Buckley & Buckley, LLC
234 Church Street
New Haven, CT 06510
Phone: 203-624-2424
mab@buckleyandbuckley.info
APPEALS IN SOCIAL SECURITY
Everything you wanted to know about Social Security Appeals
THE LEVELS OF THE PROCESS AND ADMINISTRATIVE AND JUDICIAL APPEALS
In the northeast, Region I, the levels of the process are:
(1) The Initial Application. This is the first step of the administrative process.
(2) Request for Reconsideration. This is the first administrative appeal.
(3) Request for Hearing. This is the second administrative appeal.
In the event that you receive an "Unfavorable" or a "Partially Favorable" decision, after hearing:
(4) The initial appeal is to the Appeals Council, an administrative branch of Social Security, so it is also an administrative appeal.
(5) The judicial appeal to the United States District Court, which is a federal court.
THE TIME LIMITS FOR APPEAL
The time limits are identical for each level of appeal, with one critical exception (see the very next section): Sixty (60) days from the date of the decision, with the presumption that the decision was received five (5) days after the date of the decision.
THE CRITICAL 10-DAY APPEAL PERIOD
In two types of cases you MUST APPEAL WITHIN TEN (10) DAYS OR YOUR BENEFITS WILL STOP during the appeal process. This rule applies to termination cases, in which Social Security notifies you that it believes that your disability has ceased and intends to stop your benefits and SSI cases in which Social Security notifies you that you are no longer eligible for some or all of the SSI payments.
LATE APPEALS
There are circumstances under which you may file a "late" appeal. Before Social Security, if you are able to demonstrate "good cause" for filing the appeal beyond the due date (you were prevented by your disability or other good reason for filing on time), the District Office of Social Security makes the determination whether to accept the late appeal. At the Hearing level (Request for Hearing), the administrative law judge (ALJ) decides whether there is good cause for late filing.
LENGTH OF APPEALS PROCESS
Currently, in Connecticut, it is taking approximately 3 to 4 months for the decision on the initial application. The Request for Reconsideration takes an additional 2 to 3 months. If a hearing is necessary, the average length for hearing time is 12 months. The appeal to the Appeals Council takes about a year. The appeal to the District Court takes about 6 months, in most circumstances.
HOW TO SPEED UP THE PROCESS SO IT DOES NOT TAKE SO LONG
There are certain things that may be able to be done, depending on your individual circumstances, and special circumstances based on dire need and contacting your Congress person. Most Congressional offies have staff to assist the public with navigating through the Federal system. The Congress person cannot influence the decision, but they may be able to speed up the process.
STATISTICS ON APPEAL
The current statistics in Connecticut are:
- 65% of the applications are denied at the initial application level
- 85% of the Reconsideration appeals are denied
- 61% of all cases that go to decision on the issue of disability in the hearing office are approved. There are some cases that are dismissed either for failure to appear at a hearing or late appeal or the claim is withdrawn, but of the cases that go to decision on the merits of the case, 61% are approved.
HOW TO APPEAL
There are several ways to appeal at the first two appeal levels (at the Request for Reonsideration and Request For Hearing):
(1) In person at the District Office of Social Security
(2) Online HERE
(3) Over the telephone
REAPPLY OR APPEAL
If you do not appeal, you may lose some benefits. If you believe you are disabled, you should be very careful about deciding not to appeal. This is a very important decision and the decision to "just apply later" should be made very carefully and only if you are sure that you understand all the consequences of not appealing.
.
In the northeast, Region I, the levels of the process are:
(1) The Initial Application. This is the first step of the administrative process.
(2) Request for Reconsideration. This is the first administrative appeal.
(3) Request for Hearing. This is the second administrative appeal.
In the event that you receive an "Unfavorable" or a "Partially Favorable" decision, after hearing:
(4) The initial appeal is to the Appeals Council, an administrative branch of Social Security, so it is also an administrative appeal.
(5) The judicial appeal to the United States District Court, which is a federal court.
The time limits are identical for each level of appeal, with one critical exception (see the very next section): Sixty (60) days from the date of the decision, with the presumption that the decision was received five (5) days after the date of the decision.
In two types of cases you MUST APPEAL WITHIN TEN (10) DAYS OR YOUR BENEFITS WILL STOP during the appeal process. This rule applies to termination cases, in which Social Security notifies you that it believes that your disability has ceased and intends to stop your benefits and SSI cases in which Social Security notifies you that you are no longer eligible for some or all of the SSI payments.
There are circumstances under which you may file a "late" appeal. Before Social Security, if you are able to demonstrate "good cause" for filing the appeal beyond the due date (you were prevented by your disability or other good reason for filing on time), the District Office of Social Security makes the determination whether to accept the late appeal. At the Hearing level (Request for Hearing), the administrative law judge (ALJ) decides whether there is good cause for late filing.
Currently, in Connecticut, it is taking approximately 3 to 4 months for the decision on the initial application. The Request for Reconsideration takes an additional 2 to 3 months. If a hearing is necessary, the average length for hearing time is 12 months. The appeal to the Appeals Council takes about a year. The appeal to the District Court takes about 6 months, in most circumstances.
There are certain things that may be able to be done, depending on your individual circumstances, and special circumstances based on dire need and contacting your Congress person. Most Congressional offies have staff to assist the public with navigating through the Federal system. The Congress person cannot influence the decision, but they may be able to speed up the process.
The current statistics in Connecticut are:
- 65% of the applications are denied at the initial application level
- 85% of the Reconsideration appeals are denied
- 61% of all cases that go to decision on the issue of disability in the hearing office are approved. There are some cases that are dismissed either for failure to appear at a hearing or late appeal or the claim is withdrawn, but of the cases that go to decision on the merits of the case, 61% are approved.
There are several ways to appeal at the first two appeal levels (at the Request for Reonsideration and Request For Hearing):
(1) In person at the District Office of Social Security
(2) Online HERE
(3) Over the telephone
If you do not appeal, you may lose some benefits. If you believe you are disabled, you should be very careful about deciding not to appeal. This is a very important decision and the decision to "just apply later" should be made very carefully and only if you are sure that you understand all the consequences of not appealing.
.