There are five levels of review and appeal in the Social Security Disability
and SSI process on new applications. At all levels of the process, an attorney may assist
you.One – Application
Applications are filed by telephone or in person at a local Social
Security Administration office. If you have an attorney, the attorney will arrange for the filing of the application, and help you to prepare all of the
necessary forms that accompany the application. Once your application is filed, the Disability Determination Services (DDS) makes
the initial disability determination. The DDS will secure medical and vocational evidence and
arrange for one or more consultative exams if there is not enough medical
evidence to make a decision. The wait period at Level One may take as little as three months, but can also be greater than 6 months. Having an attorney assist in preparing and mailing the application and
associated documents helps to prevent unnecessary
travel to and from the SSA office and reduces the waiting time to get
interviewed after arriving at the SSA
office. An attorney will also assist you in avoiding common mistakes
that are often made in the application process - mistakes that could
jeopardize or delay award of you benefits. The vast majority of initial applications are denied. An experienced attorney may help to improve your chances.
Two – Reconsideration
If the initial disability
application is denied, you have 60 days to ask for a reconsideration of the decision. Once you file your reconsideration request, your medical and vocational information will need to be
reviewed and updated. At this level, a different individual within the DDS organization reviews the application. The wait
period to received a decision at this level is two is three to five months. An attorney can file your request for reconsideration so that it is not
necessary for you to go into the Social Security Office or file
paperwork on your own. An experienced attorney will gather the
necessary medical evidence to support your claim at this level of
appeal, and continue to development the legal basis for winning your
claim. The vast majority of first appeals at reconsideration are denied, but having an experienced attorney may help to improve your chances.
Three – Hearing
If your reconsideration appeal is denied, you have the opportunity to request a hearing before an Administrative Law Judge (ALJ). This request for a hearing must be made within 60 days of the date on your reconsideration denial notice. Unfortunately, there is a long back-log to get a hearing with a Judge. Depending on your location, the wait may be between 10 months and 14 months. You will receive a notice of your hearing date, at least 20 days prior to the date of your hearing. Further evidence may be submitted prior to hearing, during the hearing, and in some cases, immediately after the hearing. Of course, during the hearing, testimony will be taken. The ALJ will make an independent decision on your claim, based on the body of evidence submitted and testimony taken. Statistically, claimants that are represented by an attorney are much more likely to win their claim. Your
attorney will prepare legal briefs to submit to the judge, advise you on
how best to prepare yourself to testify at your hearing. During your
hearing and while your case is pending, your attorney will protect your right to a fair hearing by objecting to improper evidence and
procedures while making persuasive legal arguments to the judges regarding
approving your disability claim and paying your case.
Five - Federal Court
Four – Appeals Council
If the Administrative Law Judge issues a denial on your claim, you have 60 days on which you can appeal the decision to the Appeals Council. The Appeals Council will make a determination as to whether the hearing decision was based properly on the law. The wait time to receive a decision from the Appeals Council is over 1 year. Very few appeals at this level result in a favorable decision - approximately 2% Having an experience attorney may help to improve your chances.
The next level of appeal beyond the Appeals Council is at the level of the Federal District Court. The action must be commenced within 60 days of the date of the decision of the Appeals Council. The district court can affirm or reverse the SSA's decision, or remand the case back to the Social Security Administration for further adjudication. If the District Court issues a denial, the case can then go to the United States Court of Appeals. The United States Court of Appeals can affirm or reverse the SSA's decision, or remand the case. Beyond the US Court of Appeals is the United States Supreme Court. It is a very rare that the US Supreme Court agrees to hear a Social Security disability case.