Changes have been made to the Social Security appeals process to protect beneficiaries and staff from the coronavirus.
How Social Security Appeals Have Changed During the Pandemic
Many Social Security applicants are denied upon their first application and choose to appeal this decision. There are four levels of appeal for those that disagree with the decision made by the Social Security Administration (The Social Security Administration (SSA) is a U.S. government agency that administers social programs covering disability, retirement, and survivors' benefits. It was created in 1935 by President Franklin D. Roosevelt.): Reconsideration, Administrative Law Judge Hearing, Appeals Council Review, and Federal Court. To keep applicants safe during COVID-19, the appeals process has changed slightly.
When applying for Social Security benefits, you will receive a written “initial determination” of the SSA’s findings. According to the SSA, these determinations are legal and factual matter and include but are not limited to:
- Whether you’re eligible for Supplemental Security Income or Disability Insurance Benefits
- The date you were last eligible for Disability Insurance Benefits (Date Last Insured)
- Whether you meet the medical eligibility requirements for the programs
Each determination made by the SSA about your eligibility or payment amount is also called an initial determination. Your first initial determination will be mailed to you, and you will receive a notice of each one made. If you want to appeal the initial determination, you must request an appeal in writing within 60 days of receiving the notice. For notices, the SSA considers a notice is received five days after the notice is dated.
Reconsideration can be requested by writing to the SSA, by filing an appeal electronically on iAppeals, completing Form SSA 561, or completing form SSA-3441. Reconsideration must be requested in writing within 60 days of the date you received your initial determination. The SSA will send you, and your representative if applicable, a notice of the reconsideration decision.
If you also disagree with the reconsideration determination, a hearing before an administrative law judge (ALJ) may be requested. You or your representative may request this hearing by writing to the SSA, filing an appeal electronically on iAppeals or completing a Form HA-501 within 60 days of receiving the notice of reconsideration determination.
The hearing itself is normally done in person, via teleconference, or phone call. While teleconference or phone call are saved for extraordinary measures, the pandemic has proved itself to be an extraordinary measure. Hearings are now completed via phone and proceed as normal as possible with a typical duration of 45 minutes to an hour.
If you disagree with the determination made by the ALJ, you or your representative may request an Appeals Council review by writing to the SSA, filing an electronic appeal or completing a Form HA-520. This must be requested within 60 days after receiving your hearing decision.
The Appeals Council will evaluate your case and grant, deny or dismiss it. If your request is granted, your case will either be decided by the Appeals Council or returned to the ALJ, which may include an additional hearing and new decision.
If the Appeals Council plans to issue a decision that is not fully favorable, you and your representative will receive a notice. You or your representative will have the chance to respond before the decision is issued. A copy of the action taken and reasoning by the Appeals Council will be sent to you and your representative.
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. This action must be filed within 60 days of receiving the notice of the action taken by the Appeals Council. The U.S. District Court may send the case back, the ALJ may be ordered to hold another hearing and make a new decision, or the District Court may advise benefits to be awarded.
Accommodations to COVID-19 Precautions
As mentioned, hearings are now being held over the phone due to office closures. It is predicted these phone hearings will last through August. There has also been a shift in the available workforce as SSA employees are working from home. New cases and initial appeals are being processed first, and continuing disability reviews have been put on hold.