Understand the Appeal Process for SSDI in Wisconsin

If your SSDI claim is denied, you can appeal the decision through a formal process. The SSA has a five-step appeals process that provides you with multiple opportunities to present additional evidence and make your case. The process in Wisconsin follows the same steps as in other states.

The steps in the SSDI appeals process are:

• Reconsideration
• Hearing before an Administrative Law Judge (ALJ)
• Appeals Council
• Federal Court Review

Step 1: Request Reconsideration

The first step in appealing a denied SSDI claim in Wisconsin is to request reconsideration. During this stage, the SSA will review your case again, including any new evidence you may provide.

Here’s how to begin the reconsideration process:

• File within 60 days: You must file your request for reconsideration within 60 days of receiving your denial notice from the SSA.
• Submit New or Additional Evidence: If you have new medical records, doctor’s opinions, or other relevant documentation, submit these to strengthen your case.
• Request Online or by Mail: You can request reconsideration online through the SSA’s website, or you can submit a Request for Reconsideration form by mail to your local SSA office in Wisconsin.

Reconsideration usually takes about 3 to 4 months, and you’ll be notified of the decision by mail. If your claim is still denied at this stage, you can move on to the next step.

Step 2: Request a Hearing Before an Administrative Law Judge (ALJ)

If your claim is denied after reconsideration, the next step is to request a hearing before an Administrative Law Judge (ALJ). This is often where many individuals have success, as it provides the opportunity to present your case in person and explain how your disability impacts your ability to work.

To request a hearing:

• File the Request: You’ll need to file a request for a hearing within 60 days after receiving your reconsideration denial. You can do this online, by mail, or by calling your local SSA office.
• Prepare for the Hearing: It’s crucial to gather all necessary medical records, letters from your doctors, and any other evidence that supports your disability. You may also want to hire a disability attorney or representative to help present your case at the hearing.

The wait time for a hearing can be 12 to 18 months in Wisconsin due to the high volume of cases. Once the hearing is held, it may take a few months for the ALJ to issue a decision.

Step 3: Request a Review by the Appeals Council

If your claim is denied after the ALJ hearing, you have the option to request a review by the Appeals Council. The Appeals Council will look at your case to determine whether the ALJ made any errors in applying the law or evaluating the evidence.

To request an Appeals Council review:

• File the Request: You must file a request for a review within 60 days of receiving the ALJ’s decision.
• Provide Arguments for Errors: If you believe the ALJ made a mistake in evaluating your case, include your arguments and reasons for why you think the decision was incorrect.

The Appeals Council typically takes several months to review your case. They can either:

• Uphold the ALJ’s decision.
• Send your case back to an ALJ for further review.
• Reverse the decision and approve your claim.

Step 4: File a Federal Court Lawsuit

If your case is denied by the Appeals Council or if they decide not to review your case, you still have one last option: filing a lawsuit in federal court.

Here’s how the process works:

• File in U.S. District Court: You can file a lawsuit in the U.S. District Court in Wisconsin. The court will review your case to determine if the SSA’s decision was correct.
• Consult with an Attorney: This step typically requires the assistance of an attorney, as the legal process can be complicated.

Filing a lawsuit in federal court can be a lengthy process, and it’s typically the last resort for individuals seeking to appeal their SSDI claim.

Tips for a Successful SSDI Appeal in Wisconsin

Appealing an SSDI claim can be complex and time-consuming. To improve your chances of success, consider these tips:

• Keep Detailed Medical Records: Make sure to keep thorough and updated medical records that clearly show how your disability prevents you from working.
• Submit All Required Documents: Make sure you submit all necessary documents, including medical records, test results, work history, and other supporting materials.
• Be Prepared to Explain Your Disability: Whether you’re at a hearing or submitting additional evidence, be clear about how your condition affects your ability to work and perform everyday activities.
• Consult a Disability Attorney: Hiring a disability attorney or representative can improve your chances of success, particularly if your case is complex or has been denied multiple times.