If an Administrative Law Judge denies your claim, you have 60 days to appeal to the Appeals Council. Instructions for appealing to the Council will be included in your opinion from the Administrative Law Judge.
Rather than appeal to the Appeals Council, consider starting the process of applying for SSDI all over again. You will lose any retrospective payments, but it may be a price worth paying to get benefits started.
The Appeals Council In General
The Appeals Council will grant review of an Administrative Law Judge (ALJ) decision where:
- There is an error of law
- There is an abuse of discretion
- The ALJ's decision is not supported by substantial evidence
- There is a broad policy or procedural issue that might affect the public interest or
- There is new and material evidence submitted relevant to the issues before the ALJ (such as a change in your health condition).
Overwhelmingly, the Council agrees with administrative law judges and rarely overturns their decision. According to National Organization of Social Security Claimants' Representatives (NOSSCR,) only 5% of the cases the Appeals Council hears are sent back to Social Security for a reevaluation or reversed at this level.
There is only one Council to review all claims in the country. It is located in Falls Church, Virginia. An appeal to the Appeals Council can take anywhere from 2 months to 24 months for a decision.
According to Christopher J. Bowes, Executive Director, Center for Disability Advocacy Right: If you are considering filing an appeal:
- Look for new evidence. If a reasonable person would change the ALJ's decision based on the new evidence, there is a good chance your case will be sent back to the ALJ for review.
- Ask for a copy of the hearing cassette and exhibits of the ALJ record. Also ask the Appeals Council to permit you to file exceptions within 30 days of receipt of the tape and exhibits. This is the only way to completely consider whether there is substantial evidence to support the ALJ's decision.
If you are considering appealing to the Appeals Council, there is almost no point in spending the time to appeal without legal help. The attorney will charge you, unless he or she is from a non-profit legal advocacy group.
If you lose at the Appeals Council level, you have the right to sue Social Security in Federal Court. Again, chances of success are low, and the process can take a long time. Legal representation is close to a necessity.
Appeals Council: The Procedure
- Your local Social Security office will assist you with requesting that the Appeals Council review your file.
- The Appeals Council will review the claim file, any new documentation submitted, the transcript of the hearing before the Administrative Law Judge, and the Administrative Law Judge's decision.
- You do not appear in person in front of the Council.
- The Appeals Council may render a decision, choose not to review the claim, or send it back to the Administrative Law Judge for further consideration.
- You will receive a copy of the Appeals Council decision or Order if your case is sent back to the Administrative Law Judge.
If the Appeals Council declines to review your case, it will mail you a notice advising that the Council finds no basis to disturb the Administrative Law Judge's decision which then becomes the final decision in the case.