The Social Security Administration (SSA) provides more than income to retired Americans. It also awards benefits to individuals who require assistance due to age or disability. Known as Supplemental Security Income, or SSI, these benefits are available to those over 65, children with limited income or resources and disabled adults, such as the blind. The SSA determines whether or not an individual is eligible for such an award based on need versus available income: the less income one receives, the higher the probability that one will receive SSI.
Sometimes, however, the SSA makes an SSI benefits decision that does not quite add up. A claim can be denied if the administration feels that an applicant's income is too high, or a medical condition has improved or abated. Fortunately, the administration has an appeals process in place so that individuals who believe they require assistance can have their claim reexamined.
When appealing, it is important to file a timely, written claim. The SSA will not consider appeals made more than 60 days after the postmark date of the initial letter informing an applicant of a decision to deny benefits.
Reconsideration
The first step of the appeals process is called reconsideration. At this step, the claim is reviewed by a Social Security employee who was not involved with the initial claim. The SSA can provide an applicant with the support of a Social Security representative, if desired. After the administration reconsiders a claim, it will send written notification of its decision to the applicant.
The Hearing
If an applicant disagrees with the decision made by the SSA during the reconsideration process, he or she may opt to request a hearing. An administrative law judge who did not participate in the consideration of the original claim will review the appeal, and may request additional or new information from the applicant to help guide his or her decision. The applicant must attend the hearing either in person or by video stream unless he or she petitions the administration in advance. After the hearing, the judge will make a decision regarding the claim.
Appeals Council
In the event that an applicant disagrees with the decision reached at the hearing, it is possible to appeal the decision further. An applicant may submit his or her claim to the Appeals Council. The council is not required to review all claims submitted, and may decide to agree with the original decision made at the hearing, at which time it will submit the claim to another administrative judge for further review. If the Appeals Council decides to review a claim, it is not necessary for an applicant to participate in the process.
Federal Court
If, at the end of the appeals council process, an applicant is still not convinced the right decision has been made, he or she may petition for his or her claim to be heard in federal district court in the form of a lawsuit against the SSA. This is the last avenue for appeals available to an SSI applicant.
If you or a loved one has been denied SSI benefits, be sure to seek the advice of an experienced attorney to assist you in navigating the appeals process.
