If you have been denied Social Security disability benefits after a hearing with an Administrative Law Judge, the next step in the appeals process is filing a Request for Review with the Appeals Council. A Social Security Appeals Council lawyer can help you increase your chances of success. Here, we will discuss the Appeals Council process and how the Social Security Appeals Council works.
What is the Appeals Council for Social Security disability?
The Appeals Council is located in Falls Church, Virginia and is tasked with reviewing all Social Security disability appeals after a hearing with an Administrative Law Judge (ALJ). The Office of Appellate Operations (OAO), through the Appeals Council, serves as the final level of administrative review within the Social Security Administration.
The Appeals Council consists primarily of administrative appeals judges (AAJ) and appeals officers (AO). The Appeals Council considers appeals from hearing level decisions. It also performs quality review, policy interpretations, and court-related functions.
What is the Appeals Council Process?
The Appeals Council review process generally begins after an application for benefits has been denied at the hearing level or a request for hearing has been dismissed. You have sixty (60) days from the receipt of the ALJ’s decision denying your claim for benefits or dismissing your request for hearing to file a “Request for Review”. This is the document that starts your appeal to the Appeals Council.
Rarely, if ever, do you need to have a hearing with the Appeals Council. Instead, the Appeals Council simply reviews the record from your hearing. This would include your medical records as well as the recording from the hearing. If you have an Appeals Council lawyer, he or she would submit a “brief” which is a several page argument about how the judge in your case made an error of law or did not base the decision on substantial evidence.
Unlike the ALJ, the Appeals Council is generally not looking to see if you are disabled. Instead, the Appeals Council is looking to see if the ALJ’s decision is supported by substantial evidence or if there was an error of law. This can be a confusing concept, but the Appeals Council allows for some level of discretion amongst the ALJs. It is possible for you to win with one judge and lose with another. Unless the judge’s decision is not supported by substantial evidence or contains an error of law, the Appeals Council will not grant your Request for Review.
This is one of the most confusing parts about the Appeals Council process. In most cases, new evidence will not be reviewed. Your Appeals Council lawyer is simply making high level legal arguments about your case.
What happens after I file a Request for Review with the Social Security Appeals Council?
The Appeals Council looks at all requests for review, but it may deny a request if it believes the hearing decision was correct. If the Appeals Council decides to review your case, it will either decide your case itself or return it to an administrative law judge for further review. When the Appeals Council reviews your case it may consider any of the issues considered by the administrative law judge, including those issues that were favorably decided in your case. You will receive a copy of the Appeals Council’s final action on your case.
If you had an Appeals Council lawyer, that lawyer will receive a copy of the decision as well.
How long does the Appeals Council take?
Appeals Council wait times vary greatly. We have seen the Appeals Council make decisions in as little as one month. We have also seen the Appeals Council take as long as 20 months to issue a decision. Unfortunately, the time it takes to process your case depends on a number of factors – all of which are beyond our control.
In some cases, you can request an expedited appeal, but this requires “good cause”. “Good cause” is a vague term, but generally means that you are suffering a near immediate harm such as a pending eviction or utility shut-off. You will need to produce evidence such as the utility shut-off notice in order to request an expedited appeal.
One of the major advantages of using an Appeals Council lawyer is that we know when you may be eligible for an expedited appeal and when it is a good idea to request one. We also know the process for requesting that your case be expedited which speeds the process along.
What are the odds of winning with the Social Security Appeals Council?
As of 2019, the Appeals Council granted less than 15% of all Requests for Review that were filed. Many people consider the Appeals Council to be a “rubber stamp” for the ALJ. While it is true that in many cases the Appeals Council will deny the Request for Review, it is important to note that thousands of people do have their Requests for Review granted each year. The full data set for Appeals Council remands is available here:
What happens if I win at the Appeals Council?
In most cases, “winning” at the Appeals Council does not mean you get benefits. It means that you get a “remand hearing”. That means that the Appeals Council sends your case back to an ALJ for a new decision. In most cases, it will be sent back to the same judge that denied you in the first place. The only saving grace here is that the Appeals Council will tell the ALJ what the ALJ did wrong and instruct them to fix their mistake.
Unfortunately, even with these instructions, sometimes an ALJ will deny your case again. This would force you to file another Request for Review with the Appeals Council.
What happens if I lose at the Appeals Council?
If you disagree with the Appeals Council’s decision, or if the Appeals Council decides not to review your case, your next step is to file a civil suit in a Federal district court. This is a very complicated process. Most SSD attorneys do not handle claims at this level. We do though. We have filed hundreds of cases in the Federal District Court.
Do I need a Social Security Appeals Council Lawyer?
While you can certainly file a Request for Review without an Appeals Council lawyer, this isn’t recommended. Too many people who file an appeal to the Appeals Council on their own are denied over technical issues that could have been prevented if the appeal was completed with a top Appeals Council lawyer.
The Appeals Council grants less than 15% of all appeals. In order to ensure that your claim has the highest chance possible of your appeal being granted, you should have an Appeals Council lawyer who knows the system help you complete your Request for Review.
Patrick J. Best of ARM Lawyers has helped thousands of individuals get their disability benefits. To get started on filing your Request for Review today, call our offices now. The best part is that we can start the whole process over the phone or by video conference so you don’t even need to come into the office!
