Can I appeal the social security quality assurance review decision?

The Social Security Administration Quality Assurance System is responsible for reviewing disability claims an agent has already approved. Its purpose is to verify the validity of the examiner of either a Social Security Disability (SSD) or Social Security Insurance (SSI) claim. They do have the power to overturn the initial approval, and deny your claim.

You can appeal this decision. The process involves filing an appeal within 60 days after you receive the notice of denial. However, the actual time for filing is based on a period of five days from the date on the letter. Your first step is to request a Reconsideration. This will involve a request for review from someone not originally involved in the process.

A denial does not necessarily end the matter. You can then request a hearing. This will take place before an Administrative Law Judge (ALJ). He or she will then look at both the original claim you made and the denial. You may be able to submit extra supporting information and call witnesses. After the hearing, the ALJ will inform you as to the decision.

If this fails, you have other options. You may appeal the decision. You do so to the Social Security Appeals Council (SSAC). The SSAC has the right to review your claim. The decision may be to allow the appeal or to deny it. If they allow the appeal, they may suggest one of the following:

• Review of the case by a different ALJ
• A reconsideration by the original ALJ – not available in all states
• A lawsuit

If you do decide to appeal the review by the Social Security Quality Assurance Review Decision, be sure to talk to a qualified lawyer.