Steps of a Long Term Disability Appeal

There are essentially three steps or there levels of appeal and review of a denial of an application for benefits to a Social Security program based on disability.  There are three more chances to contest a denial and overcome the flaws in your claim by providing specific evidence concerning the level of severity of the impairment and proof substantiating the medical diagnosis and all adverse effects the condition presents on working if an adult and on functioning if a child. 

Step 1

If you do not agree with the determination made by the Social Security on your application for benefits based on a disability claim you can appeal the decision.  You must make the request for a reconsideration of the claim, or an appeal, in writing, on the form used for that purpose and submit the form to the Social Security program within sixty days of the date on you notice of claim decision letter.  When your long term disability appeal is reconsidered you will need to submit new medical evidence concerning the claim.  If the claim was denied for the reason that the disability was not considered severe enough to interfere with an ability to work if an adult or function if a child, then you must provide additional medical data to support a finding that the condition is severe and life disruptive.  The case will be reconsidered by different people than the ones that originally denied the claim. 

Step 2

If you want to further appeal the decision regarding your disability claim you would have your case heard by an Administrative Law Judge (ALJ).   To have a hearing before an ALJ you must have the following:

• A notice of the reconsideration appeal determination
• File a request for an ALJ hearing in writing sixty days after receiving adverse notice of reconsideration determination
• You can show that your rights may be adversely affected by the reconsideration decision or you have a right to a hearing before an ALJ.

At the ALJ hearing you and your lawyer will appear in person, testify under oath concerning your condition, submit new evidence, examine old evidence, and present and question witnesses.

Step 3                 

Further review of your case may be requested by the Appeals Council of the Office of Hearings and Appeals if you do not accept the ALJ’s determination and decision.   The request to the Appeal Council must be made within sixty day of receipt of the decision of the ALJ.  The Appeals Council may summarily deny or dismiss the request or it may grant the request, issue a decision or remand the case back to the ALJ for further action.

Getting Legal Help

Having the assistance and representation of an attorney on a long term disability appeal is always the best plan of action.  Appeals often involve complicated legal and medical issues.  An attorney can provide the required legal experience to properly put the appeal processes into effect to successfully overturn an adverse decision and get you approved to receive the long term disability benefits you need.