Applying for SSDI is rarely a one-step process. While many claims are approved or denied during administrative stages, some cases do not begin and end with the Social Security Administration (SSA). When that happens, a federal court may become the next place where a disability claim is reviewed.
For Pennsylvania residents, reaching federal court means every administrative level within the SSA has already been exhausted, and a claimant is asking a federal judge to determine whether the agency has applied the law correctly.
Most SSDI claims never reach federal court
An SSDI application moves through several administrative stages before federal court becomes an option. These stages include:
- Initial application
- Reconsideration
- Hearing before an Administrative Law Judge (ALJ)
- Review by the Appeals Council
Many claims end somewhere along this path. Some applicants receive benefits after providing additional medical evidence, while others obtain a favorable decision from an ALJ. Only a relatively small percentage of claims continue beyond the Appeals Council. The federal court is considered the final level of review outside the Social Security Administration.
The Appeals Council makes the decision
After an ALJ issues a decision, the claimant may ask for a review by the Appeals Council. The council may:
- Deny the request for re-examination
- Grant review and issue a new decision
- Return the case to the ALJ for another hearing
A claimant becomes eligible to file a lawsuit in federal court once the Appeals Council either refuses to review or gives a final unfavorable decision.
For individuals in Pennsylvania whose SSDI claims remain denied after Appeals Council review, understanding the purpose of federal court can help to inform realistic expectations. Because the process involves strict procedural rules and legal standards, speaking with an experienced legal team dealing with Social Security disability appeals can be helpful in a myriad of ways.