Appeals Process

Most Social Security disability claims are reviewed and processed in the following way:

 

  2017 Waterfall Chart  showing how cases were decided at different levels of review.

2017 Waterfall Chart showing how cases were decided at different levels of review.

01 | Initial application

Your initial application goes to the Disability Determination Services (DDS), a state agency under contract with Social Security to review your medical records and other evidence to determine if you are disabled.
 

02 | Request reconsideration

If DDS denies your claim, you can appeal by filing a Request for Reconsideration within 60 days. DDS will gather evidence from doctors and other health care providers who've treated you since you filed your claim. Someone at DDS who was not involved in the first decision will review all the evidence and make a new decision.
 

03 | Request a hearing

If DDS denies your claim again, you can appeal by filing a Request for Hearing within 60 days. A hearing will be scheduled with an Administrative Law Judge (ALJ) at a hearings office in your area. After you file the Request for Hearing, Social Security will give you the option to have a video hearing where the ALJ does not meet you but appears on a video screen. (I generally do not recommend video hearings.) You'll have to notify Social Security that you don't want a video hearing within 30 days; otherwise, you'll get one.
 

04 | Request Appeals Council review

If the ALJ denies your claim, you can ask the Appeals Council (the highest level of administrative review) to review the ALJ's denial. There is no hearing at this stage. The Appeals Council simply reviews the ALJ's decision to determine if it is supported by the evidence and doesn't contain harmful legal errors.
 

05 | File complaint in federal court

If the Appeal Council denies your request to review, you can appeal by filing a complaint in federal court. You'll need an attorney at this step. If the person who represented you at your hearing is not an attorney, they won't be able to help at this step. Which is why we suggest you find out the qualifications of the actual person you're considering hiring before you hire them.

 

Theoretically, your case could go all the way to the U.S. Supreme Court (something that happens very, very rarely). Again, there is no hearing. Like the Appeals Council, the federal court will review the ALJ's decision to determine if it is supported by the evidence and doesn't contain any harmful errors.

To get the answers to your questions about this process or anything else related to your claim for disability benefits, call us right now at (336) 725-0700 or complete our free case evaluation form if you want assistance with your disability claim.