in the first decision. SSA will look at all the evidence submitted when the original decision was made, plus any new evidence. Most reconsiderations involve a review of your files without the need for you to be present. But when you appeal a decision that you are no longer eligible for disability benefits because your medical condition has improved, you can meet with our Social Security representatives and explain why you believe you still have a disability.
If you disagree with the reconsideration decision, you may ask for a hearing. The hearing will be conducted by an administrative law judge who had no part in the original decision or the reconsideration of your case. The hearing is usually held within 75 miles of your home. The administrative law judge will notify you of the time and place of the hearing. Before the hearing, SSA may ask you to give them more evidence and to clarify information about your claim. You may look at the information in your file and give new information. At the hearing, the administrative law judge will question you and any witnesses you bring. Other witnesses, such as medical or vocational experts, also may give us information at the hearing. You or your representative may question the witnesses.
In certain situations, SSA may hold your hearing by a video conference rather than in person. They will let you know ahead of time if this is the case. With video hearings, they can make the hearing more convenient for you. Often an appearance by video hearing can be scheduled faster than an in-person appearance. Also, a video hearing location may be closer to your home. That might make it easier for you to have witnesses or other people accompany you. It is usually to your advantage to attend the hearing (in person or video conference). You and your representative, if you have one, should come to the hearing and explain your case. If you are unable to attend a hearing or do not wish to do so, you must tell SSA why in writing as soon as you can. Unless the administrative law judge believes your presence is necessary to decide your case and requires you to attend, you will not have to go. Or SSA may be able to make other arrangements for you, such as changing the time or place of your hearing. You have to have a good reason for them to make other arrangements. After the hearing, the judge will make a decision based on all the information in your case, including any new information you give. SSA will send you a letter and a copy of the judge’s decision.
If you disagree with the hearing decision, you may ask for a review by Social Security’s
Appeals Council. The Appeals Council looks at all requests for
review, but it may deny a request if it believes the hearing decision was correct.
If the Appeals Council decides to review your case, it will either decide your case
itself or return it to an administrative law judge for further review. If the Appeals
Council denies your request for review, they will send you a letter explaining the
denial. If the Appeals Council reviews your case and makes a decision itself, they
will send you a copy of the decision. If the Appeals Council returns your case to
an administrative law judge, they will send you a letter and a copy of the order.
Can someone help me? Yes. Many people handle their own Social Security applications. But you can choose a representative to help you. Someone you appoint to help you is called your “representative.” SSA will work with your representative just as they would work with you. Your representative can act for you in most Social Security matters and will receive a copy of any decisions they make about your claim. Your representative cannot charge or collect a fee from you without first getting written approval from Social Security.
