The Five Levels of SSDI Application Denial Appeals

If your Social Security Disability Insurance benefit (SSDI) application is denied, there are a number of instructions that you will need to follow which are included in your notice of denial letter.  As the Social Security Administration’s (SSA) letter indicates, the first step you can take once your application is denied is to file a Request for Reconsideration.  Should this request fail, there are additional measures you can pursue in order to challenge the SSA’s denial decision.  These measures are as follows:

  1. Request for Reconsideration of Initial Claim.  As mentioned above, this is the first step that an applicant can take to challenge a denial of his or her SSDI application.  A reconsideration request is actually a complete review of one’s case, which is completed by a medical consultant and SSA claims examiner. Keep in mind that this process is completed at the Disability Determination Services (DDS) level by parties who were not involved in the review of your initial claim.  Overall, about 5% of applications are approved by the DDS when reconsidering claims.
  2. Request for Reconsideration of Ongoing Benefits.   In the event that your application is approved, the SSA periodically reviews current cases in what is known as a continuing disability review (CDR).  A SSDI recipient’s benefits may be terminated should their condition substantially approve or if they fail to cooperate with the SSA during its CDR process.
  3. Administrative Law Judge (ALJ).  Should your Request for Reconsideration be denied and you wish to pursue your case further, you must request a hearing by an ALJ within 60 days after you receive your notice of denial letter.  An ALJ is a lawyer who works for the SSA’s Office of Hearings and Appeals.  On average, about 67% of appeals are approved after being reviewed by an ALJ.
  4. SSA Appeals Council.  Should your case be denied by an ALJ during your administrative hearing, the SSA’s Appeals Council may review your case however, said decision is subject to their discretion.  The Appeals Council typically examines whether a case was denied in error by the ALJ.  Unfortunately, only about 5% of cases are approved by the Appeals Council should they choose to examine your case.
  5. Federal Court Review.   If your case is denied by the Appeals Council, your final option is to file a claim with the federal district court in your jurisdiction.  District court judges review benefit denial cases for legal errors, but may also rule on factual questions as well.   Unfortunately, only 1% of cases prevail at this level.

If you require assistance in applying for SSDI benefits or appealing a denial decision by the SSA, contact the Sanger Law Office at 785-979-4353.  We will take the time necessary to evaluate your case and advise you of all of your legal options.  Don’t wait until it is too late to obtain the benefits you deserve.