You should not become discouraged if your claim is initially denied. In a recent year roughly 60% of claims were denied. An SSDI attorney will be able to determine what documentation and evidence will strengthen your claim.
LEVEL 1: RECONSIDERATION OF YOUR INITIAL CLAIM
You must request a reconsideration of your claim within sixty days of receipt of the denial letter. Reconsideration is a complete review of your claim by someone who did not take part in the first decision. They will look at all the evidence submitted when the original decision was made, plus any new evidence.
After approximately four to six months a decision will be reached on the reconsideration request. The case will either be granted benefits or denied again. In some states, this process may vary.
LEVEL 2: HEARING BY AN ADMINISTRATIVE LAW JUDGE
If your claim is denied after reconsideration, you have 60 days to request an informal hearing. This will be in front of an administrative law judge who had no part in the first decision or the reconsideration of your case. The judge will listen to witnesses, review medical evidence, and decide your case. An SSDI appeal lawyer will help you prepare for the hearing and represent you at the hearing.
The Judge will not announce a decision at the administrative hearing. It usually takes at least two to three months after the hearing to receive the decision, if not longer. If the decision is favorable, you should receive your first check about eight to twelve weeks after the decision.
LEVEL 3: REVIEW BY THE APPEALS COUNCIL
If the Judge's decision is not in your favor, the next step is to request a review by The Appeals Council. This must be done within sixty days after you have received the hearing decision. You should be represented by an experienced SSI/SSDI lawyer to ensure you have the best chance of winning the appeal.
A failure to appeal by the deadline will result in having to start an entirely new claim unless you can demonstrate good cause for not filing the appeal prior to the deadline. Good cause includes illness, hospitalization, comprehension problems due to mental infirmity, or other circumstances beyond your control.
The 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.
If the Appeals Council denies your request for review, you will receive a letter explaining the denial. If the Appeals Council reviews your case and makes a decision itself, you will receive a copy of the decision. If the Appeals Council returns your case to an administrative law judge, you will receive a letter and a copy of the order.
LEVEL 4: FEDERAL COURT
If the Appeals Council denies your appeal and/or refuses to review your case, you have 60 days to file a lawsuit in a federal district court. After reviewing the record from your hearing, the Federal judge can (1) award disability benefits, (2) deny disability benefits, or (3) send your case back to a lower court for an additional hearing. It is critical to have good legal representation to give you the best chance of winning the appeal.
LEVEL 1: RECONSIDERATION OF YOUR INITIAL CLAIM
You must request a reconsideration of your claim within sixty days of receipt of the denial letter. Reconsideration is a complete review of your claim by someone who did not take part in the first decision. They will look at all the evidence submitted when the original decision was made, plus any new evidence.
After approximately four to six months a decision will be reached on the reconsideration request. The case will either be granted benefits or denied again. In some states, this process may vary.
LEVEL 2: HEARING BY AN ADMINISTRATIVE LAW JUDGE
If your claim is denied after reconsideration, you have 60 days to request an informal hearing. This will be in front of an administrative law judge who had no part in the first decision or the reconsideration of your case. The judge will listen to witnesses, review medical evidence, and decide your case. An SSDI appeal lawyer will help you prepare for the hearing and represent you at the hearing.
The Judge will not announce a decision at the administrative hearing. It usually takes at least two to three months after the hearing to receive the decision, if not longer. If the decision is favorable, you should receive your first check about eight to twelve weeks after the decision.
LEVEL 3: REVIEW BY THE APPEALS COUNCIL
If the Judge's decision is not in your favor, the next step is to request a review by The Appeals Council. This must be done within sixty days after you have received the hearing decision. You should be represented by an experienced SSI/SSDI lawyer to ensure you have the best chance of winning the appeal.
A failure to appeal by the deadline will result in having to start an entirely new claim unless you can demonstrate good cause for not filing the appeal prior to the deadline. Good cause includes illness, hospitalization, comprehension problems due to mental infirmity, or other circumstances beyond your control.
The 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.
If the Appeals Council denies your request for review, you will receive a letter explaining the denial. If the Appeals Council reviews your case and makes a decision itself, you will receive a copy of the decision. If the Appeals Council returns your case to an administrative law judge, you will receive a letter and a copy of the order.
LEVEL 4: FEDERAL COURT
If the Appeals Council denies your appeal and/or refuses to review your case, you have 60 days to file a lawsuit in a federal district court. After reviewing the record from your hearing, the Federal judge can (1) award disability benefits, (2) deny disability benefits, or (3) send your case back to a lower court for an additional hearing. It is critical to have good legal representation to give you the best chance of winning the appeal.
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