The Social Security Disability Claims Process Stage 4: The Appeals Council

By Mark L. Newman, Cincinnati Social Security Disability Attorney

SSD Chart ProcessOf the millions of applications received by the Social Security Administration (SSA) each year, only 30% are approved at the initial stage of the application process. What happens to the remaining 70%? If you choose to move forward in order to receive Social Security Disability benefits, you must appeal the decision that was made during this initial stage. This is why understanding the application and appeal process can make this process of applying for benefits clearer and less stressful.

If you have been going through the long and tedious process of appealing your denied claim and you have also been denied at the hearing stage (Stage 3) of the appeal process, you still have a chance. The next stage of the appeal process is to go before the Appeals Council in hopes of having your Social Security Disability claim approved or at least looked at one more time.

Let’s look at how we arrived at this stage, Appeals Council, Appeal #3:

  • Your initial application request was denied, which happens to about 70% of the applications.
  • You asked for a reconsideration, 1st Appeal, and it was denied, which is usually the case (about 85 -90% get rejected at this stage).
  • You then asked for and received a hearing before an administrative law judge (ALJ) – the 2nd appeal in the process. The ALJ hearing results in approval for benefits for about 2/3rds of all disability claimants who follow the appeal process to the hearing level.
  • If you were in the 1/3rd group at the 2nd appeal stage that did not get approved, you will now find yourself at Stage 4, the 3rd appeal and Appeals Council. This is the last level of appeal before you have exhausted the appeals process through the SSA.

A few facts about this stage, The Appeals Council, of the disability claims process:

  • When denied at the hearing stage, you have 60 days to ask for a review by the Social Security Appeals Council.
  • The average time it takes to process an appeal with the Social Security Disability Appeals Council can be anywhere from six months to one year.
  • There is no guarantee that your appeal will even be heard for review. The Appeals Council does not review every case brought before it.
  • Only about 3% of the cases at this level are approved. So based on the low odds of having your case even reviewed, the odds are just as low to have your case approved.
  • The council does not review your actual disability claim. It only reviews the legality of the decision by the administrative law judge. In most cases, the Appeals Council will simply send you a letter stating that the appeal has been denied and will uphold the decision made by the administrative law judge.
  • The Appeals Council can decide to send your case back for another hearing or overturn the decision made by the administrative law judge and approve your SSD claim, if the Appeals Council finds:

o   The judge had made a technical error when reviewing your case, or

o   The judge failed to consider valid medical evidence during your Social Security Disability hearing, or

o   The decision made by the administrative law judge was made completely in error.

  • An appeal at this stage can be handled by you alone but claimants who request an appeal at this level without a lawyer’s help are most often denied.

After the long wait and your case gets denied at this stage, you will need to go on to file another appeal with the Federal District Court. This entails filing a lawsuit at the Federal Court level. If you do not yet have an attorney representing you in your disability claim, you should retain one for this portion of your Social Security Disability appeals process.

By Mark L. Newman | Twitter  | LinkedIn

If you have any questions about any of the information contained in this blog, contact Mark Newman via phone: 513-533-2009  or by email at mln@bpbslaw.com.  Advertisement Only

The Social Security Disability Claims Process Stage 3: Hearing

SSD Claims AppBy Mark L. Newman, Cincinnati Social Security Disability Attorney

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If you are thinking about filing for social security disability benefits it is important to understand the process. The cycle of an SSD claim can be quite lengthy so having a basic understanding of each step will be helpful. Last week I reviewed the second step. This article will review the third step. This stage is referred to as the Hearing or 2nd Appeal.

SDD Process Stage 3

If you receive a notice that your request for reconsideration of your Social Security disability claim has been denied (Stage 2) and you want to appeal again, you must request a hearing before an administrative law judge (ALJ). You have 60 days from the date of your denied reconsideration to request this hearing. You can see why this is a long process – appeals, 60 day deadlines, and more appeals.

How to Request a Disability Hearing in Front of an ALJ

There are three ways that you can apply to request a hearing in front of a judge:

  • Online
  • Sending in forms, or
  • Writing a letter to your local Social Security office

You must request a hearing in writing in one of the above ways.  Click here for more information.

When you request a hearing, your case will be reviewed by an ALJ, who are attorneys that work for the SSA’s Office of Hearings and Appeals. They can do one of three things:

  1. Approve your claim,
  2. Send your case back for review, or
  3. Deny your claim.

First, the good news. At this stage, about 67% of the claims are approved. However, the average length of time to go through this Stage 3 appeal is almost 12 months. Stage 3 can take a large amount of time to get to, but if you have the time, desire and assistance it also provides the highest chance of having your Social Security disability claim approved.

The Hearing

At the hearing, you appear in person and can argue why you deserve a medical-vocational allowance. The primary goal at this stage is to deny the claim or issue a favorable/partially favorable determination and award Social Security disability benefits to the claimant.

There are several items to note that are unique at a Level 3 hearing and why you should have a qualified disability attorney present with you at this level. This is a legal hearing and while less formal, there is still protocol to follow.

  1. You can and should be present, along with your attorney or representative, and you will testify regarding your condition. Your attorney can assist you in answering questions from the judge.
  2. Witnesses can be present, such as a doctor or other vocational experts, whom the judge will also question regarding your conditions. An attorney can cross-examine these witnesses.
  3. You can submit additional evidence, which should have been submitted within ten days of the date that you filed the request for a hearing. If you are not able to submit your new medical evidence within that time frame, you may request an extension from the ALJ to submit the new evidence.

After the hearing, the Administrative Law Judge will consider all the evidence and testimony presented and he or she will render an independent written decision, of which you will receive a copy within one to two months following the hearing date.If your claim is approved you will receive both a Notice of Decision and a Notice of Award. If your claim is denied, you can move to the next Stage – Appeal #3, the Appeals Council.

Are you starting to see why this process is so lengthy?

For more information, click here. Remember, working with a lawyer can help keep this process on track so you can get the disability coverage you deserve.

By Mark L. Newman | Twitter  | LinkedIn

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