Should I Request Appeals Council Review?

 

If the administrative law judge (ALJ) denies your claim for Social Security Disability benefits after a hearing, you may want to appeal the decision to the Appeals Council in Falls Church, VA.

 

If you are unhappy with the Administrative Law Judge’s (ALJ) decision at your Social Security Disability hearing then you may request that the Appeals Council review that decision. This option is available if you the ALJ denied your claim, issued a partially favorable decision awarding your claim for benefits but with a different onset date of disability, or dismissed your hearing request because you failed to show up.

 

How to Request Appeals Council Review

 

You must file your appeal with the Appeals Council within 60 days of the date the ALJ issued the decision denying your disability claim. The request should be in writing and attach any additional evidence you want the Appeals Council to consider. If you miss the 60-day deadline then you may have to start over by filing a new Social Security Disability Application.

 

When you request review your disability attorney Richmond or Virginia Beach SSD lawyer should submit a written statement explaining why you are requesting review of the ALJ’s decision. The written statement should contain references to specific exhibits that support your claim, such as a treating source opinion.

 

Common reasons for requesting review by the Appeals Council include:

 

  • An ALJ who did not allow you to present all the evidence you wanted to present at hearing
  • An ALJ who did not give appropriate weight to your treating physician’s opinion
  • An ALJ who did not consider one or more of your physical or mental impairments to be severe
  • An ALJ who made a decision contradictory to existing case law or existing Social Security regulations.

 

What Cases will the Appeals Council Review?

 

After you file a request for review the Appeals Council will examine the evidence in your case including the medical exhibits and the hearing transcript. It will grant, deny, or dismiss your request for review.

 

The Appeals Council will review your case if:

 

  • It appears that the administrative law judge abused his or discretion
  • The administrative law judge made an error of law
  • The administrative law judge’s decision is not supported by substantial medical evidence
  • New and material medical evidence is submitted that relates to the period of disability benefits sought at hearing
  • There is a procedural issue that may affect the general public interest (i.e. some type of violation of your right to due process).

 

The Appeals Council’s function is to review the ALJ’s decision and to see if some type of mistake was made. Unfortunately the Appeals Council is not a place where disability applicants experience much success. Few denials are overturned or remanded back to the ALJ for additional proceedings at this level. But it is a necessary step in the Social Security Disability Insurance (SSDI) process.

 

How Does the Appeals Council Review Cases?

 

The Appeals Council may remand your case to an administrative law judge if it thinks that additional evidence is needed to decide your case or that the administrative law judge needs to review and reevaluate evidence presented at the initial hearing. On remand the administrative law judge must take any action ordered by the Appeals Council. When a case is remanded you have the opportunity to get a new hearing.

 

The Appeals Council may also reverse the administrative law judge’s decision at hearing. But this is rare, even when compared to the few cases that are remanded.

 

As we said above you are unlikely to receive help at the Appeals Council. But you must go through this step if you plan on filing a lawsuit in federal court.

 

Should I File a Request for Review with the Appeals Council?

 

The Appeals Council level of the administrative review process can take more than one year and is likely to lead to another denial. Because of this you should weigh the pros and cons of filing an appeal with an Appeals Council in your disability claim.

 

Advantages of Requesting Review by the Appeals Council

 

  • If your attorney thinks your case is a good one to take to federal court then you preserve the right to file a lawsuit against the SSA when you request review by the Appeals Council. You cannot pursue your disability claim in federal court unless you request review by the Appeals Council.

 

  • Your new medical evidence may be considered. If you have new and material medical evidence that you did not present at hearing then the Appeals Council may use that in making its decision.

 

Disadvantages of Appealing Your SSD Denial to the Appeals Council

 

In many cases requesting review by the Appeals Council is not in your best interest. Here are some reasons why:

 

  • The Appeals Council process takes a long time. It can take close to a year – or more – to complete this stage of the process. And you cannot file a new application for benefits until the Appeals Council makes its decision.

 

  • Low approval rate. The Appeals Council remands or overturns few ALJ denials.

 

Hire a Disability Lawyer for the Appeals Council Review

 

We recommend talking with a disability attorney when you’re trying to decide between filing a new application for disability insurance benefits or filing a request for review with the Appeals Council. Requesting review without an attorney may be a decision that leaves you with even lower odds of getting approved.

 

An experienced attorney can help you present your case to the Appeals Council effectively and make solid legal arguments to prove that your case should be remanded or reversed. We’ve helped hundreds of disabled adults in Virginia get their denials remanded or reversed at the Appeals Council level.

 

You have nothing to lose. Call, text, or email Corey Pollard today for a free case evaluation.

 

Corey Pollard
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