Skip to main content

WHAT IS THE APPEALS COUNCIL?

WHAT IS SOCIAL SECURITY'S APPEAL COUNCIL?  HOW DOES IT WORK?  WHY WOULD YOU EVER USE IT?

The Appeals Council ("AC") is a branch of the Social Security Administration that reviews decisions made by administrative law judges.  If you go to a hearing and the judge denies your Social Security benefits, the next appeal is with the Appeals Council ("AC").  It is a group of appeal judges headquartered in Falls Church, Virginia.

This review is the final administrative appeal with Social Security.  It may only be used after an administrative law judge (ALJ) has heard and denied your case.

What are your chances with the AC appeal?

 Only 1% of cases at the Social Security Appeals Council are approved—worse than any other level of appeal. Another 9% of cases get sent back ("remanded") to the hearing level for the ALJ to take further action or hold a new hearing.  The ALJ may deny your case again, of course.  So, the odds are terrible.

Here's what most claimants don't understand:  The AC does not make any attempt to decide whether you are disabled.  That was already determined by the ALJ who denied your claim.  What the AC does is review the judge's decision to determine whether (a) you received a fair hearing under the Social Security regulations, and (B) Did the judge act properly with regard to Social Security rules and procedures.  If there is no technical, legal issue, the AC will not review your case.

Even if the AC reviews your hearing and disagrees with the judge's decision, the AC will NOT change the decision.  The denial remains a denial.  If the AC determines that the hearing judge made a legal or procedural error (violated the rules),  your claim is still not approved.  It is sent back to the judge for further action to correct the error, which could be a new hearing.  But this only happens in 9 percent of all AC appeals (fewer than 1 out of 10).

Here are some other points about an Appeals Council review:

  • No one appears before the AC; there is no hearing.  It is a paper review.
  • You have only 60 days after a denial to file for an AC review.
  • The AC will not consider new medical evidence.  It will only review evidence that was available, or should have been available at the hearing.
  •  It usually takes about 1 year to get an AC decision.
  • If the AC dismisses your appeal, your only other appeal is a lawsuit in federal district court.

The absolute best odds of winning your benefits happens at the hearing with the administrative law judge (ALJ).  This is where you need to concentrate on winning.  There is never as good chance to win after the hearing.  Thus, your case should be prepared thoroughly when presented at the hearing.  Once you lose at the hearing level, your best chance has gone! Most claimants get one and only one hearing, so take full advantage of it.   

"Once you lose a hearing, your best chance to be approved has gone.

___________________________

Charles W. Forsythe is founder of The Forsythe Firm in Huntsville, AL.  He works tirelessly to help disabled individuals get their Social Security Disability benefits.  (256) 799-0297.


 

 

Comments

Post a Comment

Popular posts from this blog

CAN YOU WIN YOUR DISABILITY APPEAL WITHOUT A LAWYER?

The Social Security Administration does not require you to have a lawyer to file an appeal or to appear at a hearing.  However, most people heading for a disability hearing will hire a lawyer or advocate to help them.   Studies have shown that you are about twice as likely to win with a lawyer.  A recent study found that claimants with no lawyer win about 30 percent of the time while claimants with a lawyer or advocate win 60 percent of the time.   " He just cooked his own goose." These statistics cover only one aspect of a disability appear--your odds of winning. The other important aspects are time and convenience. If you prepare and adjudicate your own disability appeal, expect to spend 12 to 24 months working on the case.  You will be collecting, reading and submitting hundreds or thousands of pages of medical records.  These records are complex and often difficult to understand.  And you must know how each medical record helps (or hurts) your dis...
Post a Comment
Read more

GET YOUR APPLICATION RIGHT - GET PAID SSDI B ENEFITS

  Get your Social Security application right - get paid.   There are hundreds of ways to mess up a Social Security disability application.  One of the most common ways that I see?  Blank lines.  Questions left blank.  One way or another, these questions will get answered before a decision is made on your claim.  They may get answered 6 months later when the Social Security office calls you--but you have just wasted 6 months.   Worse yet, Social Security may assume that since you didn't answer the questions, all the answers are "no," so nobody bothers to call you. This will lead to a negative action on your claim.   The complete disability application will consist, not just of the basic application, but several forms.  Many of those forms will be mailed to you AFTER you file the claim.  The following is always required for a complete application: The basic disability application (5 pages)  Disability Report (14 p...
Post a Comment
Read more

HOW TO PASS A SOCIAL SECURITY DISABILITY EXAM

  So, Social Security is sending you to one of their doctors for an exam.  The first thing you may ask is, How do I pass this exam?   First, I should say that Social Security exams are not "pass or fail."  The doctor or examiner cannot tell Social Security whether or not you are disabled or whether you should get a benefit.  The doctor is going to check certain facts. For example, the doctor may check the range of motion in your joints and list the measurements. They may check your grip strength. (S)he may determine if you have difficulty walking, squatting, kneeling standing from a seated position.  The examiner may answer specific questions asked by Social Security: Is the use of a cane or assistive device medically necessary? Why is it necessary? Can the claimant use his/her hands to grasp and hold objects? Is the claimant able to understand and follow simple directions?  Here is advice I give my clients for a Social Security examination:  ...
Post a Comment
Read more