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

RED FLAGS IN SOCIAL SECURITY DISABILITY CASES

  RED FLAGS IN A SOCIAL SECURITY DISABILITY CASE A red flag is something that causes concern or raises a problem in a Social Security disability case.   In short, it’s something that may get the claim denied or cause a big problem. Here are some of the red flags that we see crop up: ·          Work after the alleged onset date (AOD).   Since the process takes so long, many claimants feel that they are forced to return to work for income.   Social Security often sees this as a sign that the claimant is not disabled. ·          Severe substance abuse.   Chronic and frequent abuse of drugs or alcohol can pose problems. ·           A skimpy work record.   A claimant who has worked very little or has jumped from job to job frequently may not have good credibility. ·          Quitting wo...
Post a Comment
Read more

WHAT YOU WILL BE ASKED AT A DISABILITY HEARING

Most Social Security disability claims will be denied twice:  First at the end of the Application process, and again after the "Reconsideration" process.  The third stop will be a hearing before a federal Administrative Law Judge (ALJ). It is here at the hearing level that most SSDI claims are paid.  So, what do you need to know about your Social Security disability hearing?     First, the judge will follow the rules established by the Social Security Administration.  His or her job is to determine whether you meet the particular laws and rules to receive disability payments.  So, it is a legal proceeding where you must prove certain things in order to get paid. Among the things you must prove:  Your insured status with Social Security:  You have worked recently enough and paid into the Social Security trust fund to gain the required "work credits" to support your claim.  You have a severe medical or mental impairment supported by adequa...
Post a Comment
Read more

HOW TO COMPLETE A FUNCTION REPORT OR ACTIVITIES OF DAILY LIVING FORM

After you apply for Social Security Disability (SSDI), you will be sent a FUNCTION REPORT to fill out and return.  This form asks a lot of very detailed questions about your daily activities:  driving, cooking, cleaning, dressing, visiting others, hobbies, etc. The Social Security Administration will use your answers to determine whether you can work or not.  You must show on this Function Report that you have limitations that do not permit you to work a full-time job.  You do this by showing your limitations in activities of daily living. Your goal in the Function Report is to show the struggles and challenges you have with everyday life.  It may not be sufficient to answer a question with "Yes" and fail to explain. For example:  "Can you drive?"  If you answer "Yes," Social Security will assume that your ability to drive is unlimited:  you can drive anytime, anywhere and as often or as far as you want.  That may not be true and would need t...
Post a Comment
Read more