C.F.R. » Title 20 » CHAPTER III—SOCIAL SECURITY ADMINISTRATION › PART 404—FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) › Subpart J—Determinations, Administrative Review Process, and Reopening of Determinations and Decisions

20 C.F.R. § 404.900

Introduction

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(a) Explanation of the administrative review process. This subpart explains the procedures we follow in determining your rights under title II of the Social Security Act. The regulations describe the process of administrative review and explain your right to judicial review after you have taken all the necessary administrative steps. These procedures apply also to persons claiming certain benefits under title XVIII of the Act (Medicare); see 42 CFR 405.904(a)(1). The administrative review process consists of several steps, which usually must be requested within certain time periods and in the following order:

(1) Initial determination. This is a determination we make about your entitlement or your continuing entitlement to benefits or about any other matter, as discussed in § 404.902, that gives you a right to further review.

(2) Reconsideration. If you are dissatisfied with an initial determination, you may ask us to reconsider it.

(3) Hearing before an administrative law judge. If you are dissatisfied with the reconsideration determination, you may request a hearing before an administrative law judge.

(4) Appeals Council review. If you are dissatisfied with the decision of the administrative law judge, you may request that the Appeals Council review the decision.

(5) Federal court review. When you have completed the steps of the administrative review process listed in paragraphs (a)(1) through (a)(4) of this section, we will have made our final decision. If you are dissatisfied with our final decision, you may request judicial review by filing an action in a Federal district court.

(6) Expedited appeals process. At some time after your initial determination has been reviewed, if you have no dispute with our findings of fact and our application and interpretation of the controlling laws, but you believe that a part of the law is unconstitutional, you may use the expedited appeals process. This process permits you to go directly to a Federal district court so that the constitutional issue may be resolved.

(b) Nature of the administrative review process. In making a determination or decision in your case, we conduct the administrative review process in an informal, non-adversarial manner. Subject to certain timeframes at the hearing level (see § 404.935) and the limitations on Appeals Council consideration of additional evidence (see § 404.970), we will consider at each step of the review process any information you present as well as all the information in our records. If you are dissatisfied with our decision in the review process, but do not take the next step within the stated time period, you will lose your right to further administrative review and your right to judicial review, unless you can show us that there was good cause for your failure to make a timely request for review.

[45 FR 52081, Aug. 5, 1980, as amended at 51 FR 300, Jan. 3, 1986; 51 FR 8808, Mar. 14, 1986; 52 FR 4004, Feb. 9, 1987; 78 FR 57259, Sept. 18, 2013; 80 FR 14835, Mar. 20, 2015; 81 FR 90992, Dec. 16, 2016]
Notes of Decisions
Cited in 687 cases (389 in the last 5 years), 1982–2026 · leading case: Biestek v. Berryhill
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Biestek v. Berryhill (2019) scotus · cites it 4× “” 20 CFR §404.900 (b) (2018); §416.1400(b).”
Carr v. Saul (2021) scotus · cites it 4× “See 20 CFR §404.900 (a). Petitioners were unsuccessful at every stage, concluding with the Appeals Council, which denied discre- tionary review.”
Sims v. Apfel (2000) scotus · cites it 5× “See 20 CFR §§ 404.900 (a)(4)—(5), 404.955, 404.”
Olivia Kneeland v. Nancy Berryhill, Acting Cmsnr (2017) ca5 · cites it 3× “20 C.F.R. § 404.900 explains the administrative review process.”
Jones v. Berryhill (2019) tnmd · cites it 4× “Plaintiff contends that the ALJ violated 20 CFR § 404.900 (b) "in failing to either advise Mr.”
Tommaso Fargnoli v. Larry G. Massanari, Commissioner, Social Security Administration (2001) ca3 · cites it 2× “See 20 C.F.R. 404.900. 3 The record also includes the treatment notes and opinions of physicians treating or examining Fargnoli, or reviewing his medical records, after his date last insured (December 31, 1990).”
Ingram v. Commissioner of Social Security Administration (2007) ca11 · cites it 2× “See 20 C.F.R. § 404.900 (b). The Appeals Council must consider new, material, and chronologically relevant evidence and must review the case if “the administrative law judge’s action, findings, or conclusion is contrary to the weight of the evidence currently of record.”
Joyce Hargress v. Social Security Administration, Commissioner (2018) ca11 “2007) ; 20 C.F.R. §§ 404.900 (b), 416.1400(b). If a claimant presents evidence after the ALJ's decision, the Appeals Council must consider it if it is new, material, and chronologically relevant.”
Andrew Cirko v. Commissioner Social Security (2020) ca3 “(citing 20 C.F.R. § 404.900 (b)). Nothing in this opinion, however, should be taken to suggest that SSA claimants are relieved entirely from the administrative-exhaustion requirement so understood, nor do we opine on any issue- 5 The Commissioner concedes that there is no…”
Muhammad v. Berryhill (2019) paed · cites it 2× “2080 (citing SSA regulations illustrating non-adversarial nature of proceedings); 20 C.F.R. § 404.900 (b) ("In making a determination or decision in your case, we conduct the administrative review process in an informal, non-adversarial manner.”
Vaught v. Scottsdale Healthcare Corp. Health Plan (2008) ca9 · cites it 2× “503-1 (h)(iv)(requiring that an ERISA plan "[p]rovide for a review that takes into account all comments, documents, records, and other information submitted by the claimant relating to the claim, without regard to whether such information was submitted or considered in the…”
Bass v. Social Security Administration (1989) ca9 · cites it 3× “900 (a)(3), 404.933). The decision made following the hearing does not become the final decision of the Secretary until the claimant requests review by the appeals council, and the appeals council either grants or denies review.”
Show all 687 citing cases →
— 20 C.F.R. § 404.900(a)(1) — 3 cases
Meyer v. Sullivan (1992) ca11
Lloyd A. Gentry v. Donna E. Shalala, Secretary of Health & Human Services (1995) ca10
Nelson v. Dudek (2025) mnd
— 20 C.F.R. § 404.900(a)(2) — 1 case
Nelson v. Dudek (2025) mnd
— 20 C.F.R. § 404.900(a)(3) — 1 case
Nelson v. Dudek (2025) mnd
— 20 C.F.R. § 404.900(a)(4) — 1 case
Jess Aylett and Barbara Aylett v. Secretary of Housing and Urban Development, on Behalf of Bobbie Burris, and Bobbie Bur (1995) ca10
— 20 C.F.R. § 404.900(a)(5) — 3 cases
Nellie Pohlmeyer v. Secretary of Health and Human Services (1991) ca6
LaVonya Moore v. Carolyn Colvin (2016) ca7
King v. O'Malley (2024) cand
— 20 C.F.R. § 404.900(a)(6) — 1 case
Grubb v. United States Social Security Administration (2021) wawd
— 20 C.F.R. § 404.900(b) — 15 cases
Ring v. Berryhill (2017) alnd
Rothschild v. Social Security Administration, Commissioner (2019) alnd
Smith v. Social Security Administration, Commissioner (2019) alnd
Blackwell v. Social Security Administration, Commissioner (2020) alnd
Lard v. Social Security Administration, Commissioner (2020) alnd
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