The Social Security Decision Appeal Process

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Receiving an unfavorable decision from the Social Security Administration (SSA) regarding benefits can be disheartening, but it’s not the final word. A formal, multi-level appeals process exists, providing the opportunity to request a review of decisions concerning various benefits, including Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), retirement benefits, and survivors benefits.

The Four Steps of an SSA Appeal

The SSA has established a clear, sequential path for appeals. You must generally proceed through these levels in order if you continue to disagree with the decision made at the previous stage. Not every appeal will need to go through all four levels; the process stops at any level where you receive a favorable decision or choose not to appeal further.

The four levels are:

1. Reconsideration: An initial review of the decision by SSA personnel not involved in the original determination
2. Hearing by an Administrative Law Judge (ALJ): A formal hearing where you can present evidence and testimony before an ALJ
3. Review by the Appeals Council: A review of the ALJ’s decision by the SSA’s Appeals Council, focusing on potential errors
4. Federal Court Review: Filing a civil lawsuit in a U.S. District Court to challenge the SSA’s final administrative decision

The first three levels constitute the administrative review process, handled entirely within the SSA. The final level involves judicial review by the federal court system, external to the agency. This tiered structure allows the agency multiple opportunities to review and potentially correct its decisions based on the evidence and applicable rules before any external judicial intervention.

Appeal Levels at a Glance

Level 1: Reconsideration – Asking for a Second Look

The first essential step in challenging most unfavorable SSA determinations is requesting a Reconsideration. This stage involves a thorough re-examination of your claim by an individual within the SSA, or the state-level Disability Determination Services (DDS) for medical issues, who played no role in the initial decision. The reviewer assesses all evidence considered initially, along with any new evidence you submit or the SSA obtains.

You might seek reconsideration for various reasons, such as disagreeing with a denial of disability, retirement, or survivor benefits, disputing the calculated benefit amount, contesting an overpayment finding, or challenging a determination that a disability has ceased due to medical improvement.

How to File for Reconsideration

Several methods are available to file a request for reconsideration:

• Online: The SSA strongly encourages online filing as the quickest and easiest method for both medical and non-medical reconsiderations. Use the agency’s official website through the “Appeal a Decision” portal. Select either the “Start disability request” or “Start non-medical request” option as appropriate.
• Paper Form (Mail/Fax): Alternatively, download, print, and complete Form SSA-561, “Request for Reconsideration”. The completed form should be mailed or faxed to your local Social Security office. Office addresses and fax numbers can be found using the Social Security Office Locator tool.
• Required Supporting Forms:
  • For appeals of medical denials, you must also submit Form SSA-827, “Authorization to Disclose Information to the Social Security Administration”. This form grants the SSA permission to obtain necessary medical records from your healthcare providers.
  • For appeals challenging a decision that disability benefits are stopping due to medical improvement (a “cessation” decision), a specific form is required: Form SSA-789, “Request for Reconsideration – Disability Cessation Right to Appear”. This form cannot be submitted online. Filing this form triggers your right to meet with a disability hearing officer.
• Assistance: You can request paper forms or assistance with filing by calling the SSA’s toll-free number (1-800-772-1213; TTY 1-800-325-0778) or by visiting your local Social Security office.

The 60-Day Deadline for Reconsideration

A critical aspect of the appeals process is the deadline. You must file your request for reconsideration (submitted online, mailed, or faxed) within 60 days of the date you receive the notice of the initial unfavorable decision.

The SSA operates under a presumption: it assumes that a mailed notice is received 5 days after the date printed on the notice itself, unless you can provide evidence proving it was received later. This effectively means that, in most cases, the deadline to file is 65 days from the date shown on the decision notice.

Filing well within 60 days of the notice date is the safest approach. If the calculated deadline falls on a Saturday, Sunday, or a federal holiday, the deadline automatically extends to the next business day.

