How to Win SSI Appeal: A Quick Guide

Getting your initial claim denied isn’t the end of your SSI journey. You can still appeal the SSA’s decision. The tricky part, however, is winning your SSI appeal.

According to the SSA, more than 60% of disability and SSI applications are denied each year. That means the chances of getting approved at the initial application stage are pretty slim.

The good news, however, is that most appealed claims eventually got approved. SSA data suggests that more than half of disability and SSI appeals are eventually approved.

But how do you appeal an SSI denial? More importantly, how do you make sure that you get your benefits this time around?

If you’re planning to appeal the SSA’S decision, here’s a quick guide on how to win your SSI appeal.

Understanding the SSI Appeal Process

The SSA’s appeals process has four levels:

• Reconsideration
• Hearing before an Administrative Law Judge (ALJ)
• Appeals Council review
• Federal court review

Upon receiving the SSA’s notice of denial, you only have 60 days to file a request for reconsideration. If you fail to file a request within this time period, it means you agree with the SSA’s decision and you’re not pursuing your claim anymore.         

Upon receiving your request for reconsideration, the SSA will review your entire case. They will take a look at their records and the new evidence (if any) you present in your appeal.

If they deny your request for reconsideration, you can request a hearing before the administrative law judge. Most denied claims are usually approved after an ALJ hearing.

However, if the ALJ also denies your claim, you can request the Appeals Council to review the ALJ’s decision. If this still fails, your last recourse is to take your case before a federal court judge. The federal court’s decision is final and irrevocable.

You may also file a new claim but you may have to lose some benefits or become totally ineligible for any benefit.

How to Appeal Your SSI Denial

Now that you know how the SSA appeals process works, here’s a step-by-step guide on how to appeal an SSI denial.

1. Understand Why You Got Denied

There are lots of reasons why the SSA will deny a claim. It could be due to a lack of supporting documents, incomplete paperwork, or a clerical error among others.

Understanding why your claim got denied will help you plan your appeal and increase your chances of getting approved.

In most cases, the SSA will explain the reason/s for the denial in their decision notice. So read through the notice and list down those reasons. Then figure out ways to address them in your appeal.

If it’s due to incomplete paperwork, make sure to submit all the required forms and documents this time around. Or if it’s due to a clerical error, make sure to inform the SSA about it to correct it as soon as possible.

2. Gather Additional Evidence

Most of the time, claims are denied due to a lack of supporting evidence. This is especially true if you’re claiming SSI based on your disability.

To increase your chances of winning your SSI appeal, you should gather as much supporting evidence as you can. This can include:

• formal diagnosis
• doctor’s statements
• sworn statements from witnesses
• medical and treatment records
• employment history

3. File an Appeal

Once you have all the paperwork and supporting evidence on hand, it’s time to file an appeal.

There are two ways to go about this: appeal the SSA’s decision online or file a Request for Reconsideration.

If you want a faster turnaround time, the SSA recommends filing your appeal through its website. For claims that were denied due to medical reasons, you can file an appeal here. If the denial is due to non-medical reasons, you can appeal it here.

If online applications aren’t your cup of tea, you can instead fill up the Request for Reconsideration Form and send it to your local Social Security Office. You will also need to submit the following forms:

• Disability Report Appeal
• Authorization to Disclose Information to the Social Security Information

Remember that you need to submit your appeal within 60 days of receiving the SSA’s decision notice.

4. Request for ALJ Hearing

If your request for reconsideration is denied, no worries. You can still request a hearing with an administrative law judge.

During this hearing, you will get the chance to plead your case before a judge. You can present witnesses and any other evidence that will strengthen your claim.

ALJ hearings can be held through video conferencing, by phone, or in person.

You can file your request online or fill out the SSA’s Request for Hearing by Administrative Law Judge form and submit it to your local SSA office.

5. Request for Appeals Council Review

As mentioned, most denied claims are approved after an ALJ hearing. But if you don’t agree with the judge’s decision, you can request the Appeals Council to review your case.

Again, you can file your request online through the SSA’s site. Alternatively, you can also fill up SSA form HA 520 and mail or submit it in person to your local SSA office.

6. File an appeal at the federal court

When all else fails and you still receive an unfavorable decision, you can file a civil suit in a federal court.

The suit has to be filed in a judicial court that has jurisdiction over your place of business or residence. You’ll need to file the suit within 60 days of receiving the Appeals Council’s decision.