Appealing a Social Security Decision: The Administrative Law Judge Process

If your application for Social Security has been denied or if you feel that you are not getting the full benefits that you deserve, there is a four-step process that you may need to follow in order to appeal the decision. The second and often the most important step in the process is requesting and preparing for a hearing before an Administrative Law Judge or ALJ. Here is what you need to know when appealing a Social Security decision.

The first step in appealing a Social Security decision is called reconsideration. During reconsideration, someone other than the original reviewer takes a look at your file as it was when it was initially reviewed. A request for reconsideration must be formally submitted. Forms can be obtained from your Social Security office. At this stage, you may add additional evidence to your file for review, in order to help support your claim. Although you do not have a legal right to meet with the person reviewing your file, you can request to do so. A decision is usually made within two to three months. If your first appeal is denied you have 65 days from the date on the notice to appeal to the next level.

If your reconsideration goes against you, the next step in appealing a Social Security decision is requesting a formal administrative hearing in front of an independent Administrative Law Judge, as mentioned above. A formal document must be completed in order to request a formal hearing. Again, a form document can be obtained from the Social Security office.

This formal hearing serves as your best opportunity to have the earlier decision overturned. As such, it is highly recommended that you obtain a lawyer to help you through the process. You are permitted to attend this all-important hearing before the Administrative Law Judge, and it is highly recommended that you do. Legal experts will tell you that in any case, it is important to put a "human face" with the name presented on the forms. Also, the Administrative Law Judge may wish to ask you vital questions that may aid him or her in making a decision in your favor. At the hearing before the Administrative Law Judge, you can also present additional evidence and witnesses to help argue and support your case. Although your advocate need not be a lawyer, he or she should have some legal training and fully understand the process and rules in connection with the hearing before the Administrative Law Judge.

Before the hearing, you should fully prepare yourself by knowing all of the facts and circumstances surrounding your case, and understanding how those facts and circumstances relate to the applicable laws. You should be prepared to answer fully any and all questions that might be asked by the Administrative Law Judge.

During the hearing, you should be well-groomed and respectful of the forum. You should answer all questions as concisely and accurately as possible. You should be organized and have any and all relevant facts and documentation at the ready. If you do not understand something, ask your lawyer or the Administrative Law Judge for clarification.

If the Administrative Law Judge rules against you, your next step in appealing a Social Security decision is to appeal to the Social Security Appeals Council. Appealing to the Social Security Appeals Council is a very difficult step in the appeals process, and you should know that at this stage the odds will be against any decisions being made in your favor. The Social Security Appeals Council is located in Washington D.C., so if your case gets chosen (not all cases are chosen to be presented) then you will have to be ready to travel. Hiring an attorney with Social Security experience is highly recommended. A special Appeals Council form must be completed. It too can be obtained from the Social Security office.

If the Appeals Council has made a decision against you, you can take your case one step further. Your fourth and final step in appealing a Social Security decision is to file a civil lawsuit in the United States District Court (federal court) in the area in which you live. You have 60 days to file a civil suit from when the appeal decision was mailed. A civil lawsuit is a major undertaking and can be costly. It should only be considered if a lawyer or other legal expert believes your case is strong. An attorney who handles Social Security cases is highly recommended. Many lawyers will take the case on a contingency basis, so you will not have to pay legal fees unless your action is successful. Social Security rules state that the lawyer or law firm that represents you can collect up to 25 percent of your past due benefits or $5,300, whichever is less.

Sources:
www.findlaw.com
www.ehow.com
www.westlaw.com