Social Security Appeals in Memphis

The Four Levels of the Social Security Appeals Process

After an initial denial, claimants have four potential levels of review. Each level must generally be requested within 60 days of receiving the prior decision notice, so acting quickly matters.

Reconsideration

The first appeal is a reconsideration, a complete review of the claim by a Social Security Administration reviewer who had no involvement in the original decision. The same evidence is reviewed, and the claimant can submit additional documentation. Many reconsiderations also result in denial, which is why the next level is often where additional opportunities may arise.

Administrative Law Judge Hearing

If reconsideration is denied, the claimant can request a hearing before an ALJ. The ALJ independently reviews the entire record and may hear live testimony from the claimant as well as from medical or vocational experts. This is often the stage where legal representation can make a meaningful difference. The Office of Hearings Operations serving the Memphis area conducts these hearings for claimants from Memphis and the surrounding West Tennessee field offices.

Appeals Council Review

When an ALJ denies a claim, the claimant can ask the Social Security Administration’s Appeals Council to review that decision. The Appeals Council is the final level of administrative review. It may deny the request for review, issue its own decision, or send the case back to an ALJ.

Federal District Court

If the Appeals Council denies review or upholds the denial, the claimant may file a civil action in U.S. District Court. At this level, the court reviews whether the Social Security Administration applied the law correctly rather than conducting a fresh review of the disability question. This is where Robert Donati’s federal court experience becomes directly relevant.

Why Social Security Disability Claims Get Denied

Understanding the reason for a denial shapes the appeal strategy. Denials generally fall into two categories.

Technical (non-medical) denials result from issues unrelated to your health, such as an incomplete application, insufficient work history, or not enough work credits to qualify for SSDI. These issues may be correctable, or a claimant may need to pursue SSI instead.

Medical denials occur when the Social Security Administration concludes the evidence doesn’t establish a qualifying disability. Common grounds include a finding that the condition isn’t expected to last at least 12 months, isn’t considered severe, or that the claimant can still perform other available work. A gap in medical records is one of the most frequent drivers of these denials, and it’s compounded by the fact that many claimants lose health insurance around the same time they stop working.

How Disability Determination Services Differs from an ALJ

During the first two stages of review, a state agency called Disability Determination Services (DDS) decides whether a claimant is disabled. A DDS team typically consists of a claims examiner and a non-examining medical or psychological consultant who review the file together without ever meeting the claimant. When the record is thin, DDS may send the claimant to a consulting doctor rather than developing additional evidence from treating physicians.

DDS staff and ALJs sometimes interpret the same legal standards differently. Cases that DDS denies are often approved at the ALJ hearing stage, which is part of why pursuing an appeal rather than giving up after reconsideration can be worthwhile. An attorney familiar with how ALJs evaluate evidence can help position the record before the hearing takes place.