FACT SHEET 6

HOW TO APPEAL AN SSA

DENIAL OF BENEFITS

DENIALS AND APPEALS

Many initial claims for Social Security Disability Benefits are denied for lack of
information necessary to approve the claim. See SSA’s Definition of Disability:
http://www.ssa.gov/dibplan/dqualify4.htm
Denials also occur because the information retrieved from healthcare providers as
listed in the Disability Report was insufficient to approve the claim.
Anyone who’s been denied may appeal within 60 days of the receipt of the denial letter.
THE REQUEST FOR RECONSIDERATION
In most instances there are four levels of appeal. They are:
 Reconsideration; http://www.socialsecurity.gov/online/ssa-561.pdf
1. CASE REVIEW: Available in all instances. Requires material and records in addition to what
was submitted with the first application.
2. INFORMAL CONFERENCE: Face-to-face with a representative of SSA. You can bring others
along to help substantiate your claim and your appeal. This works in all instances but two: If
you were denied due to insufficient medical evidence or because you're not blind. Also you
can't have it if we're giving you SSI but you disagree with the date we said you became blind
or disabled. In SVB cases, you can pick this kind of appeal only if we're stopping or lowering
your SVB payment.
3. FORMAL CONFERENCE: This is a meeting like an informal conference. SSA has the power to
subpoena people to help prove you're right. We can do this even if they don't want to help
you. You can question these people at your meeting. You can pick this kind of appeal only if
we're stopping or lowering your SSI or SVB payment. You can't get it in any other case.
Now you know the three kinds of appeals. You can pick the one that fits your case. Then fill
out this form. We'll help you fill it out.
4. HEARING BY AN ADMINISTRATIVE LAW JUDGE If you are requesting a hearing on the
denial of a claim for disability benefits, you must complete and sign additional forms. These
forms are the SSA-3441, Disability Report - Appeal, and SSA-827, Authorization to Disclose
Information to SSA. You should also complete an HA-4631, Claimant's Recent Medical
Treatment, and an HA-4632, Claimant's Medications. If you have worked since you filed your
application for disability benefits, complete an HA-4633, Claimant's Work Background.
You may also need to complete a form SSA-1696, Appointment of Representative, if you are
appointing a representative. Your representative should also sign the SSA-1696 before you
send it to us.

For further information go to www.db101.org or call

Pacific Clinics Benefits Establishment @
626-254-5000