SSA's Decision Making Levels

The SSA's five decision making levels are:

• initial decision
• reconsideration
• hearing
• appeals council
• court

Initial Decision

The initial decision is made by a state agency, which may be called the Bureau of Disability Determination of the Rehabilitation Services Commission (RSC/BDD).

On an initial decision, the deadline for moving to reconsideration is 60 days from receipt of the decision. Receipt of decision is presumed to be five days after the date of the decision, unless the claimant can prove it took longer than that.

Reconsideration

The claimant can request reconsideration of an unfavorable initial decision. It is very rare for an RSC/BDD to change its mind.

In reconsideration, different doctors look at the case. A claimant can request a face-to- face interview or a case review of the documents.

On a reconsideration decision, the deadline for moving to a hearing is 60 days from receipt of the decision. Receipt of decision is presumed to be five days after the date of the decision, unless the claimant can prove it took longer than that.

Request for Hearing

If a reconsideration decision is unfavorable, the claimant can request a hearing before an Administrative Law Judge (ALJ).

The case will be set for a hearing before an ALJ from the Office of Hearings & Appeals (OHA), unless the request for a hearing results in the claim being granted under one of these special programs:

• revised reconsideration
• Senior Staff Attorney program
• On-the-record Request by an ALJ

The deadline for moving to the Appeals Council is 60 days from receipt of the hearing decision. Receipt of the decision is presumed to be five days after the date of the decision, unless the claimant can prove it took longer than that.

Appeals Council

If the Administrative Law Judge's decision is unfavorable, the claimant can request review by the Appeals Council. The Appeals Council is a panel of judges in Falls Church, Virginia, that receives appeals from all over the country. The Appeals Council can take as long as 18 months to review an unfavorable ALJ decision.

The Appeals Council decision may deny review or may remand to the ALJ level. A given case is customarily remanded, or sent back, one time to the same ALJ who issued the unfavorable decision. On a second appeal, the Council will typically remand to a different ALJ.

On an Appeals Council decision, the deadline for moving to court review is 60 days from receipt of the Council decision. Receipt of the decision is presumed to be five days after the date of the decision, unless the claimant can prove it took longer than that.

Judicial Review - District Court

Judicial review follows this path:

• District Court, Magistrate Judge
• Circuit Court of Appeals
• United States Supreme Court