The Social Security Administration receives a large number of applications every year, and as such they need to be diligent about which ones they accept and which ones they can deny. This system is far from perfect, and as such a legitimate claim may be denied thanks to a mistake or miscalculation, resulting in a denial of benefits that you may have significant need for. However, just because your claim has been denied doesn’t mean you should give up hope: you may be able to appeal the denial and have your claim accepted. Let’s take a closer look at the appeals process.
Request an Appeal
You must request an appeal in writing within 60 days of receiving notice that your claim has been denied. Requesting the appeal is done using Form SSA-561 which is available online or from your local Social Security office.
The first step is known as “reconsideration” and simply asks the Social Security Administration to have someone who was not involved in the initial decision review your case along with all previous and new evidence submitted in order to issue a new decision.
If the reconsideration request also doesn’t go your way, you can take things a step further and request a full hearing before an administrative law judge who had no part in either the original decision or reconsideration. At the hearing, the judge will question you and any witnesses you bring such as medical or vocational experts. You may also have a Sacramento workers’ compensation attorney with you, and it’s strongly advised that you do. After your hearing, the judge will issue a new decision based on all of the information in your case, which includes any new information you provide at the hearing.
If that isn’t successful, you have a further option still by asking your case to be reviewed by the Social Security Appeals Council. The council looks at all requests for review, but may rule that the appeal decision was correct the first time and deny the appeal. If they do decide to review your case, it will then either decide your case itself or return it back to an administrative law judge to be reviewed again.
Finally, if the appeals council denies your case, you can escalate it by filing a lawsuit a federal district court. This can take a while to resolve and there is no guarantee that a lawsuit will mean your case will be accepted. It’s strongly advised you consult with a lawyer before taking this option to find out if it’s prudent for you to do so.