Savvy Senior Social Security Appeals Process

by | February 23, 2005 12:00 am

Dear Savvy Senior,

I am a 58-year-old woman, recently disabled, living alone and I would like to know more about my rights with regard to Social Security. My question is what do I do if I think I’m being treated unfairly by Social Security? While I may be disabled, I’m not about to take an unfair ruling without a fight. What can you tell me?

Fighting Uncle Sam

Dear Fighting,

A nice thing to remember when you pick a fight with Uncle Sam is you’re not alone. Hundreds of thousands of people challenge rulings on their Social Security or Supplemental Security Income each year. So many, in fact, that there is even an Office of Hearings and Appeals (OHA) dedicated to handling these cases.

If Social Security decides you won’t receive benefits, or if you disagree with their decision, you can appeal. But, you have to do it within 60 days from the date you get the letter about the decision in your case. Here are the four levels of the appeals process:

Level One – Reconsideration

When you want to appeal a decision, you must first put the request in writing. You can get the appeal form from Social Security by calling 1-800-772-1213, or you can send a signed note with your Social Security number and claim number stating that you wish to appeal the decision in your case. Social Security will then reconsider your claim by reviewing all the evidence by someone who had no part in the first decision. You will be sent a letter explaining their decision.

Claimants win reconsideration about 20 percent of the time.

Level Two – Hearing

If you disagree with the reconsideration ruling, then you have the right to ask for a hearing. At this level, one of Social Security’s Administrative Law Judges (someone with no role in the earlier decisions) will hold a hearing. These hearings are usually held within 75 miles of a person’s home. You have a right to be present with witnesses and will be notified of the time and place of the hearing. You and your representative, if you have one, should come to the hearing and explain your case in person. Be prepared for the judge to ask questions of all parties, including the witnesses, but don’t expect an immediate decision. This, too, will come in the mail.

Over half of the claimants who have a Social Security disability hearing win.

Level Three – Appeals Council Review

If you’re still dissatisfied, you can ask for a review by Social Security’s Appeals Council. They can examine the case and render a decision themselves, deny the case, or refer it back to another Administrative Law Judge for a review. Again, they’ll send you a letter explaining their decision.

Level Four – Federal Court Review

If you disagree with the Appeals Council’s decision or if the Appeals Council decides not to review your case, you may file a lawsuit in a federal district court.

Savvy Tip: You can get a lawyer or other qualified person familiar with you and the Social Security program to help you appeal your claim. Your local Social Security office has a list of organizations that can help you find a representative. For more information on the appeals process visit Social Security also offers a free publication called, “Your Right To Question The Decision Made On Your Claim” (SSA Publication No. 05-10058). To get a copy call 1-800-772-1213.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit Jim Miller is a regular contributor to the NBC Today Show and author of “The Savvy Senior” book.

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