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Your Right To Question

The Decision To StopYour Disability Benefits

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Your Right To QuestionThe Decision To StopYour Disability Benefits

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S

ocial Security wants to be surethat every decision made about

your Social Security or SupplementalSecurity Income (SSI) claim is correct.If you disagree with our decision thatyou are no longer disabled, you can

appeal it. This means we will look atyour case again to see if our decisionis correct.

When you ask for an appeal, we willlook at the entire decision, not just the

part you disagree with. If our decisionwas wrong, we will change it.

You have 60 days to ask for an appealof our decision to stop your disabilitybenefits. The 60 days start after youget our letter telling you that your ben-efits will stop. We assume that you gotour letter five days after the date on itunless you show us that it took longerfor you to get the letter.

How much time do I have

to appeal?

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If the 60-day period has passed, andyou want to appeal our decision, youshould tell us why you were late. If we

decide you have a good reason for beinglate, you still may be able to appeal. Forexample, we may find that you have agood reason for being late if the formswe sent you did not arrive on time.

If you ask for an appeal within 10

days after the date you receive ourletter, you also can request that yourpayments continue while the appealis being decided. If you are late inasking for your payments to continue,

you still may be able to get paymentsduring the appeal if we find that youhave a good reason for being late.

You may request that your payments

continue during the first two levels ofappeal—the reconsideration level andthe hearing level. We explain bothlevels on pages 5-8.

Will my payments continueduring the appeal?

What happens if I miss the time

for an appeal?

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If your payments continue duringyour appeal and you lose the appeal,

we will ask you to pay back some orall of the money.

However, you will not have to payus back if you cooperate with us duringthe appeal and we find that you need

your money for your usual livingexpenses. If you need more informa-tion about situations when you donot have to pay us back, let us know.

If your SSI stops, any medical

assistance you have that is based onSSI also may stop. If this happens,your medical assistance agency willcontact you.

You have the right to file a newapplication at any time, but filing a

new application is not the same asappealing this decision. If you disagreewith our decision, and you file a newapplication instead of appealing:

Should I just file anew application?

Will my medicalassistance continue?

Will I have to pay back

the money I receive duringmy appeal?

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• You might lose some benefits,or you may not qualify for any

benefits;• We could deny the new application

using our decision to stop your pay-ments, if the facts and issues are the

same; and• You may not ask for payments tocontinue during the appeal of a newapplication.

If you disagree with our decision to

stop your benefits, it is important foryou to ask for an appeal within 60 days.

There are four levels of appeal. Thelevels are:

• Reconsideration;

• Hearing;• Appeals Council; and

• Federal court.

If you disagree with the decision at

one level, you have 60 days to appealto the next level.

ReconsiderationIf you disagree with our decision,

you may ask for reconsideration.Reconsideration is a complete review

Do I only get one chance

to appeal?

5

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www.socialsecurity.gov

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of your claim by someone who did nottake part in the first decision. We will

look at all the evidence submittedwhen the original decision was made,plus any new evidence.

When you appeal our decision to stop

your disability benefits because we sayyour condition is no longer disabling,you can meet with a disability hearingofficer and explain why you believe youstill are disabled. You can look at the

information in your file and submitnew evidence or information. You alsocan bring someone who knows aboutyour medical condition.

When the reconsideration is

completed, we will send you a letterexplaining our decision.

Hearing

If you disagree with the reconsidera-tion decision, you may ask for ahearing. The hearing will be held byan administrative law judge who hadno part in the first decision or the

reconsideration of your case.The administrative law judge will

notify you of the time and place ofthe hearing. The hearing usually isheld within 75 miles of your home.

Before the hearing, you will have achance to give us any additionalevidence, clarification or information

(over)

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you may have about your claim. Youshould give us this information as soonas you can. You and your representa-tive, if you have one, may come to thehearing and explain your case in person.You may look at the information in

your file and give new information.At the hearing, the administrativelaw judge will question you and anywitnesses you bring. Other witnesses,such as medical or vocational experts,

may also give us information at thehearing. You or your representativealso may question the witnesses.

It is usually to your advantageto attend the hearing. If you do notwant to attend, you must tell us inwriting. If you cannot attend thehearing, you should tell us why assoon as you can. We may be able to

make other arrangements for you, suchas changing the time or place of yourhearing. You have to have a goodreason for us to change the time orplace of your hearing.

In certain situations, we may holdyour hearing by a video conferencerather than in person. We will let youknow ahead of time if this is the case.With video hearings, we can make the

hearing more convenient for you. Oftenan appearance by video hearing can bescheduled faster than an in-personappearance. Also, a video hearinglocation may be closer to your home.

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That might make it easier for youto have witnesses or other peopleaccompany you.

Unless the administrative law judgebelieves your presence is necessary todecide your case and requires you to

attend, you will not have to go. Thejudge will make a decision based on allthe information in your case, includingany new information you give.

When the administrative law judge

makes a decision, we will send you aletter and a copy of the decision.

Appeals Council

If you disagree with the hearingdecision made by the administrativelaw judge, you may ask for a reviewby Social Security’s Appeals Council.

The Appeals Council looks at all

requests for review, but it may denya request if it believes the hearingdecision was correct. If the AppealsCouncil decides to review your case,the Council will either decide your

case itself or issue an order returningyour case to an administrative lawjudge for further action.

If the Appeals Council decides not

to review your case, we will send youa letter explaining the denial. If theAppeals Council reviews your case andmakes a decision, we will send you acopy of the decision. If the Appeals

Council returns your case to an admin-istrative law judge, we will send you aletter and a copy of the order.

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Federal court

If you do not agree with the AppealsCouncil’s action on your case, you mayfile a lawsuit in a federal district court.We will tell you how to ask a court tolook at your case when we send you a

letter with the Appeals Council’s deci-sion, or when we send you a lettertelling you that the Appeals Councilwill not review your case.

You can have a lawyer, a friend orsomeone else help you with yourappeal. We will work with your repre-

sentative just as we would work withyou. There are groups that can helpyou find a lawyer or give you free legalservices. There also are lawyers whodo not charge unless you win your

appeal. The local Social Security officehas a list of groups that can help youwith your appeal.

Your representative cannot charge

or collect a fee from you without firstgetting written approval from SocialSecurity. If you want more informationabout having a representative, contactus for the publication, Your Right

To Representation (Publication No.05-10075) or you can find it on ourwebsite.

Can I get help with my appeal?

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Social Security AdministrationSSA Publication No. 05-10090ICN 468610Unit of Issue - HD (one hundred)December 2005 (November 2004 edition may be used)

For more information and to findcopies of our publications, visit ourwebsite at www.socialsecurity.gov orcall toll-free, 1-800-772-1213 (for thedeaf or hard of hearing, call our TTYnumber, 1-800-325-0778). We cananswer specific questions and provideinformation by automated phone serv-ice 24 hours a day.

We treat all calls confidentially. Wealso want to make sure you receiveaccurate and courteous service. That iswhy we have a second Social Securityrepresentative monitor some tele-

phone calls.