Types of Reconsideration Review

The nature of the reconsideration review can vary depending on the issue being appealed:

• Case Review: This is the most common type, particularly for initial denials of benefits. The SSA reviewer examines the documents in the case file, including the original evidence and any newly submitted materials, without you needing to be present.
• Informal Conference: For certain non-medical issues, such as disputes over benefit amounts or overpayments, you may have the opportunity for an informal meeting with the SSA decision-maker. This allows you to present your case, explain your position, and potentially bring witnesses.
• Disability Hearing (Medical Cessation Only): When appealing a decision that disability benefits are ending due to medical improvement (filed using Form SSA-789), you have a specific right to appear in person before a Disability Hearing Officer (DHO). DHOs are typically staff members of the state DDS. This hearing allows you to explain directly why you believe your disability continues and to present evidence and witnesses. This is distinct from, and occurs earlier than, the hearing before an Administrative Law Judge.

Payment Continuation During Reconsideration

For individuals appealing certain types of decisions, primarily related to SSI non-medical factors or the cessation of disability benefits, there’s a possibility of continuing to receive benefits during the reconsideration process. To potentially qualify for continued payments, the reconsideration request generally must be filed within 10 days of receiving the notice of the unfavorable decision. If benefits are continued but the appeal is ultimately unsuccessful, you may be required to repay the benefits received during the appeal period. You can choose to waive this continuation of payments.

Key SSA Resources for Reconsideration

• SSA’s Main Appeal Page
• Request Reconsideration Page
• Form SSA-561 (Request for Reconsideration)
• Form SSA-789 (Request for Reconsideration – Disability Cessation)
• Form SSA-827 (Authorization to Disclose Information)
• SSA Publication “Your Right to Question The Decision Made On Your Claim”

Level 2: ALJ Hearing – Presenting Your Case

If you remain dissatisfied after the Reconsideration decision, the next step is to request a hearing before an Administrative Law Judge (ALJ). ALJs are attorneys who work for the SSA but function as independent adjudicators; the ALJ assigned to your case will have had no involvement in the initial or reconsideration stages of your claim. This level represents a significant shift from the primarily paper-based review of reconsideration to a live, albeit informal, hearing where you can present your case directly.

How to File for an ALJ Hearing

Similar to reconsideration, requests for an ALJ hearing can be submitted through several channels:

• Online: The SSA identifies the online method as the preferred and quickest way to file. Use the “Request Hearing” section of the SSA’s online appeal portal. Select whether it’s a disability or non-medical request.
• Paper Form (Mail/Fax): The standard paper form is HA-501, “Request for Hearing by Administrative Law Judge.” This completed form should be sent to your local Social Security office.
• Required Supporting Forms (Disability): When appealing a denial based on medical reasons (disability), you should also submit Form SSA-3441, “Disability Report – Appeal,” and potentially an updated Form SSA-827 authorizing release of recent medical information.
• Assistance: You can obtain forms and assistance by contacting the SSA via phone or visiting a local office.

The 60-Day Deadline for Requesting a Hearing

The deadline for requesting an ALJ hearing is 60 days from the date you receive the notice of the Reconsideration decision. The SSA’s 5-day mailing assumption applies here as well, effectively making the deadline 65 days from the date printed on the reconsideration notice. Missing this deadline without a finding of good cause can result in the loss of further appeal rights.

The ALJ Hearing Explained

The hearing process involves several key elements:

