Appeals

Social Security wants to be sure that every decision made about your Social Security claim is correct. They carefully consider all the information in your case before they make any decisions that affect your eligibility or your benefit amount.

 

When SSA decides whether you are eligible for benefits, they will send you a letter explaining their decision. If you do not agree with the decision, you can ask them to review your case again. This is called an appeal.

 

When you ask for an appeal, they will look at the entire decision, even those parts that were in your favor. If their decision was wrong, they will change it.

 

If you wish to appeal, you must make your request in writing within 60 days from the date you receive their letter. SSA assumes you receive the letter five days after the date on the letter, unless you can show that you received it later.

 

There are three levels of appeal. They are:

 

(note for Alabama, Alaska, Colorado, Louisiana, Michigan, Missouri, New York, Pennsylvania, North And West Los Angeles, California the reconsideration level of appeals is absent).

 

Many people handle their own Social Security appeals with Social Security. But you can choose someone else to help you. Someone you appoint to help you is called your “representative.” SSA will work with your representative just as they would work with you.

 

Your representative can act for you in most Social Security matters and will receive a copy of any decisions they make about your claim.

 

Your representative cannot charge or collect a fee from you without first getting written approval from Social Security.

 

Hearing

 

If you disagree with the initial decision, you may ask for a hearing on the “disability” issues of your claim, such as whether you are disabled, when your disability began or whether it has ended. An administrative law judge who had no part in the first decision about your case will conduct the hearing.

 

The hearing is usually held within 75 miles of your home. The administrative law judge will notify you of the time and place of the hearing.

 

You and your representative may come to the hearing and explain your case in person. You may look at the information in your file and give new information.

 

The administrative law judge will question you and any witnesses at the hearing. You or your representative also may question the witnesses.

 

It is usually to your advantage to attend the hearing. If you do not wish to do so, you must tell SSA in writing that you do not want to attend. Unless the administrative law judge believes your presence is needed to decide the case, he or she will make a decision based on all the information in your case, including any new information given.

 

After the hearing, SSA will send you a letter and a copy of the administrative law judge’s decision.

 

Appeals Council

 

If you disagree with the hearing decision, you may ask for a review by Social Security’s Appeals Council.

 

The Appeals Council looks at all requests for review, but it may deny a request if it believes the hearing decision was correct. If the Appeals Council decides to review your case, it will either decide your case itself or return it to an administrative law judge for further review. You will receive a copy of the Appeals Council’s decision or order sending it back to an administrative law judge.

 

Federal Court

 

If you disagree with the Appeals Council’s decision or if the Appeals Council decides not to review your case, you may file a lawsuit in a federal district court.