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What Happens When Social Security Disagrees With You?

What Happens When Social Security Disagrees With You?

Did you know that you have rights to appeal decisions made by the Social Security Administration on your behalf?  It’s true.

Let’s say that you’re being paid something less than you believe you are due. You’ve reached out to them via their toll-free number and you’ve been told what you’re being paid is right… but you are convinced it should be different.

If that scenario sounds familiar it’s because you aren’t alone. As of 2015, nearly 60 million U.S. citizens were paid nearly $900 Billion in benefits… and there were plenty of complaints that the numbers were off.

So the Social Security Administration has created a specific appeals process. Be prepared to spend a little money and time walking through the process but can be worth it… as of the writing of this article, the Social Security Department has publicly declared that if there are mistakes they want to address them.

What you need to know is that there are 4 appeal levels.

Reconsideration

This offers a comprehensive review of your situation by agents at the Social Security Administration who didn’t take part during the past evaluations. They will closely examine all the facts of your situation and why the benefits were set at your current levels. Sometimes, you may have an opportunity to submit additional information.

Administrative Law Judge

Assuming Reconsideration doesn’t go your way, the next step is to go before an Administrative Law Judge. Whenever possible, the Social Security department prefers to have meetings within a 75-mile radius of your location. If that’s a hardship, the case will be heard via an alternate method such as videoconference.  As in the “Reconsideration” stage, the judge has zero prior experience with your case or the original decision that you’re appealing.

The ALJ (Administrative Law Judge) will review the merits of the case. You’ll have the opportunity to bring witnesses and the judge may ask them questions. The judge may also call on experts to help clarify concerns.

Appeals Council

If the hearing before the Administrative Law Judge doesn’t go in your favor, the next step is to bring your case before the Social Security Department’s Appeals Council. Comprised of 3 members, this is the last review that can occur inside the Social Security Administration. They can hear your case, simply make a finding, or refer it back to an Administrative Law Judge for further review.

Federal Court

This is the final stage assuming all other appeal methods have been exhausted. At this point the decision making process is removed from the Social Security Department and placed in the hands of a Federal Court. Lose your case here and you have no more rights to appeal.

Should you be considering having your benefits case reviewed, here are some extra things to remember:

 

  • You have 60 days to appeal starting on the date you received the Social Security decision.
  • If you miss a deadline, tell the Social Security department why you were late and they may be able to still grant an appeal.
  • You can have an attorney to help you organize your case and testimony. The Social Security Department strives to work with your representative. But you can just as easily have a good friend or family member also represent you while the process is internal to the Social Security Department.
  • To start an appeal, there is a special form that should be submitted. Simply ask for the form when speaking with a Social Security representative.
  • Bear in mind the appeals process can be quite lengthy.

Just in case, here’s a direct link to the Social Security Department’s Request for Reconsideration website page: https://www.ssa.gov/forms/ssa-561.html

And remember that if you are feeling squeezed by a Social Security Department finding, be sure to talk with your financial advisor and independent insurance agents to help you minimize expenses and get the best coverage for your specific situation.