Subsequent Events Related to Denied Claimants

Friday, April 29, 2016
Report Number: 
Report Type: 
Audit Report
Office Affiliation: 

Claimants who are denied disability benefits at the State disability determination services (DDS) can appeal the decision to a Social Security Administration (SSA) administrative law judge (ALJ).

A claimant who disagrees with an ALJ’s decision may request a review by SSA’s Appeals Council (AC). The AC may deny, dismiss, or grant the request. If the AC grants the request, it will either (1) issue a decision that affirms, modifies, or reverses the ALJ decision or (2) remand the case to the ALJ with instructions for further review. A claimant who disagrees with the AC decision may file an appeal with a Federal district court. The court may (1) dismiss the case; (2) affirm, modify, or reverse the AC’s decision; or (3) remand the case for further review.

In addition, after an ALJ denies a case, the claimant may reapply for benefits, return to work, or another action could occur, including but not limited to, death, imprisonment, homelessness, and/or benefit attainment from another private source/government agency.

Given the variety of possible outcomes, we performed this review to assess claimants’ status several years after SSA denied their disability applications.