Explain that if the claimant disagrees with an initial determination or decision he
or she may request further review. This is called an appeal.
The appeals process consists of several levels of administrative review that must
be requested within certain time periods and at the proper level.
The levels of administrative review are
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2.
Administrative Law Judge (ALJ) hearing, and
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3.
Appeals Council (AC) review.
Provide the claimant with information about filing his or her appeal online at www.socialsecurity.gov.
For a complete overview of the appeals process, see GN 03101.001, Summary of Administrative Appeals.
NOTE: Reconsideration is not the first level of appeal for medical determination on initial
claims in Prototype states (Alabama, Alaska, California, Colorado, Louisiana, Michigan,
Missouri, New Hampshire, New York, and Pennsylvania), unless expedited reinstatement
is involved. For additional information, see DI 13050.085, Appeals Process Under Expedited Reinstatement.
References:
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DI 12026.000, Reconsideration - Disability Hearing for a Medical Cessation/Adverse Medical Reopening
Determination - Title II and Title XVI
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DI 81010.150, Processing Claims Appeals of Medical Decisions in Electronic Disability Collect
System (EDCS)