If you disagree with a decision made by the Social Security Administration (SSA), you can request a change. However, knowing how to navigate the Social Security disability appeals process can be difficult. Pursuing an appeal may take several months or even years. You’ll want an experienced disability attorney to help streamline the process by ensuring accurate form completion, comprehensive medical documentation, and other necessary steps for claim approval. Schedule a free consultation with an experienced Social Security disability lawyer to review your claim.
Understanding the Social Security Disability Appeals Process
Claim denial is often the first step toward obtaining Social Security Disability (SSD) approval, with an average denial rate of 67 percent. When initial applications for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) are denied, you have four opportunities to appeal the decision: request a reconsideration, a hearing before an administrative law judge, a review by the appeals council, and a review by a federal district court.
Request Consideration
The first step in the appeal process is requesting a reconsideration. During the reconsideration, an examiner from the local Disability Determination Services (DDS) office will thoroughly review your case. The examiner is impartial and has no involvement in your claim’s initial review or decision. A disability lawyer can significantly assist your reconsideration by reviewing your claim denial letter and gathering additional medical documentation and evidence to strengthen your case.
You must submit a written appeal for reconsideration or submit the SSA-561-U2 Form within 60 days of your claim’s denial.
Administrative Law Judge Hearing
The second level of the appeals process involves requesting a live hearing before an Administrative Law Judge (ALJ). During this meeting, an ALJ will review your case and ask questions about your condition and inability to work. They may also inquire about work history and the reason for the initial claim denial. A Social Security disability lawyer prepares claimants before administrative law judge hearings to provide peace of mind and ensure a smoother claims process. They frequently rely on the testimonies of medical and vocational experts in their network to validate your qualifications for disability benefits.
You must submit a written appeal for a hearing or submit the HA-501 Form within 60 days after your reconsideration denial notice.
Appeals Council Review
If an administrative law judge rules against you, your next step is to request a review by SSA’s Appeals Council. A Social Security disability lawyer can provide significant assistance at the Appeals Council level by reviewing your case for potential legal errors, identifying strong points to challenge the ALJ’s decision, collecting additional evidence, creating a compelling appeal brief, and advocating for the best possible outcome.
You must submit a written appeal for a review by the Appeals Council by submitting the HA-520 Form within 60 days after you receive a hearing decision.
Federal District Court Review
The final level of appeals involves seeking a review from a federal district court. If the Appeals Council denies your claim, you can file a civil lawsuit in the U.S. District Court for your area. A judge will evaluate the administrative record to determine whether the ALJ’s previous decision contained legal errors. They will review written arguments from the claimant (you) and your disability lawyer before either upholding the previous decision or remanding the case back to the SSA for further review.
Unlike every other level of the SSA appeals process, the federal court doesn’t require or consider new medical evidence. It focuses its review on existing records from prior hearings. Your attorney must file within 60 days of the Appeals Council decision notice. If you are dealt an unfavorable ruling, you may challenge it at the U.S. Circuit Court of Appeals.
Why You Need a Disability Lawyer to Navigate the Social Security Disability Appeals Process
An experienced disability lawyer is essential for navigating the Social Security Disability appeals process because they possess deep knowledge of the complex SSA system, can spot potential errors in your claim denial, and can ensure that the necessary steps are followed correctly throughout the SSI appeal process. A disability attorney benefits your case in the following ways:
- Gathering Medical Evidence: Disability lawyers collect and organize pertinent medical documentation and records, particularly new medical evidence, to strengthen your claim during the Social Security appeals process. Medical records should include diagnoses, prescribed treatments, rehabilitation therapies, and future prognosis. Physician notes detailing how injuries affect daily life also aid in illustrating the extent of injuries. Mental health records confirming your condition’s influence on your ability to work serve as valid evidence during the Social Security disability appeals process.
- Obtaining Expert Opinions and Testimony: Expert testimony significantly strengthens a claim during appeals. Social Security disability attorneys work alongside your treating medical providers to secure detailed medical opinions that support the functioning limitations of your disability. They may also engage vocational experts to help ensure claim approval. Vocational experts offer valuable insights into the physical and mental capabilities needed to perform specific jobs. Additionally, they review records, provide expert opinions and testimonies, and respond to questions before the ALJ regarding your ability or inability to work due to your disability.
- Preparing You for Hearings: A disability attorney will prepare you for hearings. Typically, this includes practicing your responses to questions so that you can answer them confidently and effectively.
- Representing You at Hearings: A Social Security disability lawyer can attend hearings on your behalf to present evidence advocating for your claim. It provides an opportunity for them to cross-examine the SSA’s expert witnesses and call their own to solidify the need for claims approval.
Most Social Security disability lawyers work on a contingency fee basis. This type of arrangement allows access to legal representation for everyone without any upfront or out-of-pocket costs. It offers clients peace of mind, ensuring they only pay if and when their disability attorney succeeds in their appeal. There is no financial risk in securing professional legal representation for your Social Security disability claims appeal.
Consult an Experienced Social Security Disability Lawyer
You don’t have to understand how to navigate the Social Security disability appeals process without the help of an experienced attorney. Let someone else guide you through it. Schedule a free consultation to have a qualified disability lawyer review your appeal and strategize your next steps toward approval.
