The Social Security Administration (“SSA”) is an agency of the federal government that provides financial protection for millions of people throughout the country. This includes those who have been diagnosed with chronic illnesses or disabilities, veterans, retirees, children whose parents are deceased, and survivor spouses. 

The SSA is responsible for administering various social programs and financial benefits (e.g., Medicare, Supplemental Security Income (“SSI”), retirement replacement wages, etc.) to the above listed parties. The SSA is also in charge of overseeing and running the Social Security program, managing the trust fund for the program, and assigning unique Social Security numbers to every eligible individual in the United States.

Additionally, the SSA also comprises one of the largest administrative judicial systems in the world. According to its official website, the SSA issues more than half a million hearing and appeal dispositions every year. 

In the event that a person disagrees with the Appeals Council’s decision or if they decide not to review your case, then you may file an SSA lawsuit in your local federal district court. An SSA lawsuit will be your final chance to have a decision appealed.

However, there will be a time limit to file such a civil action in court. Thus, while it is possible to file social security cases in federal court, you will only have 60 days from the time you received a notice from the Council to do so. Also, just because you file a lawsuit to have a decision overturned, does not necessarily mean that a federal court will reverse the Council’s decision.  

Therefore, to ensure that you are in the best possible position to achieve a favorable outcome in your case, you should consider hiring a local government attorney for further guidance.

What are the Types of Social Security Benefits?

In general, there are five main types of Social Security benefits under SSA laws. These include:

  • Retirement benefits: Retirement benefits are a type of replacement income that gets paid to retirees who qualify for such benefits. The amount that a retiree receives will be based on a percentage of their pre-retirement wages earned during their highest 35 years of earnings, as well as on their salary at the time and when the retiree chooses to request retirement benefits. 
  • Disability benefits: Unlike the disability benefits distributed to persons eligible under the SSI program, the benefits issued by the Social Security Disability Insurance (“SSDI”) program are only given to those who have worked long enough, recently enough, and have been paying Social Security taxes on their earnings. However, both require that an individual meet the medical criteria (i.e., have a medical disability).  
  • Medicare: Medicare is a health insurance program that primarily provides benefits to individuals who are 65 years of age or older. In some cases, people who are younger may qualify for Medicare as well, such as those who have permanent kidney failure or are diagnosed with certain disabilities. 

    • Also, although Medicare helps to reduce the overall costs associated with health care and medical treatments, it does not provide coverage for all medical expenses (e.g., will not cover the costs of most long-term care needs).
  • Survivors benefits: Survivors of a family member who was still working and paying Social Security taxes when they died may be eligible to receive survivors benefits. Survivors benefits are typically given to widows, widowers, children whose parents are deceased, and in some cases, parents who are dependent on their children’s earnings.
  • SSI: SSI benefits are available to both children and adults with disabilities who have limited income and resources. Some people who are over 65 years of age and not disabled may also qualify for SSI benefits if they meet the proper financial threshold. The federal income payments that an eligible recipient can receive is intended to pay for items that are considered basic needs, such as housing, groceries, and clothing.

Why Might I Be Denied SSA Benefits?

The main reason a person may be denied SSA benefits will depend on the type of benefits for which they applied. In many cases, the most common reasons that a person is denied SSA benefits is because they did not meet the requirements for a particular benefit, failed to pay sufficient social security taxes, or did not satisfy the age threshold or medical criteria. 

For example, a surviving spouse may be denied survivors benefits if they remarry before they reach the requisite age of retirement.  

Additionally, a person can also be denied SSA benefits when there is an error with their application. This includes providing all of the information needed for the SSA to make a decision regarding their eligibility to receive SSA benefits. 

What Should I Do If I Believe I Have Been Wrongly Denied SSA Benefits?

There are four main steps that a person can take if they believe they have been wrongly denied SSA benefits. The process for obtaining relief or appealing decision under the rules of the SSA is as follows:

  • First, they may re-submit their application for reconsideration. They can do this by filing their original application with their local social security office where their claim will be reviewed and they may submit any new evidence.
  • Next, if the local social security office denies their re-submitted application, they may request an administrative law hearing where an independent administrative judge will be assigned to review the claim.
  • If the administrative judge also denies the claim, then the individual may appeal by requesting that the Social Security Appeals Council review the claim and issue a final ruling. Here, the Council may outright deny the claim based on the record and the decision issued by the administrative law judge, may ignore the request, can remand it to the administrative law judge for further review, or will review the claim themselves.
  • Lastly, while the Council’s decision may be final, an individual may challenge the outcome by filing a lawsuit against the SSA in their local federal district court. The federal district court will then review the case and make a final determination on the claim. This is the very last step that a person can take to have their decision appealed or reversed. 

What Should I Look for in a SSA Lawyer/Attorney?

A person who wishes to appeal a denial for SSA benefits should contact an SSA attorney immediately. A good SSA lawyer can help the person to navigate the confusing and intricate appeals process, including meeting legal deadlines, following the proper procedures, and discussing the next steps they should take at each level of their appeal. 

Some facts to consider when choosing which SSA lawyer to hire include:

  • Their legal background and experience with handling SSA matters;
  • The general results of each SSA matter they have worked on in the past;
  • How they bill their clients (e.g., contingency fee basis, flat fee, hourly, etc.);
  • The legal strategy that they intend on employing for the case; and
  • Whether they explain the way in which they work and resolve cases in a clear and explicit manner.

Do I Need an Attorney to Help Me Appeal My Case in Federal Court?

The process for applying, submitting, and appealing claims for SSA benefits can be very confusing. If you are unsure how to appeal a denial for SSA benefits or need help with the process, then it may be in your best interest to consult a local government attorney for immediate assistance. An experienced government attorney can guide you through both the SSA appeals process, as well as can help you file an SSA lawsuit in your federal district court.

Your lawyer can also explain why you may have been denied SSA benefits and can discuss how to fix your claim. Additionally, your lawyer will be able to provide representation in court and can present a solid argument as to why you are entitled to receive SSA benefits.