Attorney David J. King


What does an SSDI benefits appeal involve?

On Behalf of | Dec 5, 2023 | Social Security Disability

Someone who is applying for Social Security Disability Insurance (SSDI) benefits is probably already in a difficult situation. They likely have substantial health challenges and no way to work. Someone’s health issues won’t stop lenders from expecting them to make payments on their mortgage and credit card balances. Without outside help, someone with a disabling medical condition would be at risk of poverty and even homelessness.

SSDI benefits are a crucial social safety net for those not old enough to retire and not capable of continuing to work to support themselves. People submit applications and medical records when seeking benefits. The Social Security Administration (SSA) reviews every application carefully.

Proper execution of paperwork and adequate medical documentation will both be crucial to someone obtaining benefits when they initially apply. A large percentage of applicants do not get benefits and may have to appeal. What can applicants expect during the appeals process?

The first stage is a reconsideration

There are multiple different types of appeals available to those seeking SSDI benefits. The first step is a reconsideration. This is a largely internal process performed by the SSA. The applicant can correct any mistakes on paperwork and submit additional medical records prior to the reconsideration. Different SSA workers than those involved in the initial claims processing will review the application and any additional materials the applicant submitted. Sometimes, a reconsideration results in the determination that the original denial of benefits was improper. Other times, reconsideration will not be successful, and the applicant will need to request a hearing.

An administrative hearing is the second step

Administrative law judges help evaluate SSDI benefits appeals. They look at the application, the reason for the original rejection and the additional documents submitted. Occasionally, they will also hear testimony from those with an expert opinion that could impact the validity of a claim. Appeals hearings do sometimes result in a judge determining that the applicant qualifies for benefits. Other times, the judge may affirm that the SSA made the right choice. After an appeal hearing, individuals can potentially ask for a review of the hearing decision with the Appeals Council. After that, the only remaining option would be to file a federal district court action.

Seeking legal guidance and learning about what to expect during the SSDI benefits appeals process may ultimately help people feel more confident about continuing to seek benefits despite an initial rejection.