Step 4 of SSDI Reconsideration – Appeals Council Review
Of 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. So, what happens to the remaining 70%?
If you choose to move forward in the Social Security Disability Insurance claims process, you must appeal the decision that was made during this initial stage. Understanding the application and appeal process can make this process of applying for benefits clearer and less stressful, which is what we hope to do here.
If you have been going through the long and tedious process of appealing your denied disability claim and you have also been denied at Stage 3, your SSDI Hearing, 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.
In this article, Cincinnati SSDI attorney Mark Newman will cover Stage 4 of the SSDI Reconsideration Process – The Appeals Council Review.
What is Step 4 of Disability Process?
Let’s look at how we arrived at this stage of the SSDI process:
- Your initial application request was denied, which happens to about 70% of the applications.
- You submitted a request for reconsideration (Stage 2: Reconsideration Level or First Appeal) and it was denied, which is usually the case about 85 -90% of the time.
- You then asked for and received a new hearing before an administrative law judge (ALJ) – the Second Appeal in the process. This ALJ hearing generally results in approval for benefits for about 2/3rds of all disability claimants.
- If you did not get approved at the SSDI hearing level, you will now find yourself at Stage 4: the Third Appeal and Appeals Council. This is the last level of appeal before you have exhausted the appeals process through the SSA.
What Happens at an SSDI Appeals Council Review?
It’s important to understand that during this time, 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.
However, 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:
- The judge had made a technical error when reviewing your case,
- The judge failed to consider valid medical evidence during your Social Security Disability hearing, or
- The decision made by the administrative law judge was made completely in error.
How to File an Appeal for Disability
To file an appeal at the 4th stage of the SSDI reconsideration process, you must submit a request for review to the Appeals Council. This request must be in writing and include Form HA-520, which you can complete online or by mail.
Be sure to include any additional evidence that supports your case, such as updated medical condition records or documentation not previously considered by Disability Determination Services (DDS) or the administrative law judge.
You should also clearly outline why you believe the prior decision was incorrect. Submitting a thorough and well-prepared appeal is crucial, as this stage determines whether your case is returned for further review or if you can proceed to maintain your pursuit of continued benefits.
How Many Times Can You Appeal Disability?
You can appeal a denial for SSDI benefits up to four times within the appeals process. If you disagree with the initial decision, you can request a reconsideration. If denied again, you can request a hearing before an ALJ. If the hearing results in a denial, you can appeal to the Appeals Council.
Finally, if you disagree with the Appeals Council’s decision or if they decline to review your case, you can file a lawsuit in federal court.
How Long Does a Disability Appeal Take?
When denied at the hearing stage (Stage 3), you have 60 days from the hearing date to ask for a review by the Social Security Appeals Council. The timeframe of the actual appeals process can vary depending on the complexity of your case, the backlog of cases at the council, and whether additional evidence is submitted for review.
While waiting, it’s important to stay updated on the status of your appeal and continue managing any medical or financial documentation related to your claim.
How Long Does it Take to Get a Decision From the Appeals Council?
There is no guarantee that your appeal will even be heard for review. The Appeals Council does not review every case brought before it.
However, the average time it takes to process an appeal and receive a decision can be anywhere from six months to one year.
What Percentage of SSDI Appeals are Approved at This Stage?
Unfortunately, only about 3% of applicants are approved at this level. So based on the low odds of having your case even reviewed, the odds are just as low to have your case approved.
It’s important to note that 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.
Denied Disability Benefits? Call Cincinnati SSDI Attorney Mark Newman Today
After the long wait, if your case is denied at this stage, your next step is to file another appeal with the Federal District Court. This involves filing a lawsuit at the federal level to challenge the outcome of your Social Security Disability claim. At this stage, it is crucial to present your case effectively, as the court will review whether the Social Security Administration’s Office of Hearings and Appeals made an error in its decision.
To improve your chances of being found eligible and entitled to benefits, having an Ohio Social Security attorney by your side is essential. An experienced attorney like Mark L. Newman can help explain the appeals process and what you can expect during this phase while ensuring all necessary documents are filed correctly to help you obtain the SSDI benefits you deserve.
Contact Mark L. Newman today to see how he can assist you at this critical stage, as well as in earlier stages, of the appeals process. Call (513) 533-2009 or reach out online to set up a consultation.
