The Social Security Appeals Process
- Initial Application
The Social Security Application can be completed online at https://www.ssa.gov/applyfordisability/. To prepare to complete your online application, make a list of all your medical conditions and medications. Then list your medical providers with up to date contact information. This is the most important part of the application process. Social Security will request updated medical records. If they do not receive records or cannot reach your provider, you may be denied due to missing evidence. Unfortunately, only 36% of initial claims are approved.
For the best results, after you apply, gather your own medical records and submit them to Social Security directly. Social Security will ask you to complete two forms after you apply. They are called a Work History Report and a Function Report. The work history report details your jobs for the last fifteen years. The function report asks about your daily functioning from chores to hygiene to grocery shopping.
- Request for Reconsideration
After a Social Security Application is denied, you have sixty days to file an appeal. This appeal is called a Request for Reconsideration. To file a Request for Reconsideration, you must use forms SSA-561 and SSA-3441. Form SSA-561 is a simple one-page form that asks you to state your reasons for appealing. You can simply state that you disagree with Social Security’s decision and that you remain disabled.
In addition to form SSA-561, you also need to complete SSA-3441. This form is a disability report. To complete this form, you need to provide information about your updated medical conditions, treatment, test results, and hospitalizations. A new adjudicator will be assigned to your case and will issue a new decision. Unfortunately, at the reconsideration level only about 15% of cases are approved.
If a Request for Reconsideration is denied, you have sixty days to request a hearing. To request a hearing, you utilize form SSA-501. This is a one-page form that is very similar to SSA-561. Once this form is submitted, it can take 12-18 months to receive a hearing date. During this waiting period, no one from the Social Security Administration is actively reviewing your claim. The Social Security Administration often send you forms during the waiting period including a request for a video hearing, release forms, and updates on medical treatment. We always recommend that you decline video hearings and opt for an in-person option. It is important to provide Social Security with all the information that they request. You will receive notice of your disability hearing seventy-five days in advance.
When you receive notice that your hearing was scheduled you should immediately begin requesting updated medical evidence. You can access what Social Security has in their case file and request updated records. You should reach out to your treating providers for opinions about the severity of your conditions. You should also reach out your friends and family for letters of support.
On the day of your hearing, you should ask a friend or family to bring you. You should arrive at least thirty minutes early to ensure you have time to park and make it through security. The hearing process takes about one hour and is very informal. The hearing takes place in a conference room and is informal. The most formal part of the process is that you will be sworn in before you testify. The judge will speak with your representative to make sure that all of your medical records are up to date. Then the judge will ask you questions. The questions usually fall in three categories: background information and daily life, work and education history, and medical conditions, symptoms, and treatment. After the judge asks you questions, your representative may ask you additional questions.
After you answer questions, the judge will call a vocational expert to testify. This part of the process is the most commonly misunderstood. The vocational expert answers hypothetical questions that both the judge and your representative ask. They do not review your medical file and do not determine what work you can do. If a hypothetical set of limitations allows for jobs, the vocational expert will testify about which jobs are available based on the limitations posed by the judge and your representative. If the judge finds your limitations are so severe, the vocational expert may testify that you cannot work.
Unfortunately, almost all hearings conclude without the judge issuing a decision. If your case is denied, you can still appeal the judge’s decision.
- Appeals Council Review
If you receive an unfavorable decision, you have sixty days to request Appeals Council Review. To request review, you complete HA-520. This review process is an entirely written appeal and can take 12-18 months. During this time, the Appeals Council will not except any new evidence about your conditions. They will simply be reviewing the judge’s decision to determine whether or not the judge made a mistake in assessing the facts of your case or in applying the law.