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About Appeals

While we do our best to help eligible individuals get approved on the initial application, sometimes the application is denied and we need to help someone through the appeals process. This article provides an overview of the several levels of appeals and the steps to take to file an appeal. 

 
Effective October 1, 2017, the Office of Disability Adjudication and Review (ODAR) changed its name to the Office of Hearings Operations (OHO). The Appeals Council is now housed within the Office of Appellate Operations under the newly established Office of Analytics, Review and Oversight (OARO).

SSA Appeal Levels

If Social Security denies an application for disability benefits, the applicant may request an appeal. Social Security has four appeal levels:
  • Reconsideration
  • Hearing before an Administrative Law Judge
  • Appeals Council and Federal Court

Reconsideration

  • Reconsideration is an opportunity to have the application reviewed by different staff at Disability Determination Services (DDS) and to submit additional medical records and evidence.
  • 10 states (New Hampshire, New York, Louisiana, Colorado, California (LA North and West Branches), Pennsylvania, Alabama, Michigan and Alaska) that participated in the Disability Redesign Prototype have reinstituted reconsideration as of March 2020

Review the Initial Denial

  • Read the denial notice and record the following information. Confirm that it matches your records.
    • Date on notice
    • Type of claim
    • Medical Sources listed
  • Request a copy of the electronic file.
  • Carefully review the file to help you understand what went wrong and provide the basis for a Reconsideration.

Submit the Reconsideration Request

  • The request can be submitted in-person or online via iAppeals (recommended).
  • The request for reconsideration must be filed within 60 days of receipt the initial denial notice. (The 60-day period begins 5 days after the date on the denial notice, to allow for mailing time).
    • Late Filing: If the 60-day deadline is missed, you will need to submit a “Good Cause for Late Filing” request along with documents listed below to your SSA field office. This request can serve as a protective writing date (to establish a protective filing date) for a new initial claim if the applicant does not establish good cause for late filing.
Submit In-Person
​Submit On-line via iAppeals (Recommended)
  • Go to https://secure.ssa.gov/iApplsRe/start (see Filing Online with iAppeals for further information).
  • Submit the following:
    • i561: Request for Reconsideration
    • i3441: Disability Report – Appeal
    • e827: Authorization to Disclose Information to SSA
    • iAppeals Application Utility for Attachments (e.g. SSA-1696, Medical Records, new/revised MSR and other documents)

Hearings before an Administrative Law Judge (ALJ)

  • The second level of appeal is a hearing.
  • Hearings are scheduled with the Office of Hearings Operation (OHO).
  • You do not need to be an attorney to assist someone at a hearing.
  • It can take on average one year for the hearing to be scheduled

Review the Reconsideration Denial

  • Read the denial notice and record the following information. Confirm that it matches your records.
    • Date on notice
    • Type of claim
    • Medical Sources listed
  • Request a copy of the electronic file.
  • Carefully review the file to help you understand what went wrong and provide the basis for an appeal.

Submit the ALJ Hearing Request

  • The request can be submitted in-person or online via iAppeals (recommended).
  • The request for a hearing must be filed within 60 days of receipt of the reconsideration denial notice. (The 60-day period begins 5 days after the date on the denial notice, to allow for mailing time).
    • Late Filing: If the 60-day deadline is missed, you will need to submit a “Good Cause for Late Filing” request along with documents listed below to your SSA field office. This request can serve as a protective writing date (to establish a protective filing date) for a new initial claim if the applicant does not establish good cause for late filing.
Submit in-person
​Submit On-line via iAppeals (Recommended)
  • Go to https://secure.ssa.gov/iApplsRe/start (see Filing Online with iAppeals for further information).
  • Submit the following:
    • i501:Request for Hearing by Administrative Law Judge (ALJ)
    • i3441: Disability Report – Appeal
    • e827: Authorization to Disclose Information to SSA
    • iAppeals Application Utility for Attachments (e.g. SSA-1696, Medical Records, new/revised MSR and other documents)
 
**Take a look at our sample completed appeal forms in the SOAR Library!
 
Key tip: SOAR Practitioners may use "On-the-Record" requests to avoid lengthy waits for an ALJ Hearing.  Check out this article for more information.

Appeals Council and Federal Court

The third and fourth levels of appeal are less common.  If the applicant disagrees with the decision made by the administrative law judge, they can ask for a Review by Social Security’s Appeals Council. If the applicant disagrees with the decision by the Appeals Council, they can file a lawsuit in Federal district court.
 

Other Considerations

When to File an Appeal

Cases should be appealed if the applicant:
  • Meets a Listing, or
  • Equals a Listing, or
  • Has a combination of severe impairments which would preclude the completion of sedentary work, or any work in the national economy

Communicating with the Applicant

  • The review of the denial of initial application and reconsideration should be completed as soon as possible.
  • You will need to inform the applicant if you will not be able to assist with further appeals but be sure to inform the applicant of their right to appeal.
  • Share the “SSA Appeals Process” document with the applicant. 

Working with Attorneys and Non-Attorney Representatives

Attorneys or non-attorney representatives can be excellent advocates for individuals applying for benefits and appealing denials. 
  • If a representative is already involved with an appeal, see if you can help by providing additional evidence or documentation
  • If an applicant wishes to dismiss their representative, they are permitted to do so
  • The representative may file a fee petition to SSA and, if benefits are awarded, receive partial payment based on work already completed at the time of withdrawal
 
For more in-depth information about using SOAR with appeals, see our issue brief: Effective SOAR Representation for Social Security Appeals and Pam's Tips for Appealing Decisions.