Many people in North Massachusetts suffer from disabling injuries or illnesses. Most of these same individuals probably know about Social Security Disability Benefits (SSDI), but they may have heard that most SSDI benefits applications are denied. While the Social Security Administration has indeed conceded that most initial SSDI applications are denied, the availability of several appellate processes is not often talked about. A review of the different ways of appealing from the denial of an initial application for benefits shows that the initial denial is not the last brick in the road.
The first step
The SSA sends a notice of its decision on an initial SSDI application by mail to the applicant. The applicant then has 60 days to request a “reconsideration” of the decision. The request can be sent by mail, and the applicant may include any additional employment or medical evidence. If the request for reconsideration is denied, the applicant can then request a hearing before an administrative law judge (ALJ).
Hearing by Administrative Law Judge
The hearing will be scheduled for a time and location that suits the applicant’s convenience. Again, the applicant may submit additional evidence on any topic relevant to the application. With the problems created by the covid pandemic, hearings are often scheduled for hearing via an internet connection at a time that is convenient for the appellant. The ALJ will render a written opinion setting forth the reasons and factual findings behind the conclusion. If the ALJ upholds the initial denial of the claim, the applicant can then file an appeal with the SSA Appeals Council.
The Appeals Council
The Appeals Council examines all cases and requests for review. The Council may send the file back to the original office with an instruction to reconsider the evidence or the finding that led to the initial denial. The Appeals Council may decide to review the claim by itself or send it to the ALJ for further review.
Federal Court review
If the Appeals Council upholds the denial of the claim, the applicant can seek further review of the Council’s decision by filing a case in Federal District Court. While the SSA regulations do not require an attorney, federal rules require hiring a lawyer to pursue the case. Also, retaining an experienced lawyer at the outset of the appeal process may be advisable because an experienced attorney can help in each step of the appellate process.