The Social Security Administration (SSA) has established guidelines for the review of decisions unfavorable to applicants.
Unfavorable decisions of the SSA are subject to four levels of review: reconsideration before the SSA, a hearing before an administrative law judge (ALJ), review by the Appeals Council, and review by a federal court.
The first level of review is reconsideration by the SSA, which must be requested in writing within 60 days of the initial benefit determination.
The second level of review is a hearing before an ALJ, which also must be requested within 60 days. Before the hearing, an applicant may review the materials the SSA plans to use to defend the appeal. Additionally, an applicant can submit new evidence on the record before the ALJ.
The third level of review is before the Appeals Council. This is the last stage of review within the SSA. The Appeals Council will not overturn an ALJ decision unless there were errors of law, abuses of discretion, or a lack of substantial evidence to support the decision.
A final review may be requested within 60 days before a federal district court. The court will not overturn an Appeals Council decision unless the Council failed to apply the proper legal standard or failed to have a substantial factual basis for its decision.
Copyright 2012 LexisNexis, a division of Reed Elsevier Inc.