• Scheduling and Notice: Once your request is filed, the local SSA office forwards it to one of the SSA’s regional Offices of Hearings Operations (OHO). The OHO hearing office manages the case scheduling. You will receive information about the hearing process and a formal “Notice of Hearing” at least 75 days before the scheduled date. This notice specifies the date, time, and format (e.g., in-person, video, phone) of the hearing. You can waive the 75-day notice period (using Form HA-510) if you wish to potentially expedite the hearing, but this means less advance time to prepare and submit evidence.
• Location and Format: Hearings are typically scheduled to take place within 75 miles of your home. The SSA offers different ways to attend the hearing, including appearing in person at the hearing office, participating via video teleconference (VTC) from a local SSA office or sometimes another location, or attending by telephone. Information about potential reimbursement for travel expenses may be available at the SSA’s hearing travel information page.
• Who Attends: The hearing typically includes you, your appointed representative (if you have one), the ALJ presiding over the hearing, and a hearing reporter who creates an official audio recording of the proceedings. The ALJ may also call expert witnesses to testify, particularly in disability cases. These often include Medical Experts (MEs) to provide impartial medical analysis and Vocational Experts (VEs) to offer opinions on your ability to perform past work or other jobs existing in the national economy. You may also bring your own witnesses. If you require an interpreter due to language barriers or hearing impairment, the SSA will provide one free of charge upon request.
• Hearing Procedure: While less formal than a courtroom trial, the hearing follows a structured process and is officially recorded. The ALJ begins by explaining the issues to be decided in your case. You and any witnesses testify under oath or affirmation. The ALJ will question you and witnesses, and expert witnesses will provide their testimony. A crucial aspect of this stage is that you (or your representative) have the right to question any witnesses, including the experts called by the ALJ.
• Evidence Submission and Review: Before the hearing, you and your representative have the right to review the entire case file, either electronically, via CD, or in person at the hearing office. You can submit additional written evidence by mail or fax to the hearing office. A critical deadline exists for disability hearings: all written evidence you want the ALJ to consider must be submitted, or the SSA must be informed about it, no later than 5 business days before the scheduled hearing date. Failure to meet this deadline generally means the ALJ cannot consider the late evidence unless you demonstrate “good cause” for the delay. This rule underscores the need for diligent preparation and timely evidence gathering well before the hearing date. You can also request the ALJ to issue subpoenas to compel the production of documents or the testimony of unwilling witnesses, but this request must be made in writing at least 10 business days prior to the hearing.
• The ALJ’s Decision: After the hearing, the ALJ considers all the evidence presented (both written and testimonial) and issues a formal written decision. This decision will be mailed to you and your representative. The decision can be fully favorable (granting all benefits sought), partially favorable (granting some benefits or for a different period than alleged), or unfavorable (denying the claim). In some circumstances, an ALJ might issue a fully favorable “on-the-record” (OTR) decision based on the written evidence without holding a hearing, often at your request. Less commonly, an ALJ might issue a “bench decision,” announcing the decision orally at the conclusion of the hearing, followed by a written confirmation.

Key SSA Resources for ALJ Hearings

• SSA’s Request Hearing Page
• Form HA-501 (Request for Hearing)
• Form SSA-3441 (Disability Report – Appeal)
• Information About the Hearing Process
• Hearing Office Locator
• Ways to Attend Your Hearing
• Hearings, Appeals and Litigation Law (HALLEX) Manual

Level 3: Appeals Council Review – Scrutinizing the Hearing Decision

Should you disagree with the decision rendered by the ALJ, or if the ALJ dismissed your request for a hearing, the next avenue of appeal is to seek review from the SSA’s Appeals Council (AC). Located within the Office of Analytics, Review, and Oversight (OARO), the Appeals Council serves as the final level of administrative review within the Social Security Administration. Its primary role is not to conduct a new hearing or simply re-evaluate the evidence, but rather to examine the ALJ’s action for specific types of errors.

How to File for Appeals Council Review

You can request AC review using the following methods:

• Online (Preferred): The SSA recommends using its secure online platform, known as AC iAppeal. Access is typically available through the Appeals Council Review page on the SSA website.
• Paper Form (Mail/Fax): The designated form is HA-520, “Request for Review of Hearing Decision/Order”. Completed forms must be sent directly to the Appeals Council’s central office: Social Security Administration, Office of Appellate Operations, 6401 Security Blvd, Baltimore, MD 21235-6401. Alternatively, the form can be faxed to 1-833-509-0817.
• Assistance: Filing can also be initiated by contacting a local SSA office, the hearing office that handled the ALJ hearing, or by calling the SSA’s main toll-free number.

The 60-Day Deadline for Appeals Council Review

Consistent with the previous levels, the request for Appeals Council review must be filed within 60 days of the date you receive the ALJ’s hearing decision or the order dismissing the hearing request. The 5-day mailing presumption also applies at this stage. If the deadline is missed, you must provide a “good reason” for the delay in a written request for an extension of time. Failure to file timely without good cause may result in the AC dismissing the request, making the ALJ’s decision the final action of the SSA.

Grounds for Granting Review

Unlike the progression to Reconsideration or an ALJ hearing, the Appeals Council does not automatically review every case for which a request is filed. The AC examines all requests but has the discretion to deny review if it concludes that the ALJ’s decision was correct and that no significant error occurred.

