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The Four Levels of Social Security Disability Appeals

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When a claimant files an initial application for Social Security disability benefits the claimant will receive a decision usually within 3-5 months. If favorable the claimant will receive benefits but if denied then the disability claimant can appeal. This article discusses the four levels of appeals for denied Social Security disability claims.

 

1. Request for Reconsideration

If your initial application for Social Security disability benefits is denied you can file a Request for Reconsideration. The office of Disability Determination Services (DDS) which in Florida is operated by the Florida Department of Health will have another claims examiner and medical consultant(s) who were not involved in the original denial take a second independent review of your claim, review any additional records and make a decision usually within 1-4 months. If your Request for Reconsideration is denied you can appeal to the next level.

2. Request for Hearing By Administrative Law Judge

If your Request for Reconsideration is denied you can request a hearing before an Administrative Law Judge (ALJ) with the Office of Disability Adjudication and Review (ODAR) which usually takes 12-16 months to get a hearing date. The Orlando ODAR office conducts the hearings arising out of all Social Security disability claims appealed from the local SSA offices located in Orlando, Kissimmee, Lake Mary, Leesburg and Ocala, Florida. At the hearing the ALJ will conduct the hearing, the claimant and any witnesses will testify and usually a Vocational Expert (VE) and sometimes a Medical Expert (ME) will testify. A decision usually takes 1-3 months and if your Social Security disability claim is denied again you can appeal to the next level.

3. Appeals Council

If the ALJ denies your Social Security disability claim you can file an appeal with the Appeals Council who will review your claim to determine if the ALJ decision is not supported by substantial evidence or there was an abuse of discretion by the ALJ or there is a procedural or policy issue raised by the claimant for the Appeals Council to address. Most appeals take about 15-18 months for the Appeals Council to make a decision and most appeals are dismissed, or on a small number of claims the Appeals Council will send back to the ALJ for another hearing (called a remand) or rarely the Appeals Council will grant Social Security disability benefits to the claimant without a further hearing.

4. Federal Court Review

If the Appeals Council denies your Social Security disability claim you can appeal by filing an appeal in the U.S. District Court where a federal judge will determine if the ALJ made any factual or legal errors, and if so, can make a ruling in your favor granting benefits or dismiss your claim or send the claim back to the ALJ to conduct another hearing. Appeals at this level are very small in number and may take 1-2 years for the Federal District Court judge to make a decision.

At each of these levels the claimant has 60 days from the date of the denial notice plus five mailing days to appeal to the next level absent a good cause exception. A Social Security disability claimant should not try to handle the appeals at any level by themselves but should retain representation from a experienced Social Security disability attorney.

If you have any questions about Social Security disability, you can call the SSA at 1-800-772-1213, go to their website at www.ssa.gov  or call The Nuebel Law Firm, P.A. at 407-703-5999 for a free consultation.

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