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Understanding the SSDI appeals process

Many people in Houston file applications for Social Security Disability Insurance benefits every year without realizing that most initial claims are denied. When a claim for SSDI benefits is denied, the law and regulations administered by the Social Security Administration give claimants many options to appeal such a rejection. Understanding the basic features of that process may be crucial to ultimately obtaining an award of benefits.

After receiving a notice of denial, a claimant can initiate the Social Security Disability Insurance appeal process by filing a request for reconsideration. The request is given to an SSA employee who was not involved in the initial decision. That person will review all of the evidence and the original decision. The claimant can also present new evidence. If the request for reconsideration is denied, the applicant can request a hearing before an administrative law judge. Additional evidence may be presented to the ALJ. The applicant may appear before the ALJ to present this evidence, and experts may be called to testify.

If the ALJ denies the claim, the claimant can seek review by the Appeals Counsel. The Appeals Council has three options: deny the appeal if it believes the case was properly decided, refer the matter to an ALJ or make its own decision based on the record. The final appellate step is filing a civil lawsuit in United States District Court. If the court finds that the SSA decision was based on a faulty evaluation of the evidence or a mistake of law, it can reverse the order and direct the SSA to award benefits.

An SSDI claimant is entitled to be represented by a lawyer throughout the entire appellate process. A lawyer who is experienced in the SSDI claim and appellate processes can be helpful at any stage of an appeal, but legal representation is virtually essential if the claimant wants the case reviewed by a federal judge.

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