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Understanding the Social Security Disability appeals process

On Behalf of | Aug 16, 2021 | Social Security Disability |

Many people in North Carolina apply for Social Security Disability Insurance because they are unable to work after a severe and life-changing disability. However, despite the desperate circumstances many face when applying for SSDI, a large number of applicants are rejected when they initially apply for benefits. Many people who win their SSDI benefits later in the process must go through appeals before they obtain the support they need.

Levels of SSDI appeals

When you receive a Social Security Disability Insurance denial letter, you will receive information about the level of appeal necessary to proceed with your application. The first appeal level is a reconsideration request, followed by an administrative law judge hearing, a review of a hearing decision or order and, finally, a review in a federal court. A reconsideration appeal is performed by a different examiner and medical consultant than the initial decision-maker, so around 10-15% of people with reconsideration claims win their appeals at this level.

ALJ hearings provide a greater likelihood of success

The next appeals level is a hearing before an administrative law judge, or ALJ, which must be requested within 60 days after a reconsideration appeal is denied. Many applicants have much greater success at a hearing with the opportunity to have a disability lawyer represent them and present additional evidence. Around half of all applicants who take their appeals to the hearing level are successful and begin receiving disability benefits; represented applicants are likelier to succeed.

The administrative law judge hearing provides the greatest likelihood of a successful appeal, but a denial at this hearing can be taken to the Appeals Council for a review. Here, the first issue examined is a mistake in law made by the ALJ presiding over the hearing. In around 10% of cases, the council sends back the case for further proceedings. However, this step must be pursued for applicants who want to proceed to federal court for further review of their case.