Basic (03-86)

DI 42010.001 Overview

When a claimant is dissatisfied with a decision made by SSA through the reconsideration level, he or she can request to have the decision reviewed by an Administrative Law Judge (ALJ). This request for a hearing by the ALJ must be made in writing. It may be formal or informal, and must be requested not later than 60 days from receipt of the notice of the reconsideration decision. (Five additional days are allowed from the date of the notice for mailing time.)

In concurrent title II-XVI common issue medical cessation cases the first appellate step is a hearing. Any claimant or any other person who can show that his right to present or future benefits or to a period of disability may be prejudiced by a reconsidered or a revised determination has a right to request a hearing.

If the ALJ decision is not favorable, a request for review of that decision by the Appeals Council (AC) is then made. The AC may also review a hearing decision on its own motion.

The next appellate step is the District Court and then the U.S. Courts of Appeals. The Supreme Court handles the final level of appeal.

Decisions by the ALJ, AC or Court are processed as follows

  • Title II claimant under age 54 are the jurisdiction of the Office of Disability Operations (ODO).

  • Title II claimants age 54 or older are processed in the Program Service Center (PSC).

  • Title XVI only cases are processed in the field office (FO)

  • All Title II nonmedical issue decisions (i.e., age, validity of marriage, scrambled earnings, etc.) are handled by respective processing centers (see GN 03102.175).

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DI 42010.001 - Overview - 12/11/2014
Batch run: 01/15/2019