Many, if not all, applications for Social Security Disability Insurance (SSDI) are initially denied by the Social Security Administration (SSA). Instead of speculating on possible reasons for this decision, an unsuccessful applicant may be better advised to commence an appeal using the extensive appeal procedures provided by the SSA.
The four levels of appeal
The SSA provides four levels of appeal of an SSDI application that has been denied. Each level has its own unique procedures that must be clearly understood by the applicant or the applicant’s attorney.
The first level of appeal is a written request for reconsideration. The appeal may be submitted in writing or on-line. The evidence in the case will be reviewed by a person who was not involved in reviewing the initial application. The applicant can submit new evidence with the request for reconsideration.
If the request for reconsideration is denied, the applicant can request a hearing before an administrative law judge. Many hearings are held by video. The applicant and any witnesses will appear either live in front of the administrative law judge or remotely via teleconferencing. Like the decision on a request for reconsideration, the review by the administrative law judge will be conducted by a person who was not involved in either of the first two decisions.
The last review within the SSA is a request to the Appeals Council. The Appeals Council has several options, including outright denial of the appeal if the Council finds that either of the first two denials was supported by the evidence and complies with social security law and regulations.
The council can also review the case to see if the decision is supported by the evidence and complies with existing laws and regulations; if the Council finds that the decision is erroneous, it can either reverse the outcome or send the case back to an administrative law judge for further review.
Federal court review
The final level of review is the commencement of an action in federal court. The federal judge will generally review all of the evidence and determine whether the case was properly decided. As may be inferred, the services of an attorney experienced in SSDI cases will be necessary to go to court. Anyone whose claim for SSDI benefits has been denied may wish to consult a lawyer with experience in SSDI law to evaluate the chances of obtaining a favorable decision via an appeal.