According to SSA regulations, the Appeals Council will grant review if it finds one or more of the following issues:

• Abuse of Discretion: It appears the ALJ misused their authority or acted unreasonably in handling the case (e.g., improperly limiting testimony).
• Error of Law: The ALJ applied the wrong legal standard, misinterpreted a statute or regulation, or failed to follow binding SSA policy (e.g., improperly evaluating a treating physician’s opinion).
• Lack of Substantial Evidence: The ALJ’s findings of fact or overall conclusion are not supported by “substantial evidence” in the record. Substantial evidence is a legal standard meaning more than a mere scintilla; it’s such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. This doesn’t mean the evidence must overwhelmingly favor the ALJ’s decision, only that a reasonable basis exists for it in the record.
• Broad Policy or Procedural Issue: The case presents a significant issue related to SSA policy or procedure that could impact the public interest or many other claimants.
• New and Material Evidence: The AC receives additional evidence that meets all of the following strict criteria:
  • It is new (not previously submitted)
  • It is material (relevant and potentially impactful to the decision)
  • It relates to the period on or before the date of the ALJ’s hearing decision
  • There is a reasonable probability that the additional evidence would change the outcome of the decision
  • You show good cause for not submitting the evidence earlier (before the ALJ or within 5 days of the hearing), based on specific reasons outlined in regulations

The focus on these specific grounds indicates that the AC review is primarily concerned with the legal and procedural correctness of the ALJ’s actions and the basic factual sufficiency of the decision, rather than simply offering a second opinion on the evidence.

Submitting New Evidence to the Appeals Council

If you wish to submit additional evidence, you should ideally do so at the same time you file your request for review (Form HA-520 or online equivalent). However, the AC will only consider this evidence as a potential basis for granting review if it meets the stringent five-part test (new, material, relevant period, likely impact, and good cause for lateness).

If evidence is submitted that does not relate to the period on or before the ALJ decision date, or if you fail to show good cause for not submitting it earlier, the AC will not consider it when deciding whether to grant review. However, even if not considered for granting review, this evidence will typically be included in the official administrative record if the case is later appealed to Federal Court. The AC’s notice denying review will usually explain this and inform you about the possibility of filing a new application for benefits, potentially using the date of the AC request as a protective filing date if a new application is filed within six months.

Possible Outcomes of Appeals Council Review

When the Appeals Council acts on a request for review, several outcomes are possible:

• Denial of Request for Review: The AC finds no grounds for review under the regulations and determines the ALJ’s decision was correct. The request is denied, and the ALJ’s decision stands as the SSA’s final administrative decision.
• Dismissal of Request: The AC may dismiss the request for procedural reasons, such as late filing without good cause, or if you withdraw the request.
• Granting Request and Issuing a Decision: The AC agrees to review the case and, after reviewing the record (and potentially the new evidence if admitted), issues its own decision. This decision could affirm the ALJ, reverse the ALJ (find you disabled), or modify the ALJ’s findings.
• Granting Request and Remanding the Case: The AC finds an error or issue requiring further action and sends the case back (remands) to an ALJ (often the same one, but not necessarily) with specific instructions for further proceedings. This might involve holding a new hearing, obtaining additional evidence, or re-evaluating certain aspects of the case.

Scope of Appeals Council Review

It is important to note that if the Appeals Council grants review, it is not limited to only the issues you raised. The AC has the authority to review the entire case and consider any issue that was before the ALJ, including parts of the decision that were initially favorable to you.

Key SSA Resources for Appeals Council Review

• Appeals Council Process Information
• Form HA-520 (Request for Review)
• AC iAppeal Online Portal
• Regulation on Grounds for Review (20 CFR § 404.970)
• HALLEX Manual (Detailed AC Procedures)

Level 4: Federal Court Review: The Final Appeal Stage

If you remain dissatisfied after the Appeals Council has acted – either by denying your request for review or by issuing an unfavorable decision after granting review, the final step in the appeals process is to seek judicial review by filing a civil lawsuit against the Social Security Administration in a United States District Court. This action takes the case out of the SSA’s internal administrative system and places it before the federal judiciary.

