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Explainer: the four levels of Social Security Disability appeals

It is a common occurrence: a person goes to the Raleigh Social Security Administration office, fills out and submits the forms and then waits to hear if their Social Security Disability (SSD) claim has been approved. Unfortunately, more than half of all SSD claims are denied after the initial application has been filed.

At that point, you have a couple of choices: accept the decision or appeal the decision. If you accept it, you will have to figure out how to make do without SSD benefits that include monthly compensation and access to medical care. If you decide to appeal, you need to figure out that process and accompanying paperwork.

Here’s a quick overview of how SSD appeals work.

  • Reconsideration: the first step is to ask the SSA to review its denial of your claim.
  • Hearing: if, after your request for reconsideration, your claim is denied again, you have 60 days in which you can continue your appeal. This time you can request a hearing before an administrative law judge (ALJ). About half of all disability claims heard by an ALJ are approved for SSD benefits.
  • Appeals Council: if half of those cases are approved, that means half are denied. The next step is to ask for an Appeals Council review. However, the Appeals Council selects its cases for review randomly and it can grant your request for review as well as deny or dismiss it. The Appeals Council typically looks for flaws by the ALJ who heard your case before agreeing to review.
  • Federal court: if your claim has not been reviewed and approved, you can file a lawsuit in U.S. District Court. Federal judges review the case and do one of three things: sends your claim back to the SSA, decides that the SSA decided your case properly or overrules the SSA and awards SSD benefits to you.

An experienced legal representative understands each step of the appeals process and knows how to present required information to improve your chances for benefits approval.

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