How Many Appeal Levels are there in Social Security Disability Cases.

 There are many levels in Social Security Disability Cases.


1. Original Application:

This is the first step in your case. This part of the case is decided at the SSA level. You do not go before a judge at this level. Whether you are applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), or both, an initial application is needed. This can be done through an attorney’s assistance or on your own at www.ssa.gov. It may also be done by contacting Social Security at 800-772-1213. Approximate Wait Time: four months to eight months.


2. Reconsideration:

At this level your case is reviewed by a new person who works for SSA. Once again this is not a decision made by judge. The person deciding is supposed to review all the medical information and make a new decision. Unfortunately, most of these decisions are just rubber stamped and not thoroughly reviewed. New medical records can be received and reviewed. This first appeal also has a high denial rate (approximately 90 percent). Approximate Wait Time: three to five months.


3. Hearing Level:

The second level of the Appeals process is reached if you were denied reconsideration. You must file an appeal within 60 days of the denial of reconsideration. You can request a hearing online at SSA. gov. 

At this stage, you will appear before an Administrative Law Judge who will make an independent decision based on the law and facts of your case. It is very important at this stage to update all your medical records not in your file. Social Security will not update your medical records, it is up to you to do this. All your medical evidnece must be submitted 5 days prior to your hearing. 

This will be most claimants’ best opportunity to receive a favorable decision, but the wait time for a hearing is substantial because of a Social Security backlog. Approximate Wait Time: 1 year to 1 ½ years.


4. Appeals Council:

If you disagree with the judge’s decision, you (or your representative) may request an appeal by writing to us requesting an Appeals Council review, or by completing a Form HA–520 (Request for Review of Hearing Decision/Order). I usually attach a brief explaining what errors the judge's decision has. If there is any new medical evidence I will attach it to my brief. 

If the Appeals Council grants your request for review, it will either decide your case or return it to the judge for further action, which could include another hearing and a new decision.  If the Appeals Council grants your request and plans to issue a decision that is less than fully favorable to you and does not intend to remand the case for further proceedings, it will send you (and your representative) a notice of its proposed action and will allow you or your representative an opportunity to respond before issuing the decision.  If the Appeals Council plans to issue a fully favorable decision, plans to remand your case for further proceedings, or plans to issue a decision that is favorable in part while remanding the remaining issues for further proceedings, the Appeals Council will not notify you (or your representative) prior to taking action, but will send notice of its review with the decision or remand order. 

The Appeals Council will send you (and your representative) a copy of the action it takes on your request for review and explain the reasons for this action.  Approximate Wait Time: 1 year.


5. Federal Court: 

If the Appeals Council issues a decision or denies your request for review of a judge’s decision, and you disagree with the action of the Appeals Council, you may file a civil action with the U.S. District Court in your area. 

Many lawyers do not take cases in Federal Court because the win rate is very low. 

You must file an action in U.S. District Court within 60 days after you receive the notice of Appeals Council action.  We consider that you receive notice of the Appeals Council action 5 days after the date on the notice.  The U.S. District Court will review the evidence and the final Agency decision. The District Court may send the case back to the Agency, and a judge may be ordered to hold a new hearing and issue a new decision. The District Court may also direct the agency to award benefits or dismiss the case. Depends on federal court docket, but you should be prepared to wait at least several months to a year.

If you need helping applying for Social Security Disability or SSI, please contact me at joshben99@gmail.com. I have over 25 years experience with Social Security Disability cases.

Location: Michigan, USA

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