When to Appeal to an Administrative Law Judge

When a Social Security disability program applicant receives notice by letter that his claim was denied he may opt to appeal that decision by requesting a reconsideration of the denial in writing within sixty days of receiving the letter.  He must submit additional information concerning his claim to respond to any previous shortcomings that may have resulted in the denial of his original claim and aid the reconsideration process.  If he yet and still receives a second claim denial based on the reconsideration he may again, request in writing, within sixty days of receipt of the reconsideration claim denial, a hearing before an Administrative Law Judge (ALJ) of the Office of the Disability Adjudication and Review.    

An ALJ may Dismiss the Request for a Hearing

• The hearing request was made orally or in writing at the hearing
• Neither the claimant nor his legal representative appears at a scheduled hearing
• The appeal was not requested within the sixty day limit period
• The claimant has no right to a hearing
• A fully favorable revised reconsideration decision was entered at that level
• You die and no substitute requests a hearing
• A previous decision has entered concerning the same people, issues and facts  

Actions ALJ may Take on a Request of a Hearing

• Hold a hearing and issue a decision
• Hold a limited hearing to determine if there is any new evidence to base a reopening of the case
• If the case involves a mental disability he may send the case back for preparation of a standard form that is required in mental disability cases
• Send the case back to DDS for a revised determination based on new evidence

Once an ALJ holds a hearing on a case it will not be sent back to Disability Determination Service for any reason.  The ALJ will usually issue a written decision based on the evidence before him.  He may also formally request additional evidence to make a final decision, send the case to the Appeals Council for a final decision or simply dismiss the case.  He will notify all parties of his decision and his reasons for making that decision.

Getting Legal Help

If you or a member of your family has received a decision notice from a request for reconsideration of a claim determination and you disagree with that second decision and want to appeal the decision to an ALJ it may be important to discuss the situation with a disability lawyer.  An attorney can provide valuable guidance on the ALJ appeal hearing process and help to secure an ALJ decision awarding disability benefits.