How Do I Get Benefits Granted?

Nationwide, about one of every two claimants is eventually granted Social Security benefits.

Claimants must first apply for benefits through their local office of the Social Security Administration. [Click here to visit the Social Security Administration site] The Social Security Administration then supports five decision making levels to determine a claimant's right to benefits.

Of those who are granted benefits somewhere along the way, about one in three (30%) is granted benefits right off the bat, at the state agency level. They do not go to a hearing. Of the two-thirds who have to push on to a hearing before an Administrative Law Judge, three-fourths are granted benefits by the ALJ.

Bottom line: Don't give up if you are denied at the early levels of initial decision and reconsideration. Chances are, you will eventually be granted.

Each decision making level has deadlines for appealing its decision to the next level.

Appeal Deadlines

The deadline to appeal a decision is almost always 60 days from the date the claimant received the unfavorable decision, but there are two exceptions:

  1. A claimant has only 30 days to request that the Appeals Council review a case remanded to an Administrative Law Judge by a federal court.
  2. Upon receiving notice that benefits are to be terminated, the recipient has only ten days to request that benefits be continued. See Cessation Decision for more information.

The Social Security Administration assumes that the claimant received the decision five days after the date of the decision, unless the claimant can show otherwise.

Good Cause for Late/Untimely Appeal

A claimant who misses the deadline should not abandon the claim or file a new application to start all over again. The claimant may be able to give Social Security a good reason the claimant's appeal was late (illness, family emergency, misunderstandings).

Even if the claimant does have to file a new application, if less than one year has passed, the claimant may be able to reopen the old application and get benefits reaching back to the original application.

In certain unusual circumstances, applications abandoned even four years ago may be reopened.

 


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