Can a Favorable ALJ Disability Decision Be Overturned by the Appeals Council?

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Question

I had my disablity hearing a few weeks ago and I'm waiting to receive a decision letter. The hearing seemed to go well and the judge seemed sympathetic to my case. I've aso heard this judge approves most disability cases. If the judge decides I should get disability benefits, is that the end of it, or can the judge's decision be overruled by Social Security?

Answer

Technically, yes, a favorable ALJ decision (one that grants benefits) after a disability hearing can be overturned by the Appeals Council. 

The Appeals Council can choose to review any ALJ decisions for review, and the Appeals Council can choose to grant benefits that an ALJ denied or deny benefits that an ALJ granted. However, it's very unlikely that your case would be chosen for review, but it is possible. Even less likely would be that your approval of benefits by an ALJ would be denied by the Appeals Council, but again, it does happen.

The Appeals Council can review the decisions of administrative law judges (ALJs) much in the same way that DQB, the Disability Quality Branch, selects random cases for quality review and reviews the initial approval or denial decisions made by DDS disability claims examiners. In either case, though, the percentage of cases pulled for such review is very small, and the chance of a disability approval being overturned is also very small.

When the Appeals Council decides to review a case on its own, you will be notified of its proposed action (to reverse the ALJ's decision or to affirm it), and you will be given an opportunity to offer your input.

Read more about whether it makes sense to ask the Appeals Council to review the ALJs' decision.

Updated by: , J.D.

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