How and Where to File a Federal Lawsuit

Initiating this stage involves formal legal action:

• Filing a Complaint: You (now the plaintiff) must file a legal document called a “complaint” with the appropriate U.S. District Court. This document outlines the basis for the lawsuit and asks the court to review the SSA’s decision.
• Proper Venue: The lawsuit must be filed in the U.S. District Court for the judicial district where you reside or, if you do not reside in the U.S., where you have your principal place of business. For claimants living or working entirely outside any U.S. judicial district (e.g., residing abroad), the correct venue is the U.S. District Court for the District of Columbia.
• Filing Fee: Filing a lawsuit in federal court requires payment of a filing fee. If you cannot afford the fee, you may petition the court to proceed “in forma pauperis” (as an indigent person), potentially allowing the fee to be waived.
• Legal Assistance: The SSA cannot provide assistance with filing a federal court action. Due to the legal complexities and formal procedures involved, obtaining representation by an attorney experienced in Social Security appeals is highly advisable at this stage.

The 60-Day Deadline for Filing Suit

Similar to the administrative appeal deadlines, there is a strict time limit for initiating federal court review. The civil action (lawsuit) must be filed within 60 days of the date you receive the notice of the Appeals Council’s final action (either the notice denying review or the AC’s decision). The SSA’s 5-day mailing presumption generally applies to the receipt date of the AC’s notice. Missing this deadline typically bars you from seeking judicial review.

Notifying the SSA (Service of Process)

Properly notifying the SSA about the lawsuit is a critical procedural requirement. After filing the complaint, the court will issue a document called a “summons.” You are responsible for ensuring that copies of both the filed complaint and the court-issued summons are delivered to the SSA’s Office of the General Counsel (OGC) that serves the geographic area where the suit was filed.

This delivery, known as “service of process,” must be done using certified or registered mail. Failure to properly serve the SSA according to these rules can lead to dismissal of the lawsuit on procedural grounds, regardless of the merits of your case. You can find the correct OGC address by consulting the SSA’s Program Operations Manual System (POMS) section GN 03106.020. This strict requirement highlights the increased legal formality involved when appealing to federal court. Once served, the SSA’s Office of Appellate Operations prepares the certified administrative record (the complete file from the SSA proceedings) for submission to the court.

Scope of Judicial Review

Federal court review of SSA decisions operates under specific constraints. The District Court judge does not conduct a new trial, hear new testimony, or independently re-weigh the evidence presented during the administrative process. The court’s role is more limited and deferential to the agency’s findings.

The court reviews the final decision of the Commissioner (which is typically the ALJ’s decision if the Appeals Council denied review, or the Appeals Council’s decision if it granted review and issued one) based on the administrative record compiled by the SSA. The review focuses on two key questions:

• Was the decision supported by substantial evidence? This is the same standard applied by the Appeals Council. The court looks to see if there is “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion” within the administrative record. If substantial evidence exists to support the Commissioner’s decision, the court must affirm it, even if evidence also exists that could support a different conclusion.
• Was the decision based on correct legal standards? The court determines whether the SSA applied the correct provisions of the Social Security Act, regulations, and relevant case law. If the agency made an “error of law” that might have affected the outcome, the court can reverse or remand the decision, even if substantial evidence might otherwise support it.

This deferential standard of review means the court primarily acts as an overseer, checking whether the SSA followed its own rules and the law, and whether its factual conclusions had a reasonable basis in the evidence presented during the administrative process.

Possible Outcomes of Federal Court Review

After reviewing the case based on the administrative record and legal briefs submitted by you and the SSA, the District Court judge will issue a decision with one of the following outcomes:

• Affirmance: The court finds the Commissioner’s decision was supported by substantial evidence and free of legal error, upholding the denial of benefits.
• Reversal: The court finds the Commissioner’s decision was not supported by substantial evidence or was based on legal error, and reverses the decision. In some cases, the court may direct the SSA to award benefits (a “reversal for benefits”).
• Remand: The court identifies a legal error, a lack of substantial evidence for a particular finding, or inadequate development of the record by the SSA, and sends the case back to the agency (usually to an ALJ) for further proceedings consistent with the court’s instructions. Remands are a frequent outcome, often requiring the SSA to re-evaluate evidence, obtain additional expert opinions, or hold a new hearing.

If you are unsuccessful at the District Court level, further appeal may be possible to the U.S. Court of Appeals for the relevant circuit, and potentially even to the U.S. Supreme Court, although these appeals are increasingly difficult to pursue and win.

