Skip to main content

YOUR CHANCES AT THE APPEALS COUNCIL (AC)

Your odds of winning a $million at the lottery are 1 in 292 million.  

Everything in life comes with odds. 

 Odds with Social Security disability are a lot better, but still risky.

If your disability claim is denied at the hearing level, your next step is with the Appeals Council (AC).  That's a group of  appeal judges headquartered just outside Washington, DC at Falls Church, VA.

Your odds at the hearing were about 50/50.  At the Appeals Council (AC), the odds are drastically worse.  Here is the average AC case disposition:

2 percent are awarded benefits.  

14 percent are remanded (sent back) to the hearing office for a new hearing.

84 percent are denied--so that the denial by the administrative law judge is upheld.

By the way, there is no hearing and no personal appearance before the Appeals Council.  Everything is submitted on paper and is reviewed in the absence of the claimant or the representative. It's a paper review.

The AC does not try to decide whether you are disabled or whether you meet the rules for a disability benefit.That's has already been decided by an Administrative Law Judge (ALJ). The only questions by the AC are:  Did the ALJ give you a fair hearing, and did the ALJ violate any Social Security regulation which might have produced an unfair decision?  If neither of these are true, the Appeals Council will not provide any relief.

So, the AC will not re-hear your case.  It will not try to decide if the administrative law judge made the correct decision in the hearing.  

I often see claimants who want to appeal their case to the AC because they disagree with the judge's decision.  But the real question is:  How did the hearing judge violate the rules?  How were the claimant's rights violated?  If no rules were violated, the AC will not reverse the judge's decision and will not remand the case for further action, whether it agrees with the judge's decision or not.

It's impossible to under-estimate the importance of the hearing.  The hearing is the best chance to win the claim.  If you attend your hearing unrepresented and are denied, there is no other further good chance to win.  Your one and only best-chance is gone and isn't coming back.  That's why it is so important to be prepared and represented at your hearing.  Most likely, you will not get a second hearing. 

 Make your one and only hearing count!  Be prepared.  Be represented.

____________

The Forsythe Firm, Huntsville, AL (256) 799-0297.

 

Comments

Post a Comment

Popular posts from this blog

MOST IMPORTANT FACTORS IN A SOCIAL SECURITY DISABILITY CASE

What are the top 3 most important factors in a Social Security disability case? 1.  Medical Evidence. 2.  Medical Evidence 3.  Medical Evidence 4-10     Medical Evidence Federal regulations set the eligibility requirements for Social Security disability (SSDI) benefits.  A claimant must meet these strict legal requirements More than anything else, the claimant's medical evidence will determine the outcome of the claim or appeal.  Without strong objective medical evidence Social Security cannot legally pay you a benefit. Objective Medical Evidence means the result of medical examinations, laboratory tests or imaging studies (X-rays, PT scans, MRI or CT scans). This type of evidence can only be obtained by going to your doctor. There's an old adage that says truthfully:  "The path to Social Security disability benefits runs straight through your doctor's office."  Being approved for an SSDI benefit requires objective medical proof. ...
Post a Comment
Read more

SOCIAL SECRITY DISABILITY: THE DECISION WRITING PROCESS

  By Charles W. Forsythe - The Forsythe Firm in Huntsville An Administrative Law Judge (ALJ) has made a decision on your Social Security disability appeal hearing. The decision must now be sent to to a process called "Decision Writing" - where an attorney or paralegal will draft the formal binding decision, explaining the judge's legal rationale for the decision and explaining the mandatory 5-Step decision making process. The decision writing process translates a judge's ruling into a formal, legally binding document. It is a vital but time-consuming phase that ensures all medical evidence and vocational factors align with the law. A typical written decision will be 10 to 20 pages, thus very detailed.  It takes time to write one. There are many decisions ahead of yours and usually they are written in the order received. The step-by-step process breaks down as follows: The Judge’s Ruling & Instructions:  Following your hearing, the Administrative Law Judge (ALJ) r...
Post a Comment
Read more

UNDERSTANDING THE 5-STEP SOCIAL SECURITY DISABILITY PROCESS

Receiving Social Security disability payments depend on one thing:  Proving that you are not able to work. The one and only thing that SSDI pays for is the physical and/or mental inability to work for a period of at least 12 months.  Who decides if you are able to work?  The Social Security Administration (SSA) will decide.--according to their own strict rules and regulations. In reaching that important decision, are you disabled or not, Social Security must use a 5-step examination process.  It's important to understand these 5 sequential steps. STEP 1:  The work Test .  Is the claimant now engaged in Substantial Gainful Activity (SGA)?  If yes, the claim is denied at Step 1.  They look no further.  You cannot be eligible for SSDI benefits if you are working at SGA, regardles of your medical condition.  (In 2026 you are working at SGA if you earn at least $1,690 per month from work or self-employment). STEP 2.  The Medical Requirem...
Post a Comment
Read more