Skip to main content

Social Security: Applying for Benefits, Appealing Adverse Decisions

Posted by attorney Nathaniel Hubley

If a person has severe medical impairments that prevent them from engaging in competitive employment, that person should apply for Social Security Disability benefits. The two most common types of disability claims fall under Title II (SSDI) and Title XVI (SSI). Both types of claims are administered by the Social Security Administration ("SSA"). All decisions made by the SSA regarding SSDI or SSI claims may be appealed.

In order to file an application for either SSDI or SSI benefits, the person should know what is needed to complete the application. To complete an application, a person will need proof of age, information regarding past work history, information regarding their medical condition(s), including the names of healthcare providers, dates of hospitalizations, and a list of the medications that person is being proscribed. The more information provided, the more likely the application will be processed in a timely fashion.

There are several different ways an application can be completed. A person can visit SSA's website, visit a field office, or call the SSA's toll free number.

After filing the application, a person's claim may be denied for any number of reasons. There are essentially four stages in the disability process. The first two stages are internal decisions which are based only upon the application, medical evidence, and supplmental information provided by the claimant. Statistically, more claims are denied at these first two stages.

After a claim has been denied twice, the claimant can appeal the decision to an Administrative Law Judge ("ALJ") and have a hearing at the Office of Disability Adjudication and Review ("ODAR"). At this stage it is highly recommended you contact a Disability Attorney who will help the claimant prepare for the hearing.

At this third stage (the hearing in front of the ALJ), the claimant will have the opportunity to tell his or her story to the ALJ. The claimant can also have a loved one testify regarding the claimant's difficultities with activities of daily living ("ADLs").

The ALJ reviews all information in the record and considers the testimony of the claimant and the claimant's witnesses, if any, as well as any additional evidence submitted at the hearing. The ALJ may also request the assistance of a vocational expert ("VE") or medical expert ("ME").

Sometimes the ALJ will make a decision at the conclusion of the hearing, other times, the ALJ will keep the matter under advisement and issue a decision several weeks later.

If the ALJ's decision is unfavorable, the claimant can appeal that decision to the SSA's Appeal Council. This is considered the fourth stage of the process. The decision of the Appeals Council is the final administrative decision. The claimant has 60 days to file a complaint for judical review in federal district court. At this point, the matter is outside the SSA's review. The federal district court will consider new evidence only under limited circumstances; its review is limited to the evidence found in the administrative record.

For that reason, it is very important that the claimant get a disability attorney involved at the hearing level with the ALJ.

Additional resources provided by the author

For more information about the Social Security Disability Process, visit my website:

Author of this guide:

Was this guide helpful?