Key SSA/Government Resources for Federal Court Review

• SSA’s Court Process Information Page
• POMS GN 03106.020 (Service of Process on SSA)
• General Information on U.S. District Courts
• General Information on U.S. Courts of Appeals

Navigating the Appeal Process: Essential Information

Beyond understanding the specific levels, several overarching factors are critical for anyone pursuing a Social Security appeal.

Deadlines are Crucial

The importance of meeting deadlines cannot be overstated.

• The 60-Day Rule: As detailed for each administrative level (Reconsideration, ALJ Hearing, Appeals Council) and for filing in Federal Court, the standard deadline is 60 days from the date you are presumed to have received the notice of the prior decision. Remember the 5-day mailing assumption generally makes this 65 days from the date on the notice. Missing a deadline without a valid excuse typically means the appeal cannot proceed, and the last decision issued by the SSA becomes final and binding.
• Requesting Extensions: The SSA recognizes that circumstances can sometimes prevent timely filing. It is possible to request an extension of time to file an appeal, but you must provide a written explanation demonstrating “good cause” or a “good reason” for the delay. SSA personnel can assist with filing this written request. Examples of what might constitute good cause include situations where SSA’s actions misled you, where you had a physical, mental, educational, or linguistic limitation preventing timely action, or where some other unusual, unexpected, or unavoidable circumstance occurred. Simply forgetting or neglecting the deadline is unlikely to be considered good cause.
• Weekend/Holiday Rule: If the calculated 60-day (or 65-day) deadline falls on a Saturday, Sunday, or a federal holiday, the deadline is automatically extended to the next business day.

Your Right to Representation

Claimants navigating the appeals process have the right to appoint someone to help them.

• Who Can Represent: A representative can be an attorney or another qualified individual (non-attorney representative) who is familiar with you and Social Security rules. The representative must adhere to SSA’s standards of conduct. You appoint individual representatives, not entire law firms or organizations, although the individual may work for such an entity. Individuals suspended or disqualified by SSA cannot serve as representatives.
• What Representatives Do: An appointed representative acts on your behalf. Their duties can include obtaining information from the SSA file, assisting in gathering crucial evidence like medical records, accompanying you to interviews or hearings (though they cannot testify for you), filing appeal requests and legal arguments, preparing you and witnesses for hearings, and questioning witnesses called by the ALJ. The representative also receives copies of all notices and decisions issued by the SSA regarding the claim.
• How to Appoint a Representative: The appointment must be formally documented in writing. The standard method is using Form SSA-1696, “Claimant’s Appointment of a Representative.” Both you and your chosen representative must sign this form. An electronic version, e1696, allows for online submission and can be initiated by the representative. Before a representative can be formally appointed, they generally need to register with the SSA using Form SSA-1699, “Registration for Appointed Representative Services and Direct Payment.”
• Finding and Paying for Representation: Local SSA offices can provide lists of legal referral services, bar associations, and non-profit organizations that may offer representation, sometimes free of charge for qualifying individuals. Many representatives work on a contingency fee basis, meaning they only charge a fee if you are ultimately awarded benefits. The SSA heavily regulates representative fees. Generally, a representative cannot charge or collect a fee from you without first obtaining written approval (authorization) from the SSA. Under specific circumstances, the SSA may pay the authorized fee directly out of your past-due benefits.
• Changing or Ending Representation: Formal procedures exist if you wish to revoke a representative’s appointment (Form SSA-1696-SUP1) or if a representative needs to withdraw from a case (Form SSA-1696-SUP2). Representatives are expected to withdraw in a manner that doesn’t disrupt the case processing, especially once a hearing is scheduled.

Gathering and Submitting Evidence Effectively

Successfully appealing an SSA decision often hinges on having strong supporting evidence.

• Continuous Process: Developing evidence is not a one-time event. You should continue to gather and submit relevant information as it becomes available throughout the appeal levels.
• Reconsideration Stage: New evidence should be submitted along with the request for reconsideration. For medical issues, this often involves updated medical records and ensuring an SSA-827 authorization is on file.
• ALJ Hearing Stage: This is often the most critical stage for evidence development. You should submit all updated medical records, reports from treating physicians, and any other supporting documents. Remember the strict deadline: written evidence must generally be submitted at least 5 business days before the hearing date. Medical source statements detailing functional limitations can be particularly helpful.
• Appeals Council Stage: New evidence is only helpful if it meets the strict criteria: new, material, relating to the period before the ALJ decision, likely to change the outcome, and accompanied by a showing of good cause for not submitting it earlier. Evidence should ideally be submitted with the request for review.
• Federal Court Stage: Generally, the court reviews only the evidence that was part of the administrative record created during the SSA proceedings. New evidence is typically not submitted or considered at this level.

