If Social Security denies your application for any reason, they'll notify you by mail.
Don't be discouraged! If you don't agree with the decision, you may appeal it.
If you win the appeal, Social Security will pay you for the months you missed.
What you can do:
Request a hearing with the Office of Disability Adjudication and Review (ODAR). An ODAR administrative law judge gathers the evidence, conducts the hearing, and makes a decision.
Click on the link at the end of the page to see the Request for Reconsideration form. (You can also find the form online here.)
Submit this form within 60 days from the date you got the letter.
On the form, under Three Ways To Appeal, check the first box: Case Review.
Click the boxes below to learn more:
You have to submit this form within 60 days from the date you received the denial letter.
The Office of Disability Adjudication and Review (ODAR) assumes you received the letter within 5 days of the date printed on the letter.
If you are requesting a hearing because you or your family member was denied SSI benefits, you must also fill out and sign two more forms:
Disability Report - Appeal - this form asks questions about your medical history, education, work or vocational rehabilitation, and other information that may have changed since you submitted your first application.
Authorization to Disclose Information to SSA - this form gives permission for SSA to get information from your various providers, such as doctors, schools, and social workers.
Keep in mind - if any information about your condition changes after you submit your documents, make sure you let SSA know within 10 days. In some states you can submit new evidence until 5 business days before the hearing.
If you're appealing Social Security's denial that your family member has a disability,
this is how you should complete the Request for Reconsideration form.
Since the denial is disability-related, you'll choose Case Review. An outside team hired by Social Security reviews the disability determination. In this case, there's no meeting or hearing with the reviewers.
You should submit any new evidence before the review, such as a more recent evaluation, doctor's letter, bank statement, or other information that can help your case.
Here is a link to a good article on preparing for your appeal. (While this Guide focuses on SSI, this article applies to both SSI and SSDI.)
The Reconsideration form, Part 1: under ISSUE BEING APPEALED, write 'disability,' and then write in your reasons on the next line.
Attach additional pages if you need more space to explain your reasons.
Part 2: Check CASE REVIEW, and attach any new facts or documents that support your reasons.
Part 3: Fill in your contact info and sign it.
Social Security will fill out the rest of the form, so you should leave it blank.
To submit the form:
Once you complete the rest of the form and sign it, make a copy for yourself and keep it in an organized file or binder.
You can mail in the form, or drop it off to your local Social Security office.
If you mail it, you can ask for certified mail at the post office.
If you drop the form off, bring a copy and ask Social Security to date stamp it.
In either case, you'll have proof it was filed on time.
Social Security will notify you of their decision on the appeal through the mail.
If you're denied the first time, you can appeal again:
This time, you can ask for a hearing with theOffice of Disability Adjudication and Review (ODAR)
Fill out the Request for Hearing by Administrative Law Judge form to officially request this hearing. Click the link at the bottom of the page to download a PDF of the form.
If you're denied again, you can appeal again, all the way up to federal court.
These steps are outside the scope of this Guide. You should speak with an attorney who has experience in special needs cases.
Further steps: If you're denied again, you can appeal again, all the way up to federal court. These steps are outside the scope of this Guide. You should talk to a lawyer who has experience in special needs cases.
This conference is meant to be informal and relaxed.
It’s important, but you shouldn’t be nervous.
What you can do:
Bring any papers you have that can show why the first decision was wrong.
Bring any other new information that may help your case
What you can expect:
You’ll go to your local Social Security office, the one that processed your application
You’ll sit with an examiner and explain why you think the decision was wrong.
This person will be someone who wasn't involved in the initial denial
There are no courtroom-type procedures or rules.
The conference is recorded.
Your family member does not have to go to the meeting, but you should invite him or her if you feel it could be helpful
You may be asked come back for a second interview
After this conference, you should get a written decision within 60 days
Need legal help?
It may help to get a lawyer to help with your appeal.
Click on the box below to learn more:
What can a lawyer help with?
Sometimes it helps to have a lawyer or attorney help with your appeal. They can review documents to find flaws in the case, help get expert evaluations and reports, and write legal briefs. They can even argue your case to the judge.
How do I find a lawyer?
- Contact the Special Needs Alliance or the Academy of Special Needs Planners. These associations can help you find a good local lawyer who knows about the SSI process.
- You should also check the denial letter from Social Security. It should include a list of resources that help people with appeals, such as disability law groups, law schools, and legal aid organizations. Many of these provide free legal services for those with low income.
- If you live in Louisiana or Massachusetts, see our Resource Directory to find legal services near you. (Go to Tools at the top of your screen, or scroll to the bottom of the Exceptional Lives website.)
What about the fees?
There are limits on the fees private attorneys can charge. The maximum fee is 25% of any past due benefits, or $4,000, whichever is less. Past due benefits means the unpaid SSI benefits that you should have been paid while the appeal was being processed. In addition:
The attorney's fee must be approved by Social Security.
When they decide to approve the fee, Social Security will look at these kinds of things: the background and skills of the lawyer, the complexity of the case, the time involved, the result, and - most important - whether you agree to the proposed fee. This is to protect you.
Sources: Jackins (2010), Social Security