If a claimant’s Social Security Disability or SSI claim is denied by an Administrative Law Judge, then the claimant has sixty days to appeal to the Appeals Council. The request for review must be in writing in the form of a letter or on a Form HA-520-U5. Though the Appeals Council is generally a review on the record, it is always a recommended to support the appeal with a brief. The claimant may submit new evidence that relates to the period of disability prior to the ALJ’s decision.
The Appeals Council first decides whether it will even hear an appeal. If it grants a review, it has the power to affirm, reverse in whole or part, and it can remand for a new hearing. A decision by the AC may be very timely or it may take months upon months filled with anxiety, frustration, and anger. The AC is neither predictable, nor dependable in overturning unjust opinions.
The scope of review is limited. The Appeals Council will review a case if:
- there is an abuse of discretion by the ALJ;
- there is error of law;
- the action finding or conclusions of the ALJ are not supported by the substantial weight of the evidence; or
- there is a broad policy or procedural issue that may affect the general public interest.
Common ALJ errors often sighted on appeals are ALJ misconduct, ALJ bias, failure to grant additional time to submit new evidence, an error of law, procedural error, erroneous dismissal, rejecting medical evidence in favor of the ALJ’s own observation of the claimant, failure to inform claimant of right to obtain counsel, failure to give proper weight to claimant’s subjective complaints or pain or other symptoms, relying on opinions of non-examining physicians to the exclusion of opinions by treating or examining physicians, or failure to consider all relevant evidence.
If the AC affirms the unfavorable ruling, then the only remedy is to file in Federal District Court or start over.
If you need more information about a Social Security Disability/SSI, personal injury, EEOICPA, long or short-term disability, VA disability, or a workers compensation matter, please contact the Law Offices of Tony Farmer and John Dreiser for a free case evaluation. We can be reached at (865) 584-1211 or (800) 806-4611 or through our website. Our office handles claims throughout East Tennessee, including Knoxville, Chattanooga, Kingsport, Bristol, Johnson City, Morristown, Maryville, Rogersville, Dandridge, Tazewell, New Tazewell, Jefferson City, Strawberry Plains, Sevierville, Gatlinburg, Loudon, Kingston, Halls, Maynardville, Crossville, Cookeville, Jamestown, Sweetwater, Lenoir City, Athens, Oak Ridge, Clinton, LaFollette, Lake City, Jacksboro, Bean Station, Cosby, Newport, White Pine, Mosheim, Wartburg, Sunbright, Pigeon Forge, and Deer Lodge.