If your initial claim for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) is denied, you have multiple opportunities to challenge that decision. And while pursuing an appeal can take months, even years, you do have some chance of succeeding. Among workers who were awarded SSDI benefits from 2011 through 2020, nearly a third were applicants who appealed after first being turned down, according to Social Security's most recent annual report on the program.
There are four stages in the appeal process.
Medical eligibility for disability benefits is reviewed by state-level Social Security agencies called Disability Determination Services (DDS). If they reject your claim, your first recourse is to ask the Social Security Administration (SSA) to reconsider. You can file for reconsideration online, or by filling out forms SSA-561, SSA-3441 and SSA-827 and sending them to your local Social Security office.
In a reconsideration, an examiner and medical team from your state DDS who were not involved in the initial review take a fresh look at your claim. You can provide additional evidence, such as records of more recent medical examinations or treatment, and point out evidence DDS may have missed the first time around. The examiners may request additional information themselves.
According to the most recent SSA data available, the average time it takes to get a reconsideration decision is 147 days, and about 1 in 9 reconsideration requests yield benefit approvals.
2. Hearing before an administrative law judge
If DDS won't change its mind, you can request a hearing with an administrative law judge (ALJ), who will review the evidence in your case and listen to your testimony and that of expert witnesses. To request a hearing, use the online appeal system or complete and send in a form HA-501. You can choose to have your hearing in person, by phone or via online video.
Be prepared for it to take a while to get a hearing date: In October 2022, average wait times in the country's 168 regional Social Security hearing offices ranged from 8 to 24 months.
Disability hearings generally last less than an hour but can run longer if there are multiple witnesses. Afterward, it can take anywhere from several weeks to several months to get a decision. The approval rate for applicants at the hearing stage declined from nearly three-quarters in the mid-2000s to just under half in the mid-2010s but has ticked up to around 57 percent in more recent years, according to Social Security data.