TN 16 (11-23)

DI 42010.001 Appeals at and Above the Hearing Level

A. Overview of Disability Appeals at and above the Hearing Level

1. Requesting an appeal

Any person who shows in writing that their rights may be adversely affected by an initial determination we make regarding a claim for disability benefits may request reconsideration. If the person remains dissatisfied with our determination after a reconsideration or a revised determination, they may request a hearing before an administrative law judge (ALJ).

Any person may request a hearing before an ALJ if we have made -

  • A reconsidered determination;

  • A revised determination of an initial determination, unless the revised determination concerns the issue of whether, based on medical factors, the person is disabled;

  • A reconsideration of a revised initial determination concerning the issue of whether, based on medical factors, the person is disabled;

  • A revised reconsidered determination;

  • A revised decision based on evidence not included in the record on which the prior decision was based;

  • An initial determination denying waiver of adjustment or recovery of an overpayment based on a personal conference see 20 CFR § 404.506; or

  • An initial determination denying waiver of adjustment or recovery of an overpayment based on a review of the written evidence of record (see 20 CFR § 404.506), and the determination was made concurrent with, or subsequent to, our reconsideration determination regarding the underlying overpayment but before an ALJ holds a hearing.

2. Time limit for requesting a hearing

A person must request a hearing in writing within 65 days (includes 5 days for mailing) of the date of the reconsideration notice, unless we find good cause for the late filing. We provide the form HA-501-U5 (Request for Hearing by Administrative Law Judge) to facilitate the request for hearing but will accept any written statements expressing an intent to request a hearing.

3. Possible actions or decisions after a request for hearing

Upon consideration of a hearing request, the ALJ may dismiss the request, recommend a decision to the AC, or the ALJ may hold a hearing and then issue a favorable, partially favorable, or unfavorable decision. The ALJ may also issue an "on-the record" decision without holding a hearing, based on the claimant’s request or on their own if they can make fully favorable findings on every issue. Finally, the ALJ may also issue a bench decision at the hearing.

4. Bench decision by an ALJ

Oral (bench) decisions are fully favorable decisions that the ALJ enters into the record of the hearing proceedings. A bench decision provides the ALJ an alternative procedure for use when issuing a written decision.

An ALJ may issue a bench decision and use its incorporation-by-reference procedure only if all the following criteria are present:

  • The case is an initial adult disability case under title II and/or title XVI of the Social Security Act (Act), or a claim for benefits as a disabled widow, widower, or surviving divorced spouse under title II of the Act, or a claim for payments as a child under age 18 under title XVI of the Act.

  • Drug addiction or alcoholism is not an issue in the determination of disability.

  • The case does not involve a title II disabled adult child, a title XVI age-18 redetermination, a continuing disability review, a closed period of disability, or a non-disability claim.

  • There is no reason to believe that fraud or similar fault is an issue in the case.

  • The ALJ decides at the hearing that a wholly favorable decision is warranted

  • There are no changes to the findings of fact or the rationale for the ALJ decision between the time the bench decision is made at the hearing and the written decision is issued.

If the ALJ chooses to make a fully favorable oral decision at the hearing, the ALJ is required to include as an exhibit in the record a prescribed document that sets forth the key data, findings of fact, and narrative rationale for the decision. During the hearing, the ALJ must clearly delineate the decision from the rest of the hearing proceedings. When announcing the oral decision, the ALJ is required to clearly speak and enunciate so that the decision is audible and understandable by the claimant or other reviewing component, and the decision must include the case's procedural history, the ALJ’s findings and rationale, and the ultimate conclusion (see HALLEX I-2-8-19B.2.b).

5. Review of an ALJ decision

After receipt of an ALJ decision, a claimant may request that the Appeals Council (AC) review the ALJ decision. The AC may also review a hearing decision on its own motion without a request for review by a claimant (see 20 CFR § 404.969 and 20 CFR § 416.1469). When the AC grants the claimant’s request for review or initiates review on its own motion, the AC may remand a case back to the ALJ for further proceedings, issue a new AC decision, or dismiss the claimant’s request for hearing for any reason the request for hearing could have been dismissed by an ALJ. If the AC denies or dismisses the claimant’s request for review, the ALJ’s decision becomes the final decision of the Commissioner in the claimant’s case.

After the AC denies the claimant’s request for review, the claimant may further appeal their claim by filing a complaint with the U.S. District Court, and, if an unfavorable decision is issued, appealing to the U.S. Courts of Appeals, and then, the U.S. Supreme Court.


In medical cessation cases, a reconsideration request is evaluated at a disability hearing unit, which is not to be confused with an ALJ hearing. For disability hearing unit procedures, see DI 33000.000

B. Processing component jurisdiction

1. Title II cases

The Office of Disability Operations (ODO) has sole jurisdiction for processing domestic ALJ or AC decisions for disability claimants under the age of 54 involving only title II. Responsibility for processing title II ALJ or AC decisions for disability claimants aged 54 or older lies with the appropriate processing center (PC) see GN 01050.075A.

Title II non-medical issue determinations (e.g., age, validity of marriage, scrambled earnings, etc.) are handled by the processing center having jurisdiction see GN 03102.175.

2. Concurrent title II/ XVI cases

ODO processes the title II portion and the servicing FO processes the title XVI portion of concurrent title II/XVI hearing decisions for claimants under age 54. The PC with jurisdiction over the claim processes the title II portion of concurrent decisions for claimants aged 54 or older.

In concurrent claims, after the title II portion is processed, the claim is then sent to the servicing field office (FO) to calculate any potential windfall offset. For instructions on processing concurrent claims when windfall offset may be involved, see GN 02610.055.

3. Title XVI cases

In domestic title XVI- cases, the claimant’s servicing FO processes the decision.

4. Foreign cases

The Office of Earnings and International Operations processes claims for claimants who reside outside of the United States. For information about processing foreign claims, see DI 43501.000.

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DI 42010.001 - Appeals at and Above the Hearing Level - 11/28/2023
Batch run: 11/28/2023