How to Appeal a Social Security Decision
Part of the Social Security For Dummies Cheat Sheet
Copyright © 2012 AARP. All rights reserved.
If you’ve applied for Social Security disability benefits and you’ve been denied, don’t give up. You can challenge a benefits decision by Social Security — you just have to take certain steps in a certain order.
Keep in mind that the time clock starts clicking as soon as you receive an adverse decision on your application. At that point, you have 60 days to begin the appeal. (The 60-day time frame generally applies for each step of the appeals process.)
You can start your appeal online (go to www.ssa.gov and click “Appeal a disability decision online”), over the phone (by calling 800-772-1213, or TTY 800-325-0778), or at your local Social Security office (go to www.ssa.gov and click “Locate a Social Security office”).
Most challenges to Social Security decisions involve disability benefits. But the appeals process exists to settle other benefits disputes, as well. An appeal may go through four stages if it isn’t resolved along the way:
Request for reconsideration: At this stage, you don’t actually show up in person anywhere. You just file a request for reconsideration (the form is available at www.ssa.gov/online/ssa-561.pdf) if your initial application is turned down.
Such requests don’t have a very good chance of success, but they are required in most places if you want to proceed to the next phase, where you have better odds of prevailing.
Note: Residents of the following places may skip reconsideration and go straight to Step 2: Alaska, Alabama, Colorado, Louisiana, Michigan, Missouri, New Hampshire, New York, Pennsylvania, and parts of the Los Angeles metropolitan area. (Check with your local field office to be sure.)
Administrative law judge hearing: This stage is when you make your case before the administrative official who has the power to rule in your favor. This is your best shot in the appeals process to win. The judge looks at your case without taking into account the prior ruling, and it may be the first time you’ll be face to face with the decision maker.
You may want to hire a lawyer or other representative who understands the Social Security appeals process and can make your case.
To request a hearing before a judge, print the form at www.ssa.gov/online/ha-501.pdf, sign it, and mail it to your local Social Security office.
Appeals Council: This group of administrative appeals judges is the top level of review inside the Social Security Administration. They may choose to review your challenge, not to review it, or to send it back to an administrative law judge, perhaps with a recommendation that helps your case. At this point, though, most cases are rejected. Nonetheless, you must go through this administrative step if you want to appeal your case in federal court.
Federal court review: When you’ve exhausted your options inside the Social Security Administration, the next step is to sue in federal court. This process can take many months. You won’t testify, but your attorney may argue with his government opponent before the judge. If you lose in federal district court, you can appeal to the appropriate U.S. court of appeals.