Health & Benefits

You have the right to appeal almost any decision that the Social Security Administration (SSA) makes. If the SSA denies your application for benefits, you can appeal the decision. If the SSA reduces or terminates your benefits, you can appeal the decision. Reducing your benefits means that your benefits are lowered. Terminating your benefits means your benefits are ended. 

Your first appeal is called a "request for reconsideration." If you appeal, you have 65 days from the date on the decision notice to request the reconsideration.

If you appeal because SSA is reducing or terminating your benefits, try to appeal within 15 days of the date of the notice. In your appeal, ask to keep your benefits going during the appeal. If you miss the 15 day deadline, you still have the full 65 days to file your appeal, but your benefits will be reduced or stopped while the appeal is going on.

When you ask for reconsideration, the SSA will review your claim again. 

If you are appealing because Social Security has said that you are not disabled, your case will be reviewed in Springfield at the same office that looked at your original claim. That office is called the Bureau of Disability Determination Services. You have the right to send in more evidence. In fact, if you do not send in more evidence, especially medical evidence, you probably will not win the reconsideration.

If you are appealing because the SSA says your medical condition has improved and you are no longer disabled, you have the right to meet with the SSA staff for a hearing. You will then explain why you believe you still have a disability.

If the SSA says it is lowering your benefits, you will probably meet with someone at the local SSA office to talk about your appeal. There are many reasons that the SSA might have for lowering your benefits.

You have the right to get a written decision about your reconsideration request. The SSA is usually good about putting their decision in writing, but if your reconsideration is with someone at the local SSA office, you might have to ask for a written decision. Be polite but firm.  

If you lose the reconsideration, do not give up. You have the right to appeal again. You have a better chance of winning if you stay in the appeals process than if you give up and start again later. The next appeal step after reconsideration is asking for a hearing with an Administrative Law Judge (ALJ).

You have 65 days from the date on the reconsideration decision to appeal. You must make a written request for an ALJ hearing. 

If you are appealing the SSA’s decision to reduce or terminate your benefits, try to file the appeal within 15 days of the date of the reconsideration decision. That way, you can ask to keep your benefits going until the ALJ makes their decision.

NOTE: The ALJ hearing is usually the most important step in the appeals process. The ALJ hearing is your best chance to give evidence to show you are disabled. It is your best chance to make legal arguments for your case. You can meet in person or by video with the ALJ. You always have the right to represent yourself with the ALJ, but it is best to have an attorney or paralegal who is familiar with Social Security law represent you at this important step.

To find a lawyer in your area, go to Get Legal Help. There, you can find out if you qualify for free legal assistance, and if there is a legal aid program in your area. The National Organization of Social Security Claimants' Representatives (NOSSCR) can also help connect you with a disability representative through their referral service at (845) 682-1881. 

If you lose the Administrative Law Judge (ALJ) hearing, you can appeal again. This time you would appeal to SSA's Appeals Council. You have 65 days from the date on the ALJ decision to make a written request for review by the Appeals Council. 

You may win your case with the Appeals Council, but this is very unusual. The Appeals Council might send your case back to the ALJ. This is a common outcome if the Appeals Council decides that the ALJ made a mistake.

The Appeals Council might refuse to review your case or it might decide against you. You have 65 days from the date of the Appeals Council's decision to appeal the case to the United States District Court. If you want to file a case in district court, it is best to have an attorney.