Serving Eastern North Carolina Since 1981

What Happens If You Are Denied Social Security Benefits?

If you are denied Social Security benefits, you will need to file an appeal. The Social Security Administration (SSA) denies nearly half of all applications for disability benefits. Nevertheless, an initial denial does not mean the process is over, as there are four levels of appeal if you do not agree with the SSA’s decision.

Most people who recover Social Security benefits do so after filing at least one appeal. If you are denied Social Security benefits, you should appeal, too.

The four levels of appeal include:

  • Reconsideration
  • Hearing by an administrative law judge
  • Review by the Appeals Council
  • Federal Court review

Keep reading to learn more about each one – and when it may be helpful to contact an attorney.

Reconsideration

When the SSA denies your claim, it sends you a letter explaining its decision. If you do not agree with the decision, you must submit a request for reconsideration within 60 days. You will need to use the Form SSA-561, Request for Reconsideration (opens a PDF in a new window).

At this stage, you may not need an attorney, but it can be helpful to start talking to one. If your claim is denied again, you will need to request a hearing before an administrative law judge, and you will want an attorney by your side during this process.

A good lawyer can also review your request for reconsideration and help you present any new evidence you have to offer. Still, you should be prepared for another denial. Unless you have had a major surgery or can present additional evidence of disability, you will likely need to progress to the next level of appeal.

Hearing

If you receive another denial, you will need to request a hearing before an administrative law judge within 60 days. You can do so by completing the Form HA-501, Request for Hearing by Administrative Law Judge (opens a PDF in a new window). If you are appealing a claim for disability benefits, you may have to fill out and sign additional forms, as well.

At this stage, you should also appoint a representative and submit new evidence at least 5 days before your scheduled hearing. If you appoint a representative, you will have to fill out a special form, but your lawyer can help.

You and your lawyer can ask the judge to make a decision based on the evidence in your file, or you can appear in person, by video teleconferencing, or by telephone at the appointed date, time, and location. Make sure the details work for you and your attorney because if you fail to attend the scheduled hearing, you may lose your right to appeal and recover benefits.

Before your hearing, the judge may ask you to complete medical exams or tests, which the SSA will schedule and pay for. The judge may also ask witnesses to testify at the hearing, and as long as you ask the judge 10 business days before your hearing, you and your lawyer can call witnesses, too.

While you prepare for your hearing, it is important to gather evidence and meet deadlines. During your hearing, you will present the case you prepared and all admissible evidence.

You are not required to have an attorney, but the judge will recommend you consult a lawyer to help you with your case.

Review by the Appeals Council

After your hearing, the judge will send you and your lawyer a copy of the hearing decision. If you are still unsatisfied with the SSA’s conclusion, you can submit your case to the Social Security Appeals Council by filling out Form HA-520, Request for Review of Hearing Decision/Order (opens a new window).

You must request your appeal within 60 days. From there, the Appeals Council will examine your case and grant, deny, or dismiss your request for review. If the Appeals Council finds the hearing decision is in accordance with social security law and regulations, it may deny your request for review. If the Appeals Council decides to review your case, it will either decide your case or return it to an administrative law judge.

Whether you disagree with the Appeal Council’s final decision, or the Council decides not to review your case, your only remaining option is a lawsuit.

Federal Court

Although the SSA can help you complete every other phase of the review process, once you file a civil suit in federal district court, you will need to contact an attorney.

You must file your lawsuit within 60 days and adhere to all the rules and regulations of the District Court.

Once you have presented your case, the District Court may send the case back to the SSA, order an administrative law judge to hold a new hearing and issue a new decision, award benefits, or dismiss the case.

For more information about filing a lawsuit in federal court, you will need to talk to a lawyer or legal help group that has experience in this field.

Get Help with Your Social Security Claim

You can build your case for Social Security disability benefits before or after an SSA denial. Davis, Murrelle & Lyles, P.A. is ready to help you create the strongest possible case at the earliest stages of your Social Security claim. Our firm has more than 50 years of collective legal experience, offers personalized attention and care, and Attorney Martza J. Majstoravich has a special focus on Social Security Law. If you’re worried about cost, know that our firm will not charge legal fees unless we recover benefits for you.

To speak to Attorney Majstoravich during a free consultation, please call us at (252) 512-5909 or online.