Exhaust All Administrative Appeals

Before filing a lawsuit against Social Security, you must exhaust all administrative remedies. This means you need to go through the appeals process within the SSA before taking your case to court. If your claim for benefits is denied, here’s what you should do:

Step 1: Request Reconsideration

If your SSDI or SSI claim is denied, the first step is to request reconsideration. This is a full review of your case by someone who wasn’t involved in the original decision. During reconsideration, you can submit new evidence and clarify any mistakes or omissions from your initial application.

Step 2: Request a Hearing Before an Administrative Law Judge (ALJ)

If your reconsideration request is denied, the next step is to request a hearing before an Administrative Law Judge (ALJ). At the hearing, you and your lawyer (if applicable) can present evidence, cross-examine witnesses, and argue your case. The ALJ will make a decision based on the hearing.

Step 3: Appeal to the Appeals Council

If you are still denied after the ALJ hearing, you can request that the Appeals Council review the decision. The Appeals Council can either agree with the ALJ's decision, deny your request for a review, or send the case back to the ALJ for further review.

Step 4: File a Lawsuit in Federal Court

If the Appeals Council denies your appeal or you disagree with the final decision, you can file a lawsuit in federal court. This is the final step in the appeals process and where you will take your case outside of the SSA’s administrative system.

Filing a Lawsuit in Federal Court

Once you have exhausted the administrative appeals process, you can file a lawsuit in a U.S. District Court. Here’s how the process typically works:

Step 1: Consult with an Attorney

Before filing a lawsuit, it’s highly recommended that you consult with an attorney experienced in handling Social Security cases. An attorney can help you assess whether filing a lawsuit is appropriate, guide you through the legal process, and represent you in court.

• Contingency Fee: Many attorneys who handle Social Security cases work on a contingency fee basis, meaning they only get paid if you win your case. The fee is usually a percentage of your back pay, typically up to 25% of the past-due benefits.

Step 2: File a Complaint

To initiate the lawsuit, you need to file a complaint with the U.S. District Court in the area where you live. This complaint outlines the legal grounds for your lawsuit and why you believe the SSA's decision was incorrect. The complaint should include:

• The legal basis for your claim.
• A summary of the SSA's decision and why you believe it was wrong.
• Any relevant evidence or documents supporting your case.

Step 3: SSA Response

Once the lawsuit is filed, the SSA will have an opportunity to respond. They may file a motion to dismiss or provide their argument and evidence supporting their decision. Your attorney will respond to their motion and argue your case in court.

Step 4: Court Hearing

If the case goes to a hearing, both parties (you and the SSA) will present arguments before a judge. The judge will review the evidence and issue a decision. It’s important to note that the judge will only review whether the SSA followed the law properly and whether the decision was supported by substantial evidence.

Step 5: Court Decision

After the hearing, the judge will issue a ruling. If the judge rules in your favor, they may order the SSA to reverse its decision and grant you benefits. If the decision is not in your favor, you can appeal to the U.S. Court of Appeals.

What Are the Possible Outcomes of a Lawsuit?

When you file a lawsuit against the Social Security Administration, there are several possible outcomes:

• The Court Rules in Your Favor: If the court agrees that the SSA made an error, they may reverse the decision or remand the case back to the SSA for further review. This can result in the approval of your benefits.
• The Court Denies Your Lawsuit: If the court upholds the SSA's decision, you may not receive benefits. You may still be able to file a further appeal with the U.S. Court of Appeals.
• The Case is Remanded: Sometimes, the court may send the case back to the SSA for further review. This means the SSA must reconsider its decision, but the court has not made a final determination.

Timeline for Filing a Lawsuit Against Social Security

The timeline for filing a lawsuit against Social Security can vary, but it generally follows these steps:

• Request for Reconsideration: Takes around 3 to 4 months.
• Hearing Before an ALJ: Typically takes 12 to 18 months to get a hearing scheduled, depending on your location.
• Appeals Council Review: This process may take 6 months to 1 year.
• Federal Court: Filing a lawsuit in federal court can take several months to a few years, depending on the complexity of your case and the court's schedule.