Social Security Appeals

What happens if a brain injury survivor applies for social security benefits and gets turned down? Don’t worry. All is not lost! It’s not uncommon that Social Security benefits are initially turned down, but there is an appeals process that the survivor can go through.

First of all, if the agency decides the survivor does not meet the eligibility requirements for benefits, a letter will be sent to the survivor explaining the decision. The survivor then has 60 days from the date of the letter to file an appeal.

Sometimes your initial appeal won’t be granted. Keep at it. There are four levels to the appeals process.

1. If you receive a letter from the agency saying that your request for benefits was denied, you may request to have your claim reviewed by someone who didn’t review it the first time around. This is called a “reconsideration.” This request must be made in writing, within 30 days of the date of the letter stating that benefits were denied. All of the evidence you submitted previously will be looked at again, as will any new evidence you wish to submit.

2. If the reconsideration is denied, you may ask for a hearing. An administrative law judge who has had no prior involvement in your claim will be asked to review your case. The survivor and/or a representative may attend the hearing. New information or evidence that wasn’t previously considered may be submitted.

3. If benefits are denied at the hearing, you may request a review by the Social Security’s Appeal Council. The council does not have to review all requests, but may, upon looking at the case, decide that the hearing decision was fair. If the council does decide to review your case it will either do so itself, or will assign the case to an administrative law judge.

4. If the Appeal Council elects not to hear your case, the final step is to file a lawsuit in a federal district court. Similarly, if the Appeal Council does hear your case and rejects it, you may also file a lawsuit in a federal district court.

Because the process is complicated and there are lots of legalities involved, those who elect to hire a lawyer with extensive knowledge of administrative law will probably fare better in the appeals process. There are plenty of lawyers who specialize in Social Security law. In order to find one in your area, try contacting the National Organization of Social Security Claimants’ Representatives for a referral. They can be reached at 1.800.431.2804. Or try logging on to their website, www.nosscr.org. You can also contact the State Bar Association for your state to locate legal counsel in your area.

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