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APPEALS PROCESS

You can appeal most determinations and decisions we make about whether you tin can get Supplemental Security Income (SSI) or if we make changes to your benefit amount. That ways you can ask united states of america to wait at your example again.

When you inquire for an appeal, we volition look at the entire determination or determination, even those parts that were in your favor.

HOW TO Entreatment SOCIAL SECURITY DETERMINATIONS AND DECISIONS

Nosotros have established appeals procedures for individuals who disagree with the determination(s) or decision(s) we make. The determination(s) or decision(s) that you can appeal are chosen "initial determinations" and nosotros discuss them farther beneath. The levels of appeal are:

Reconsideration;

Hearing past an administrative law judge;

Appeals Quango Review; and

Federal Court.

INITIAL Determination

Nosotros phone call the determinations we make that you lot tin appeal "initial determinations." These determinations are SSA's written findings regarding whatsoever legal or factual outcome, including just not express to:

Whether you are eligible for SSI.

The amount of your SSI payment.

The fact that you lot were overpaid, the amount of the overpayment, and whether yous must repay it.

After y'all file an awarding for SSI, nosotros will postal service you lot a written initial conclusion.  This is your get-go "initial conclusion", but each time we make a determination about your eligibility or payment amount after that is besides an initial determination.

Every time we make an initial determination, nosotros will send yous a notice. If you want to appeal the initial decision in that discover, you must request an appeal in writing within 60 days of the date you receive your observe. That notice will tell you how to appeal. The observe will besides tell y'all if you lot are entitled to continued benefits. If y'all file an appeal for a non-medical initial conclusion within 60 days of the date you receive your find, your SSI benefits may continue at the same corporeality until we make a determination on your appeal. If you lot file an appeal for a medical disability cessation within 10 days of the engagement you receive your notice and elect payment continuation, your SSI benefits may proceed at the same amount until we brand a decision on your entreatment.

Contact the states an we can help you lot file your entreatment.

STEPS IN THE APPEALS PROCESS

i.  Afterthought

If you disagree with the initial determination, you may request reconsideration.

• For a inability claim or non-medical issue, take one of the following actions.
• Online
  The quickest and easiest way to file a asking for a afterthought on a inability claim or not-disability outcome is online at our Appeal a Decision page. Select "Reconsideration" and so the "Request Medical Reconsideration" or "Asking Non-Medical Reconsideration" button every bit applicable. Follow the instructions on the screens to complete and submit the appeal electronically.
• Ship Us a Form past Mail or Fax
  Y'all may also download, complete, and print the form Asking for Reconsideration (SSA-561-U2) and and so mail the completed form to your local Social Security office. You can find the local office fax number and accost from the Social Security Office Locator page by entering your ZIP lawmaking.
• Medical Disability Cessation

  You may write to u.s. or consummate a Class SSA-789 (Asking for Reconsideration Inability Cessation).

Yous or your representative must enquire in writing for afterthought inside 60 days of the date you receive the written find of the initial decision. Nosotros consider that you receive a find five days later on the date on the detect unless you bear witness the states prove it was received afterward the five days.

Payment Continuation for non-medical initial determination and medical disability abeyance determination:

• Non-Medical Initial Conclusion:
  • If you ask for reconsideration in writing within 10 days of the date you lot receive the notice, whatever payment we are currently making will continue until we brand our reconsideration determination, if you continue to meet all other SSI eligibility requirements.
  • If you ask for a reconsideration more than 10 days later the of the appointment yous receive the notice, but inside 60 days of the date yous receive the discover, your payment may decrease temporarily. Nevertheless, nosotros will restart whatever payment we are currently making once we receive and enter your afterthought. Yous volition continue to receive that payment until nosotros make our afterthought conclusion if you continue to encounter all other SSI eligibility requirements.
  • If you do not want to continue to receive payments, you can enquire the states non to proceed payments by completing Form SSA-263 (Waiver of Supplemental Security Income Payment Continuation).


• Medical Inability Cessation Determination:
  • If you appeal a medical disability cessation determination and yous want to keep receiving benefits until we make a new decision, yous must complete a written asking for benefit continuation within 10 days after the date you receive the written notice. Y'all are entitled to a hearing with a disability hearing officeholder.

We will ship yous (and your representative if you have one) a notice of the reconsideration conclusion.

We have released a new and improved service to check the status of your appeal. The service provides detailed data about inability and Supplemental Security Income appeals filed either online at www.ssa.gov or with a Social Security employee. To cheque the condition of your appeal Code of Federal Regulations § 404.930, create or log in to your personal my Social Security account.

2.  HEARING

If you disagree with the reconsideration determination, you or your representative may request a hearing earlier a guess past writing to us or by completing a Grade HA–501 (Asking for Hearing by Administrative Law Judge). Go to www.ssa.gov/benefits/disability/appeal.html to consummate an online request for a hearing. If needed, we can assist you complete this form.

You or your representative must request a hearing inside 60 days after you get the find of reconsideration determination (or, in rare cases, the initial determination). We consider that you receive the discover 5 days after the date on the observe. You or your representative may review your file before the hearing and may submit or inform us about new evidence no afterwards than 5 business organization days before the date of the hearing. Yous may continue to receive your SSI if you are appealing a conclusion that your disability has concluded. You must ask in writing for your benefits to proceed within 10 days of the cessation notice.

