Social Security disability appeals

A denied Social Security disability claim can be appealed through four levels: reconsideration, a hearing before an administrative law judge, Appeals Council review, and a civil action in federal court. At each level you generally have 60 days from receiving the decision to file, and most claims never need all four.

The same steps apply to SSDI and SSI. Below is what happens at each level, the deadline that comes with it, and where we fit in.

The four levels of appeal

You move to the next level only if you disagree with the decision at the one before. SSA notes that you may not have to go through all of them. For many people, the hearing is the step that matters most.

Reconsideration

Reconsideration is the first appeal. For a medical denial, an examiner at Disability Determination Services in your state reviews your request and your original application, along with any new evidence you send.

To request it, you file a request for reconsideration (form SSA-561) and an appeal disability report (form SSA-3441), plus a signed medical release (form SSA-827) for each new medical source. SSA accepts these online through its appeals site. A representative can file them for you.

Reconsideration is still a paper review. You do not meet the examiner. That is why it matters what goes into the file: updated treatment records, any new diagnoses or tests, and a clear account of how your condition limits your work.

Hearing before an administrative law judge

If reconsideration is denied, you can ask for a hearing before an administrative law judge. You can request it online or with form HA-501.

The hearing is the first time someone deciding your claim hears from you directly. You testify under oath. The judge may call a vocational expert or medical expert, and your representative can question them. SSA requires written evidence to reach the hearing office no later than 5 business days before the hearing, with narrow exceptions.

SSA sends notice of the hearing date, time and format at least 75 days in advance. Hearings may be held by online video, by phone or in person. The judge then issues a written decision based on all the evidence. Read more about hearing representation, or look up SSA data for your office on hearing offices.

Appeals Council review

If you disagree with the judge’s decision, you can ask SSA’s Appeals Council to review it, online or with form HA-520.

The Appeals Council reviews the judge’s decision and the record. SSA says it may:

• Deny review, if it finds the judge’s decision was correct.
• Decide the case itself.
• Send the case back to an administrative law judge for another look.

It can consider any issue the judge decided, including issues decided in your favor. You can submit additional evidence with your request.

Federal court review

If the Appeals Council denies review or rules against you, the last step is a civil action in a U.S. district court. You have 60 days after receiving the Appeals Council’s notice to file. There is a court filing fee, and SSA prepares the claim record for the court.

Federal court is outside the work we handle. Our representation covers the SSA levels: the initial application, reconsideration, the hearing and the Appeals Council.

Appeal deadlines you cannot miss

The 60-day deadline is the most important rule on this page.

• When the clock starts. The 60 days run from the date you receive the notice. SSA assumes you received it five days after the date printed on it, unless you show it came later. That generally gives you about 65 days from the letter date.
• What a missed deadline costs. If you miss it, the decision can become final. You may then have to start over with a new application, which can mean a later filing date.
• Good cause. You can ask in writing for more time and explain why you were late. SSA extends the deadline when you show good cause. Examples in SSA’s rules include serious illness, a death or serious illness in your immediate family, records destroyed by fire or accident, and never receiving the notice. SSA also considers physical, mental, educational and language limitations.
• Two other dates at the hearing stage. Evidence is due 5 business days before the hearing. If you object to appearing by phone or agency video, you must object in writing within 30 days after receiving the notice SSA sends about it.

Good cause is decided case by case. If you are near your deadline, file the appeal now and add evidence afterward. If your claim was just denied, start with what to do after a denial.

How we build an appeal

An appeal succeeds or fails on the record. Here is how we approach it.

1. Protect the deadline. We confirm the date on your notice and file the appeal on time.
2. Read the denial closely. The notice says why SSA denied the claim. We find the specific gaps behind that reason.
3. Gather what is missing. We request records from your treating providers and help you obtain statements that describe what you can and cannot do.
4. Keep the file current. We send new evidence as treatment continues, so the reviewer or judge sees your condition as it is now.
5. Prepare you for the hearing. We go over the questions the judge is likely to ask and what the vocational expert may say.
6. Review a bad decision. If the judge denies the claim, we look at whether an Appeals Council request is worth filing.

Our disability advisors handle Social Security disability claims only. There is no fee unless you win, and SSA sets and approves the fee. See who your representative is or check who qualifies.

Common questions

Can I submit new medical evidence when I appeal?

Yes. New evidence is often what changes the outcome. At the hearing level, it must reach the hearing office at least 5 business days before the hearing, with limited exceptions.

What if I missed my appeal deadline?

Ask SSA in writing to extend it, and explain why you were late. SSA grants an extension only if you show good cause.

Do I need to go through every level?

No. Many claims are decided at reconsideration or at the hearing. You move on only if you disagree with the decision at the level before.