COMMONLY ASKED QUESTIONS AND ANSWERS
Question: Who makes the decision as to whether I am disabled or not and what are my appeal rights if I am denied?
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Answer
There are several levels of appeals involved in a Social Security Disability claim. The initial determination is made by the Disability Determination Services which is part of the Social Security Administration. If the initial examiner denies you, you have 60 days to file an appeal which is called a Request for Reconsideration.
At the reconsideration level, Disability Determination Services will again make the decision. It will be someone else within that system "reconsidering" your claim. If you are again denied disability benefits, you have 60 days to file an appeal which is called a Request for Hearing.
When you are at the hearing level, your case will be decided by an Administrative Law Judge. At this level of the system you are provided an opportunity to appear in front of the ALJ and provide testimony as to your disability as well as any other relevant evidence. If you are denied by the ALJ, you have 60 days to file a Request for Review by the Appeals Council.
The Appeals Council is the final adjudicator within the Social Security system. The Appeals Council reviews the specific decision of the Administrative Law Judge. The Appeals Council can affirm or agree with the ALJ's denial, they can refuse your appeal, they can reverse the ALJ's decision and grant benefits, or they can send it back to the ALJ for further development. If you are denied at the Appeals Council level, you have 60 days to file a lawsuit in Federal Court.
If you file a Federal Court lawsuit, your case is decided by the Federal District Court Judge. The Federal Court can deny your appeal, affirm the Social Security Administration's denial, reverse their decision and grant benefits, or remand the case back to the Social Security system for further development. If you are successful in your Federal Court action, you would have an opportunity to seek attorneys' fees against the Social Security Administration for the work that the lawyer had to do in the Federal Court lawsuit. If you are denied by the Federal District Court Judge, you have an opportunity to appeal to the 10th Circuit Court of Appeals and to the Supreme Court of the United States.
On behalf of McCULLOUGH, WAREHEIM & LaBUNKER, P.A. we hope this material will be of benefit to you in answering your questions relative to social security disability. Contact one of our SSD claims lawyers representing clients in Emporia, Kansas (and throughout the State of Kansas) today to schedule a free consult on your file.