Third Level of Appeal for Disability: Appeals Council & Remands

In most states, the Appeals Council is the third level of review.

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If your disability appeal is denied again after a hearing with an administrative law judge (ALJ), you have the option of filing an appeal with the Social Security Appeals Council. The Appeals Council is located in Falls Church, Virginia. You have 60 days from receipt of the ALJ decision to send a Request for Review to the Appeals Council. This request must be done in writing only, and you must use Form HA-520.

The Disability Appeals Council comprises the third step in the Social Security disability system's appeal process. This rung in the process is different from the other levels of appeal, in that its purpose is not to evaluate the merits of a disabiliy claim, but merely to determine if the administrative law judge (ALJ) who denied the claim made an error.

It usually takes a  long period of time for the Appeals Council to evaluate your case. The most recent figures show that the average review time was almost one year, or 345 days.

How Does the Appeal Council Review Disability Appeals?

The Appeals Council will review the ALJ's decision along with your entire case file, and any additional evidence that you submit. The Council will look to see if the ALJ committed any legal or procedural errors and whether all of the evidence was properly considered.

Upon review, the Appeals Council can perform one of three options:

  • deny the Request for Review (take no action on your case). If this happens, then you will have 60 days to file an appeal in federal district court.
  • remand the case to the ALJ (return the case back to the ALJ for a new decision). This will usually mean you will have another hearing with the ALJ, or
  • issue a new decision and award disability benefits on your case.

Deny the Request for Review

In most instances, an appeal sent to the Appeals Council will result in a letter mailed to a claimant that states "Your request for review (of the administrative law judge's decision) has been denied." This means that the Appeals Council won't approve your benefits and won't send your case back for another ALJ hearing; it translates as a denial.

However, there are many instances in which Appeals Council conducts a thorough review of the ALJ hearing proceedings and takes the second or third option above.

Remand the Case

The Appeals Council can decide that the judge made a technical error or failed to consider some of your medical evidence, resulting in the need for a remand (a remanded case is one that is sent back for a second ALJ hearing). (This happens about 22% of the time.)

Overturn the Denied Claim

The Appeals Council can decide that the judge's decision was completely in error and overturn the decision, resulting in an approval. (This happens only 3% of the time, however.)

How Long Does the Appeals Council Take?

As with every other step of the disability process, there is no way to know. Sometimes, cases wait as long as 18-24 months for a decision of some kind to be made. Other times, Appeals Council decisions can be made in as little as three months.

Does an Appeal to the Appeals Council Require a Lawyer?

This type of appeal can be handled by the disability claimant alone, but claimants who request appeals council reviews without a lawyer's help are most often denied. A disability lawyer is able to spot and point out legal errors made by the ALJ during the first hearing -- without being able to show the ALJ made an error, you won't win your appeal to the Appeals Council. If you're interested in having a consultation with a disability lawyer, you can use our disability lawyer finder.

If you're going to try to appeal to the Appeals Council without a lawyer, you'll need to submit a brief. For more information, see our article on writing a letter to the Appeals Council.

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LA-NOLO5:DRU.1.6.5.20141022.29090