Aggrieved individuals may appeal initial determinations of the Social Security Administration with respect to a variety of issues. A non-exhaustive list of appealable issues includes whether an individual is eligible to receive Supplemental Security Income (SSI) benefits, the amount of an individual’s SSI benefit, whether an overpayment has occurred and the amount to be repaid, and whether the individual suffers from a “disability.” Though individuals have sixty days to initiate the appeal process, only those individuals who appeal within ten days may have their benefits continued until the appeal is decided. If ultimately, the individual’s appeal is unsuccessful, the payments he received in the interim will be considered overpayments. After each decision in the appeal process, the individual has another sixty days in which to appeal to the next level.
Initially, the appeal will go through a reconsideration process. Should the individual disagree with the reconsideration decision, he may request review by an administrative law judge (ALJ), either with or without a hearing. If no hearing is requested, the ALJ will make a decision based on the evidence in the file, which will include any new evidence submitted by the individual. If a hearing is requested, the ALJ may examine witnesses and, if necessary, order further medical exams. The individual may also examine witnesses at the hearing as well as present new evidence for the ALJ’s consideration.
An individual who disagrees with the ALJ’s determination may seek review by an appeals council though it is possible that the appeals council may deny the request. Should the appeals council grant review, it will either decide the matter or return it to the ALJ for further action.
Finally, individuals who remain aggrieved after the appeals council’s determination can file a civil action in federal court. The court will not conduct another hearing. Rather, its determination will be based on an examination of all the evidence including the previous decisions.