The
4-Levels of Appeals
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After you have filed your Initial Application for benefits with the Social Security Administration it may take between several weeks to several months to receive your decision. If you disagree with the decision that you receive you have the right to appeal that decision. Keep in mind that once a decision is received you have 60-days in order to appeal it. Social Security will assume that you receive the decision within 5-days of the date listed on the decision itself. If the 60-day period ends on a Saturday, Sunday, or national holiday the 60-day limit will be extended to the next workday. It is very important that you appeal within the 60-day time frame or else the decision will become final and you will be unable to appeal it. If there is a good reason for missing the appeal window Social Security may give you more time, however, you must request for it in writing and explain the reason for failing to appeal in time. Social Security may deny that request if the reason is not good enough. Because of this it is always a good idea to appeal within the 60-day time frame to avoid any potential issues.
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In terms of Appealing there are essentially 4-Levels of appeals that are available to you. These levels include:
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Reconsideration
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Hearing
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Appeals Council Review
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Federal Court Appeal
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It is very important to obtain representation when you are Appealing a Social Security Disability Decision at any level. Statistics have shown that you have a significantly higher chance of success when you have representation.
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Call Lemmens & Norcross today and get an expert by your side! 616-210-3403
New Application or Appeal?
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The first question is whether you should file a new application or appeal the current one. You do have the right not to file an appeal and in the alternative to simply file a new application instead. While this is an option available to you it is not the same as appealing a prior decision and can have significant legal ramifications on the type/amount of benefits you may be eligible for, the amount of backpay you may be entitled to, and the medical evidence social security will be reviewing, your right to continued benefits during the appeal, Last Date Insured issues that may occur as a result, and other potential consequences.
Reconsideration
1st Level of Appeal
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The first appeal after the initial application is called Reconsideration. A reconsideration is a review by Social Security by an individual who did not take part in the initial decision. This essentially will allow a fresh set of eyes to look at the original decision, medical evidence the decision to based on, and any other information you provided to them to either uphold the original decision or to reverse it. Once that decision is made they will send you a letter with the result of the Reconsideration. When appealing this sort of a medical condition decision the process Social Security will use is called Case Review. In this process they look at your case without meeting you. If you are appealing a decision that is something other than a medical decision the Social Security Administration will use a process called an Informal Conference. This means that you can see your file, provide more information, and have a conference with the reviewer to explain why you think the original decision was incorrect. There is also a Formal Conference that is available for those whose payments have been changed or stopped. This allows witnesses and Social Security can also require witnesses to appear before them.
Hearing
2nd Level of Appeal
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The 2nd Level of Appeal that takes place after the Reconsideration is called a Hearing in front of a Social Security Administrative Law Judge. Again, this appeal must be made within 60-days of the Reconsideration Decision. In a hearing you are allowed to provide additional evidence, medical documentation, and witnesses. Additionally, you will be provided with the opportunity to testify yourself in front of the Judge as to your condition, how it is affecting you, vocational information, why you disagree with the decisions thus far, and other pertinent information that they will need to make a decision.
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These hearings can be in person or by Video Telephone Conference (VTC). An in-person hearing will typically be held within 75-miles of your home. You will receive a Notice of Hearing informing you of the date, time, and place of the Hearing. A VTC Hearing is a hearing where the Judge and you are in different locations, but you can still see each other and speak with one another like you would an in-person hearing. VTC Hearings can often times be scheduled quicker then an in-person hearing as you would not have to wait for a Hearing Time Slot to become available at a Social Security Hearing Office within 75-miles of your home.
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lf you are unable or unwilling to attend a hearing Social Security requires that you inform them in writing as to the reason. The Administrative Law Judge may requiring you to be there anyway, make other arrangements for the hearing, or make a decision without a hearing.
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After the Hearing the Judge will send the decision to both you and your representative if you have one. The decision can take anywhere from several weeks to many months to receive.
Appeals Council Review
3rd Level of Appeal
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If you disagree with the decision made by the Administrative Law Judge you have the option to appeal to the Appeals Council. The Appeals Council may do one of three things. One, they may deny your request for review or deny you benefits. Two, they may make a positive decision in your case on their own. Three, they may remand the case back to the Administrative Law Judge with instructions.
Federal Court
4th Level of Appeal
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At the 4th Level of Appeal it is an appeal up to the Federal Court. This level of appeal can only be made if you disagree with the Appeals Council Decision or the Appeal Council decided not to review your case. At the Federal Court level in many instances the court will make a decision based on briefs filed by your representative and counter briefs by the Administration. In some cases the court may require or request you present yourself to make arguments based on the law and the medical record.