How to Check Your Appeal Status

Waiting for decisions can be stressful. You can check the status of your appeal through these methods:

• Online: The most direct way is by logging into your personal my Social Security account online. This portal provides status updates for pending applications and appeals.
• Phone: You can call the SSA’s toll-free number, 1-800-772-1213 (TTY 1-800-325-0778). An automated service provides application/appeal status 24/7 (say “application status”). Representatives are available during business hours (typically 8 a.m. to 7 p.m. Eastern Time, Monday-Friday).
• Appeals Council Specific Check: To confirm if the Appeals Council has received a request for review, you can contact your local SSA office, the hearing office, or call the AC’s Claimant and Public Assistance Branch directly at 703-605-8000 or toll-free at 1-877-670-2722. The AC requests that you avoid making repeated status inquiries.

Key Terms You Should Know

Understanding the terminology used in the SSA appeals process can be helpful:

• Appeal: The formal process of asking the SSA (or subsequently a court) to review a decision with which you disagree.
• Reconsideration: The mandatory first level of appeal, involving a complete review of the claim file by SSA personnel (or state DDS staff) not involved in the initial determination.
• Administrative Law Judge (ALJ): An independent judge employed by the SSA who conducts the second level of appeal, known as the hearing.
• Appeals Council (AC): The body within SSA that handles the third level of appeal, reviewing ALJ decisions for errors of law or fact.
• Federal District Court Review: The fourth and final level of appeal, which involves filing a civil lawsuit against the SSA in a U.S. District Court.
• Deadline: The specific time limit (typically 60 days from receipt of notice, plus 5 days mailing time) within which an appeal must be filed at each stage.
• Representative: An attorney or other qualified non-attorney whom you formally appoint to assist with your Social Security claim or appeal.
• Evidence: Information submitted to support a claim, such as medical records, physician statements, work history, and claimant testimony.
• Substantial Evidence: The legal standard used by the Appeals Council and Federal Courts to review ALJ decisions. It means more than a mere scintilla of evidence; enough relevant evidence that a reasonable person could accept as adequate to support the conclusion reached.
• Error of Law: A mistake made by the ALJ in applying or interpreting the relevant statutes, regulations, or SSA policies. This is a basis for review by the Appeals Council or reversal/remand by a Federal Court.
• Good Cause: A legally acceptable reason for failing to meet a deadline (like submitting evidence late to the Appeals Council) or for requesting an extension.
• Disability Determination Services (DDS): State-level agencies contracted by SSA to make the initial medical determinations on disability claims and conduct reconsiderations of those decisions.

Key Forms

• SSA-561: Request for Reconsideration
• HA-501: Request for Hearing by Administrative Law Judge
• HA-520: Request for Review of Hearing Decision/Order
• SSA-1696: Claimant’s Appointment of a Representative
• SSA-3441: Disability Report – Appeal
• SSA-827: Authorization to Disclose Information to SSA
• SSA-789: Request for Reconsideration – Disability Cessation Right to Appear

Official SSA Guides and Resources

The Social Security Administration provides numerous resources online and via phone to help individuals understand the appeals process:

• SSA Main Appeals Page
• How to Appeal a Decision Page
• Online Disability Appeal Portal
• Check Application or Appeal Status
• SSA Forms Page
• Representation Information
• Publication: “The Appeals Process” (EN-05-10058)
• Publication: “Your Right To Representation” (EN-05-10075)
• Hearing Process Details Page
• Appeals Council Process Details Page
• Federal Court Process Details Page
• Social Security Handbook
• Program Operations Manual System (POMS)
• Hearings, Appeals and Litigation Law (HALLEX) Manual
• Toll-Free Number: 1-800-772-1213 (TTY 1-800-325-0778) for questions and assistance

Our articles make government information more accessible. Please consult a qualified professional for financial, legal, or health advice specific to your circumstances.