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What is the appeal process for a SSA decision?

Rejecting a claim for Social Security Disability or Supplemental Security Income may be financially life-altering. Fortunately, claimants have the right to timely appeal these decisions.

If an Social Security disability application was denied, a claimant must make an appeal request within 60 days from receiving the SSA's decision letter. The SSA assumes that a claimant received the letter five days after the date posted on its letter.

First, a claimant may seek reconsideration by someone who was not involved in the first decision. Normally, reconsideration includes a review of the file without the claimant being present. The claimant can meet with a SSA representative and explain that the disability still exists when benefits are denied because of an improved medical condition.

If a claimant disputes the reconsideration decision, a hearing may be requested before an administrative law judge. The hearing is usually held within 75 miles of the claimant's home or through a video conference. Claimants may explain their case at this hearing. The ALJ, the claimant, or the claimant's representative may question witnesses.

After the hearing, the judge will issue a decision based on all the information in the claimant's case. A copy of this decision is sent to the claimant.

A claimant can seek review of the ALJ's by the Social Security Appeals Council. The Council can refuse to review a case if it finds that the hearing decision was correct.

If it reviews the appeal, the Council will decide the case or return it to the ALJ for further review. The Council's decision will be mailed to the claimant. A claimant may then file an appeal of the Council's decision on the merits or on not reviewing the case to a federal district court.

A claimant can ask for continuance payment of SSD benefits continue to pay benefits during appeals concerning the denial of disability benefits because the medical condition is not disabling, or because the claimant is now ineligible for SSI payments or that these payments should be reduced or suspended.

SSA must be informed within 10 days of the denial letter for benefits to continue. If the appeal is turned down, a claimant may have to repay ineligible benefits.

A person may utilize a representative, such as an attorney, during these appeals. Legal representation can help assure that the rights to these benefits are preserved.

Source: Social Security Administration, "The appeals process," Accessed Nov. 30, 2015

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