When SSA decides your eligibility for benefits, they will send you a letter explaining their decision. If you do not agree, you have the legal right to ask SSA to reconsider your case. This is called an appeal. When you ask for an appeal, SSA will look at the entire decision, even those parts that were in your favor. If SSA finds their decision was wrong, they will change it.
When And How Can You Appeal?
If you wish to appeal, you must make your request in writing within 60 days from the date that you receive the notification letter from SSA. SSA assumes you receive their letter five days after the date on it. If that is not the case, you must be able to prove the date on which you actually received the notification.
How Many Levels of Appeal Are There?
Your appeal may be handled at any of three levels:
When SSA notifies you of a decision on your claim, they will tell you how to appeal the decision and at what level your appeal will be heard.
Can Someone Help With Your Appeal?
Yes. Many people handle their own Social Security appeals with free help from Social Security. But you can choose a lawyer, a friend or someone else to help you. Someone you appoint to help you is called your "representative." SSA will work with your representative just as they would work with you had you chosen to represent yourself.
Your representative can act for you in most Social Security matters and will receive a copy of any decisions SSA makes about your claim.
Your representative cannot charge or collect a fee from you without first getting written approval from SSA.
If you want more information about having a representative, contact SSA. They can give you a free factsheet, Social Security And Your Right To Representation.
If you disagree with SSA's initial decision, you may ask for a hearing on the "disability" issues of your claim, such as whether or not you are disabled, when your disability began, or whether or not it has ended. An administrative law judge who had no part in the first decision of your case will conduct the hearing.
The hearing is usually held within 75 miles of your home. The administrative law judge will notify you of the time and place of the hearing. You and your representative, if you have one, may come to the hearing and explain your case in person. You may look at the information in your file and give new information.
The administrative law judge will question you and any witnesses at the hearing. You or your representative also may question the witnesses.
It is usually to your advantage to attend the hearing. If you don't wish to do so, you must tell SSA in writing that you don't want to attend. Unless the administrative law judge believes your presence is needed to decide the case, he or she will make a decision based on all the information in your case, including any new information given.
After the hearing, SSA will send you a letter and a copy of the administrative law judge's decision.
If you disagree with the hearing decision, you may ask for a review by Social Security's Appeals Council. SSA will help you ask for this review.
The Appeals Council looks at all requests for review, but it may deny a request if it believes the hearing decision was correct. If the Appeals Council decides to review your case, it will either decide your case itself or return it to an administrative law judge for further review. You will receive a copy of the Appeals Council's decision or order sending it back to an administrative law judge.
If you disagree with the Appeals Council's decision or if the Appeals Council decides not to review your case, you may file a lawsuit in a federal district court.
How to Get More Information
You can get recorded information 24 hours a day, including weekends and holidays, by calling SSA's toll-free number, 1-800-772-1213. You can speak to a service representative between the hours of 7 a.m. and 7 p.m. on business days. SSA's phone lines are busiest early in the week and early in the month, so, if your business can wait, it's best to call at other times. Whenever you call, have your Social Security number handy.
People who are deaf or hard of hearing may call our toll-free TTY number, 1-800-325-0778, between 7 a.m. and 7 p.m. on business days.
All calls are treated with absolute confidentiality.
You also can reach SSA on the Internet at www.socialsecurity.gov.