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What happens after your SSA disability case is denied at the Administrative hearing?

Up to 60% of disability claimants are denied at the Administrative Hearing level. If you wish to pursue your disability claim, you have several options.

The Social Security Administration has created an appeals process which allows Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) claimants to appeal their disability denial decisions multiple times. What if you claim is denied at the administrative hearing level? You can request a review of the disability denial by the Appeals Council.

Request a review with the Appeals Council

A request for an Administrative Council review must be made within 60 days from the date of the denial letter. If an appeal is filed with the Appeals Council they will review each request but have the choice to grant, deny or dismiss the case. The Appeals Council has the following options:

• Deny the request for a review if it believes the hearing decision was correct
• Grant the review and evaluate the case themselves OR Remand the case back to the Administrative Law Judge who initially reviewed the Social Security Disability case and made the denial decision

The SSA will send you a copy of the Appeals Council final review for your disability claim.

Who are the Appeals Council?

According to the SSA, “The Appeals Council is made up of approximately 53 Administrative Appeals Judges, 59 Appeals Officers, and several hundred support personnel. The Appeals Council is physically located in Falls Church, Virginia, with additional offices in Crystal City, Virginia, and in Baltimore, Maryland.“ The Appeals Council looked at approximately 128,000 requests for review in fiscal year 2010.

Filing a Federal Court Case

If the Appeals Council refuses to review your case or if they review it and you are denied again, your only recourse is outside of the Social Security Administration appeal process. A request for an Appeal Council review is the final step appeal within the SSA disability determination process.

The next step, if you want to continue to pursue your claim, is to file a civil case in federal district court. According to the SSA, they received 12,257 new civil actions during last fiscal year (October 2009 - September 2010).

Will the SSA help with the civil suit? The SSA states that they are, “responsible for gathering the information they used for their disability decision and putting this file together for the court.” There are very specific deadlines for requesting a court hearing. If you have not hired a disability lawyer at this point; it is time.

Hiring a Disability Lawyer

Whether you are filing a review with the Appeals Council or a federal case in court, get ready to wait. The processing time to have the Appeals Council hear your case can be as high as 300 days.

If you have been denied multiple times, it is time to talk to a disability lawyer. Unfortunately, because of the challenge of winning an Appeals Council case, many disability lawyers are hesitant to take cases at this level, especially if they have not been involved with the case from the beginning.

Some, but not all disability lawyers will advise you to apply again rather than appeal to the Appeals Council. Other disability lawyer may, however, welcome the challenge.