If your Social Security claim has been denied, you have options. Deciding to appeal may get your claim approved or, if you’ve previously had Social Security benefits, have your benefits reinstated. Here’s what you need to know when pursuing an appeal.
Deciding to Appeal
The appeal process can be long and draining, both emotionally and physically. Before you appeal, ask yourself these questions:
Are you willing and able to commit to the time requirements of the appeal process? Unlike most kinds of court decisions, Social Security decisions may be appealed and litigated with no time limit for a final verdict. On average, reconsiderations take about four months. However, there are many examples of first reconsiderations taking longer than six months to complete.
Are you physically and mentally able to complete the process? Social Security appeals require accurate paperwork. If you are unable to complete the paperwork yourself, you are permitted to have an attorney, friend, or other person represent you.
But the appeal process will require more than just paperwork: it can be stressful and labor-intensive. If your condition will allow you to proceed, do so. Otherwise, you may need to hire a representative to handle your claim for you or give up the appeal.
Has your condition improved? If you are now able to work, an decision maker won’t overturn the denial. If, however, your condition has worsened, gather new evidence (such as medical records and witness statements) and get ready to appeal.
Was the reason for denial valid? Your denial letter will include the reason the decision maker gave for denying your claim. If the denial was for a valid reason, it is unlikely that the decision will be overturned on appeal.
Go over the denial paperwork in detail. Are there any incorrect statements you would like to challenge? If so, you may benefit from an appeal.
Guidelines for Appealing
Social Security appeals are subject to specific guidelines and rules. Knowing and following these guidelines is essential to successfully completing your appeal.
Once you decide to appeal, you have 60 days from the day you received your denial letter to submit a written appeal request. If you applied for Social Security benefits or Supplementary Security Income (SSI) and your claim was denied for medical reasons, you can request your appeal online.
Then get started on the required paperwork. Here are the most common appeal forms:
- Form SSA-561-U2 (“Request for Reconsideration”): Fill out this form to appeal the denial of an initial claim.
- Form SSA-3441-BK (“Disability Report—Appeal”): If you are appealing the denial of disability benefits, fill this form out in addition to the request for reconsideration.
- Form SSA-789-U4 and Form SSA-3441-BK (“Request for Reconsideration—Disability Cessation” and “Disability Report—Appeal”): If you have received disability benefits before and want to appeal the decision to stop your benefits, you’ll need to fill out the appeal form as well as the disability cessation form.
You can get the needed forms online from the Social Security Agency’s website or at your local Social Security office.
Levels of Appeal
There are several levels of the appeal process. If your claim is denied in reconsideration, don’t give up! You have three higher levels you can appeal to that can reinstate your benefits.
Reconsideration: During reconsideration, your case and any new evidence is presented to an decision maker. The chosen decision maker will not be the same one who previously denied your claim. Reconsideration can take as little as four months, but may take as long as six.
Hearing before an Administrative Law Judge: If your appeal is denied, you have the option of having your claim presented before an administrative law judge. The judge will not have seen any part of your claim previously. Hearings are typically scheduled within 75 miles of the claimant’s home, within a year of the request.
Many people decide to represent themselves during reconsideration. However, 80% of claimants seek representation at this level. Talking to an attorney such as Iain T. Donnell, a lawyer in Markham, can ensure all your paperwork is filed correctly and no errors impede your appeal.
Appeal before the Social Security Appeals Council: If the administrative law judge does not rule in your favor, you may ask for a review by the Social Security Appeals Council. If the Council decides there is merit to reviewing your claim, they may review it themselves or give the claim back to the administrative law judge. This process may take more than a year to complete.
Lawsuit in Federal Court: If you disagree with the decision reached by the Council, or the Council decides not to review your claim, you may file a lawsuit in federal district court.
Appealing a denied claim gives you a second chance to secure needed disability benefits. Follow the guidelines above and consult with the appropriate legal counsel to give your appeal the best possible odds.
About the author: A recent college graduate from University of San Francisco, Anica Oaks loves dogs, the ocean, and anything outdoor-related. She was raised in a big family, so she’s used to putting things to a vote. Also, cartwheels are her specialty. You can connect with Anica here.