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Appealing the decision when denied Social Security disability

When a North Carolina resident has an injury, illness or condition that he or she believes warrants an approval for Social Security disability benefits, it can be a disappointment when the claim is denied. With that in mind, it is possible to appeal when denied disability or Supplemental Security Income or SSI. When the decision is made and the claimant does not agree with it, he or she can ask for an appeal. The decision will be looked at again and if it is deemed to have been denied in error, it can be reversed. There are four different levels of appeal: reconsideration, a hearing by an administrative law judge or ALJ, a review by the Appeals Council and a federal court review.

With reconsideration, the entire case will be reviewed by someone who had no involvement in the initial decision. The evidence from the original claim plus any new evidence will be examined. The claimant generally does not have to be present for this. If the appeal is due to the benefits ending because the medical issues improved sufficiently, the claimant will have to meet with a representative from the Social Security Administration to explain why the benefits should continue.

After the reconsideration, there can be a hearing. The ALJ will oversee the hearing and will be held within 75 miles of the claimant's residence. The claimant can provide more evidence, testify and bring witnesses such as medical or vocational experts. If the person cannot attend the hearing, there must be an explanation for this. It might not be necessary for the claimant to attend.

If the hearing results in a denial, there can be a review by the Appeals Council. The Appeals Council does not have to agree to hear an appeal. The Appeals Council can refuse to hear the case, make a decision on its own, or send it back to an ALJ. Finally, there is federal court. If the Appeals Council refuses to review the case or the claimant disagrees with the decision made by the Appeals Council, a lawsuit can be filed in federal court.

Simply because a claim for SSD benefits was denied, it does not mean that the case is automatically over. A person has the right to appeal when denied Social Security. Having Social Security disability legal assistance can be beneficial to a case whether it is an initial claim or an appeal at any level. It is imperative that applicants understand the options afforded to them so they can take the proper steps to protect their interests.

Source: ssa.gov, "The Appeals Process," accessed on Nov. 21, 2016

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  • North Carolina Advocates for Justice Protecting People’s rights
  • NOSSCR National Organization of Social Security Claimants’ Representatives
  • American Association for Justice formerly the Association of Trial Lawyers of America ATLA
  • ABA American Bar Association
  • NOVA
  • North Carolina State Bar
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