If you do not want to appear at a hearing earlier a judge, you or your representative may ask the approximate to make a conclusion based on the bear witness in your file.

If you exercise want to have a hearing before a judge, it is very of import that you or your representative appear at the scheduled hearing. While the Bureau determines the way of appearance, yous may request a hearing in person, by video teleconferencing or telephone. We will provide notice of the hearing date, location, and problems to be decided at to the lowest degree 75 days before the hearing. If for any reason you cannot get in to your hearing, contact the hearing part in writing, as presently as possible before the hearing, only non afterward than five days before the date prepare for the hearing or xxx days later receiving the notice of hearing, whichever is earlier, and explicate why you lot cannot attend. If you do not attend the scheduled hearing, you may lose your entreatment rights and benefits.

We may pay y'all for travel costs if the altitude to the hearing from your home is more than 75 miles one way. If you lot need money for reasonable and necessary travel costs, tell the judge equally soon as possible before the hearing.

The hearing process is very similar for all types of appeals. If your asking for hearing is about whether yous are disabled, the Administrative Law Judge (ALJ) volition focus on your medical condition(s) and brand a decision based on the evidence in your case file. The ALJ may as well call witnesses to prove. For case, the ALJ may call a medical or vocational expert to show. During the not-medical hearing process, the ALJ will focus on the reason y'all requested a hearing and asking prove specifically related to that consequence. Examples of non-medical hearing request reasons include eligibility for SSA benefits, or problems that may have caused an overpayment.

The gauge may enquire other witnesses, such as medical and vocational experts to testify at the hearing. At least 10 business organisation days before the hearing, you (or your representative, if yous have 1) may ask the gauge to order certain witnesses to attend the hearing, and the judge will decide if the witness' testimony is reasonably necessary.  During the hearing, the judge will explain your example and may ask you and any of your witnesses questions.  You may too ask whatsoever witnesses questions and present new evidence under certain circumstances.

For claims that are based on an application for inability benefits, yous (or your representative, if yous have one) must inform the guess about or submit all written evidence, objections to the bug, and pre-hearing written statements no later than five business days prior to the scheduled hearing and must submit amendment requests no later than 10 business organisation days prior to the hearing. The approximate may reject to obtain or consider late submissions of bear witness, objections, written statements, or subpoena requests unless you run across certain requirements listed in Social Security'southward rules at 20 CFR 404.935(b) and 416.1435(b). These rules practice not utilise to claims not based on an application for non-disability benefits (20 CFR 416.1435(c)).

The hearing is breezy, but we make an audio recording. You may enquire for a copy of the hearing recording.

The judge will send you (and your representative, if you have one) a copy of the hearing decision.

iii.  APPEALS Quango

If y'all disagree with the gauge'southward conclusion, you (or your representative) may request an appeal by writing to usa requesting an Appeals Council review, or by completing a Class HA–520 (Request for Review of Hearing Decision/Social club). Go to www.ssa.gov to consummate an online asking for Appeals Council review. Nosotros tin help you complete this form.

Yous (or your representative) must ask for an Appeals Council review within lx days later on you get the hearing decision.  We consider that you receive the hearing determination 5 days after the date on the hearing determination.

The Appeals Council may as well decide to review your case on its own within 60 days of the appointment of the decision.

You or your representative may submit or inform usa about new evidence. The Appeals Council will simply review a example based on additional evidence if information technology is new, cloth, related to the menstruation on or before the hearing decision, and there is a reasonable probability the evidence would change the upshot of the decision.

The Appeals Council will examine your case and will grant, deny, or dismiss your request for review.

If the Appeals Council grants your request for review, it will either make up one's mind your instance or return it to a judge for further activity, which could include another hearing and a new decision. If the Appeals Quango plans to issue a decision that is less than fully favorable to you and does not intend to remand the case for farther proceedings, it will send you (and your representative) a discover of its proposed action and volition allow yous or your representative an opportunity to respond before issuing the decision. The Appeals Council may issue a fully favorable determination, remand your case for farther proceedings, or issue a decision that is favorable in part while remanding the remaining problems for further proceedings. In these circumstances, the Appeals Council volition non notify yous (or your representative) prior to taking action, only volition send notice of its review with the determination or remand gild.

The Appeals Council will ship you (and your representative) a copy of the activeness it takes on your asking for review and explain the reasons for this action.

4.  FEDERAL Courtroom

If the Appeals Council problems a decision or denies your request for review of a gauge's decision, and you disagree with the activeness of the Appeals Council, you may file a ceremonious action with the U.S. District Court in your surface area.  We cannot help you file a courtroom action.  You may want to contact a lawyer or a legal assist grouping to help you.

You must file an activity in U.S. Commune Court inside sixty days after y'all receive the notice of Appeals Council activeness.  Nosotros consider that you receive find of the Appeals Council action five days after the appointment on the notice.  The U.S. Commune Court will review the evidence and the last Agency decision. The District Courtroom may send the case back to the Agency, and a judge may be ordered to hold a new hearing and issue a new decision. The District Courtroom may also direct the agency to honour benefits or dismiss the case.

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Source: https://www.ssa.gov/ssi/text-appeals-ussi.htm

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