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The Administrative Law Judge Denied My Claim. Can I Appeal?

Injured woman and male judge in the courtroom

If your application for Social Security benefits is denied, you have the right to appeal the decision to a higher authority. There are several levels of appeal, and whether you can or should appeal beyond a certain level depends on your circumstances. To learn about challenging a denial of Social Security benefits, read on. If you need help obtaining disability coverage, call a dedicated California social security disability insurance lawyer for assistance.

Levels of Social Security Appeal

If you apply for Social Security Disability Insurance (SSDI) benefits or Supplemental Security Income (SSI) and your application is denied, you have the right to challenge the decision of the Social Security Administration (SSA). You can appeal the decision via written request to the SSA within 60 days of the date you receive your decision.

There are generally four levels of appeals for SSI and SSDI benefits:

  • Reconsideration
  • Hearing by an administrative law judge (ALJ)
  • Review by the Appeals Council
  • Federal court review

Appealing Beyond the Administrative Law Judge

Assuming you have already had your benefits denied, petitioned for reconsideration, and had your case reviewed by an ALJ, what are your next steps? The ALJ’s decision is not the final word on the matter. If you believe the ALJ’s decision was made in error, you can appeal further to the Appeals Council.

The Appeals Council will not undertake a completely fresh review of your case. Instead, the Appeals Council will consider whether the ALJ’s decision was supported by the evidence at the hearing, or whether the ALJ made a procedural error in rendering its decision. If the Appeals Council feels that the decision was supported by the evidence presented and that there were no material procedural errors, then they will deny your appeal. To overturn the decision, the Appeals Council must be presented with clear evidence that the ALJ’s decision was incorrect–for example if the ALJ blatantly failed to properly consider certain medical records. If the decision is a wash, that is, if the Appeals Council concludes the ALJ could have gone either way based on the evidence, they will not second-guess the ALJ.

If the Appeals Council finds the ALJ’s decision was not supported by the evidence, they will either send (remand) the case back to the ALJ for reconsideration in light of their findings, or they will decide the matter themselves. If your appeal is denied, or if they review your case and decide to reject your claim, then you will either need to file a new application for benefits or take your case to federal court.

There are distinct advantages and disadvantages to appealing an unfavorable decision. Talk to a seasoned California disability lawyer about your claims to discuss whether appealing the case and/or continuing your claims in federal court is your best option for collecting your benefits.

Get Help With Your California Disability Claim Now

For help obtaining disability benefits in southern California or statewide, call the dedicated and experienced Social Security Disability (SSD/SSI) attorneys Drake & Drake at 818-914-4055.

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