Appeals

Articles

Once an applicant receives notice of a denial and decides to appeal the decision, SOAR case workers can help prepare and assist with the appeal. This article discusses how to file appeals online, using iAppeals. 

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. Appeals may also be necessary when we meet someone who has already applied and been denied or if we were not able to provide sufficient evidence for the initial application. This article reviews the several levels of appeals as well as suggestions for working with attorneys and other non-attorney representatives.

This packet combines articles from the SOARWorks website into one comprehensive resource about the Social Security Administration (SSA) appeals process. All articles can be accessed electronically at https://soarworks.prainc.com/topics/appeals

Here are some tips from the SOAR TA Center on assisting an applicant with a pending application or an appeal.

Online access to SOAR applicants’ electronic folders or eFolders (EFs) is now available for Appointed Representatives with ALJ hearing and Appeals Council level cases. 

The Social Security Administration (SSA) keeps all new disability files in electronic format. Applicants and authorized representatives have the right to obtain relevant application information on a CD-ROM. When you are preparing to appeal a denial of disability benefits, you should request the case file so that you can review key components of the file and decision.

To consider or prepare for an appeal after an SSI/SSDI denial, reading and understanding SSA denial notices and forms is essential. This article will explain the types of SSA notices and forms you should review and how to request copies from SSA when necessary. 

In addition to requesting an “On the Record” review, SSA has established a ‘Prehearing Review’ procedure which may a good opportunity for SOAR applicants to receive a decision without a hearing. Under this procedure, the Social Security Administration may only issue a revised determination if it is fully or partially favorable to the applicant.

Here are some FAQs about Continuing Disability Reviews (CDR) associated with the SOAR TA Center's 2014 Webinar, "SOAR Representation with CDRs."

SOAR Practitioners may use On-the-Record (OTR) requests to avoid lengthy waits for an ALJ Hearing. An OTR request asks Office of Hearings Operations (OHO) to consider approving a claim based on the documentation in the record without appearing before the judge.

SOAR TA Center Senior Project Associate, Pam Heine, worked for 12 years at Legal Services of New Jersey’s SSI Project, representing nearly 1,000 adults and children. She represented individuals at the Administrative Law Judge and Appeals Council stages, achieving a 97 percent approval rate. Her years of experience in the areas of developmental disabilities, mental health, public assistance and supported employment informed her work as a non-attorney representative. Pam is our content expert on using the SOAR model with SSI/SSDI appeals and provides some tips below.

Webinars

This webinar, held on June 22, 2016, is designed for SOAR practitioners to continue building their "ALJ Hearing Toolbox."

This webinar, held on Thursday, June 25, 2015, provided the tips and tools necessary to understand SSA’s Administrative Law Judge (ALJ) hearing process. 

This webinar, held on August 28, 2013, describes the SSA Appeals process and how to utilize SOAR when assisting applicants with their appeals.

Issue Briefs

This issue brief, developed by the SAMHSA SOAR TA Center, provides basic information and practical tips on assisting with appeals for applicants who have been denied at the initial application level.

SOAR Voices Blogs

Effective Hearing Argument: Telling Your Applicant’s Story

How can you make compelling opening statements, ask thought provoking questions, and carry your theory of the case (i.e., why you think the applicant is disabled ) from start to finish? Think back to the process of writing the medical summary report (MSR).

A little over a year ago, as part of an upgrade to iAppeals, the Social Security Administration (SSA) began a practice called “single-submission.”  The SOAR TA Center recommends not only filing initial applications online, but also reconsideration and hearing appeal paperwork too. You can actually submit the SSA-1696 and medical documents online! Not only are you sending in a complete appeal application, you are expediting the disability determination process at the appeals level too. However, there are some slight variations with filing appeals online.

FAQs