Appeals Council – Your Third Appeal

After the Administrative Law Judge makes a decision on your case, you will be notified via a hearing decision through the mail.  If the Judge denied your claim or finds that you are disabled, but became so at a different date than what you claim, you may appeal the decision to the Appeals Council.  As in previous appeals, you have sixty days after you receive notice of the decision to ask for an appeal.  In calculating the sixty days, the Social Security Administration presumes that you received the notice five days after it was mailed, unless you can prove otherwise.  If you do not appeal within this timeframe, your appeal may be dismissed and you will lose a chance at a further review.  You may submit reasons to the Council for missing the deadline, however, it is very rare that they will extend the original timeframe.

This third appeal is unlike any of the previous appeals and hearing that the claimant experienced.  Most importantly, the Appeals Council does not review your case to determine whether you qualify for benefits, rather the Council evaluates whether the Administrative Law Judge committed an error in the denial.  The Council will review the hearing transcript to decide whether the Judge made an error or failed to look at the medical evidence.  Often, the Council upholds the ALJ’s decision and the claimant’s request for review is denied.

If, however, the Council decides that the Judge committed a technical error or did not thoroughly consider the medical evidence and testimony, the case is sent for a remand or second hearing.  In the event that the Council determines that the Judge’s decision was in complete error, the denial can be overturned and the claimant will be approved for disability benefits.  These Council decisions often take awhile to make, therefore you should be prepared with any supporting evidence to help speed up the process.  For this reason, as well as the complexity of an appeal, it is always good practice to have an attorney represent you in these matters.

An attorney can write a brief on your behalf so that the Council knows exactly what to examine in the way of an error on the ALJ’s part.  Additionally, he can collect and submit supporting medical evidence and comments to bolster your claim.  Finally, make sure ascertain whether the Council received your request for review.  In addition to helping with the Appeals Council brief and evidence, an attorney may also advise a claimant to file a new disability application at the same time the appeal if file.  This automatically gives you a second chance at winning.  In addition, this will also protect you if your appeal happens to get denied.  Keep in mind that if your appeal in your first case is denied, you may qualify for benefits in your second case as early as the day after your denial.  Additionally, if your request for review is denied by the Appeals Council, you still have another step in the process.