Understanding Supplemental Security Income
Appeals Process2008 Edition

  HOW  TO  APPEAL  SOCIAL  SECURITY  DETERMINATIONS  

We have established appeals procedures for individuals who wish to file an appeal. The levels of appeal are:

	reconsideration;
	Administrative Law Judge Hearing;
	Appeals Council Review;
	Federal Court.

We call the determinations we make that you can be appeal initial determinations. These determinations include but are not limited to:

	whether or not you are eligible to receive SSI benefits;
	the amount of your SSI benefit; and
	the fact that you were overpaid and the amount of the overpayment and whether you must repay it.

You must request an appeal in writing within 60 days of the date you receive your notice. The notice will tell you how to appeal. If you file an appeal within 10 days, your SSI benefits may continue at the same amount until we make a determination on your appeal. Your notice will advise if you are entitled to continued benefits.

Contact us, and we can help you with your appeal.

You may appoint a representative to act for you in our appeals process. For information on how to appoint a representative, see our chapter on HOW SOMEONE CAN HELP YOU WITH YOUR SSI.

  INITIAL  DETERMINATION  

After you have filed an application for SSI benefits, we will mail you a written determination. This is your first initial determination. Each time we make a decision about your eligibility or benefit amount after that is also an initial determination.

  STEPS  IN  THE  APPEALS  PROCESS  

1.  RECONSIDERATION

If you disagree with the initial determination, you may request reconsideration by writing to us or by completing:
Form SSA–561 (Request for Reconsideration); or,
Form SSA–789  (Disability Cessation Appeal).

You or your representative must ask in writing for reconsideration within 60 days of the date you receive the written notice of the initial determination. If you ask for reconsideration within 10 days, any payment we are currently making will continue until we make our determination, providing that your income and resources are not over our limits.

We will send you a notice of the reconsideration determination.

If you appeal a disability cessation and you want to continue receiving benefits until we make a decision, you must make a written request for benefit continuation within 10 days of the date you receive the written notice. You are entitled to a face–to–face hearing with a disability hearing officer.

In certain States, we are using a revised appeal process which may replace the reconsideration step. If you are in one of these States, the notice of our determination will give you specific instructions about how to appeal.

2.  HEARING

If you disagree with the reconsideration determination, you or your representative may request a hearing before an Administrative Law Judge by writing to us or by completing a Form HA–501 (Request for Hearing). We will help you complete this form.

You or your representative must request a hearing within 60 days after you get the notice of reconsideration determination. You or your representative may review your file before the hearing and may submit new evidence then. You may continue to receive your SSI benefits if you are appealing a determination that your disability has ended. You must ask in writing for your benefits to continue.

If you do not want to appear at a hearing before a judge, you or your representative may ask the judge to make a decision based on the evidence in your file.

If you do want to have a hearing before a judge, it is very important that you or your representative appear in person at the scheduled hearing. If for any reason you cannot make it, contact the judge as soon as possible before the hearing and explain why. If you do not attend the scheduled hearing, you may lose your appeal rights and benefits.

We may pay you for travel costs if the distance to the hearing from your home is more than 75 miles one way. If you need money for travel costs, tell the judge as soon as possible before the hearing.

In a disability case, the judge may also want you to have more medical exams or tests. You may request further medical exams or tests if you think you need more medical information. The judge decides whether to grant your request.

The judge may ask other witnesses, such as doctors, to come to the hearing. You may ask the judge to order certain witnesses to attend the hearing.

During the hearing, the judge will explain your case and may ask you and any of your witnesses questions. You may also ask any witnesses questions and present new evidence.

The hearing is informal, but we record it. You may ask for a copy of the tape or the CD.

The judge will send both you and your representative a copy of the hearing decision.

3.  APPEALS COUNCIL

If you disagree with the judge's decision, you or your representative may request an appeal by writing to us and requesting an Appeals Council review or by completing a Form HA–520 (Request for Review of Hearing Decision/Order). We will help you complete this form.

You or your representative must ask for an Appeals Council review within 60 days after you get the hearing decision.

You or your representative may submit new evidence.

The Appeals Council will carefully examine your case and will grant, deny, or dismiss your request for review. If the Appeals Council grants your request for review, it will either decide your case or return it to the judge for further actions, which could include another hearing and a new decision.

The Appeals Council will send you and your representative a copy of its decision, which will explain the action taken on your request.

4.  FEDERAL COURT

If you disagree with the action of the Appeals Council, you may file a civil action with the U.S. District Court in your area. We cannot help you file a court action. You may want to contact a lawyer or a legal aid group to help you.

You must file an action in Federal court within 60 days after you receive the notice of Appeals Council action.

The Federal Court will review the evidence and the earlier decisions, but will not conduct another hearing.