If your Social Security Disability benefits are denied again after you have a hearing before an Administrative Law Judge (ALJ), you have the option of appealing your case to the Appeals Council. You must file an appeal with the Appeals Council within 60 days of receiving your administrative hearing decision. (If you miss the 60-day deadline, it's possible to get special permission to file the appeal if you can show you had a good reason for missing the date.)
Before accepting your case, the Appeals Council (AC) will review the decision to see if the judge made an "error of law." An error of law is a mistake the ALJ makes in applying the rules of the Social Security Administration. Some errors of law include missing an important piece of medical evidence or incorrectly classifying your past relevant work. Simple mistakes of fact—like the ALJ saying that you have two cats instead of three—aren't enough for the council to find an error of law.
The council will reconsider ALJ decisions only where the judge made an error of law. If the council finds that the judge's decision was based on substantial evidence in the record and that the judge didn't make any procedural errors, they will deny your appeal. If your appeal is denied, you'll have to either start over with a new initial application or go to federal court.
To overturn the ALJ's decision, the Appeals Council must find clear evidence that the decision made by the ALJ was incorrect. Hearing judges are given a lot of deference, meaning that the council doesn't want to second guess their decisions. Because ALJs have the opportunity to speak with you in person and the AC doesn't, the council usually finds that the hearing judge is better at determining whether you're disabled than they are.
Judges are still human and can make mistakes, though. For example, if you received an unfavorable decision because the ALJ overlooked a medical source statement from one of your doctors, the Appeals Council will likely reconsider the case. But if the medical evidence could support a decision either way (favorable or unfavorable), the council will leave the judge's decision alone, even if they wouldn't have arrived at the same conclusion.
If the AC decides that the ALJ incorrectly decided your case, one of two things will happen:
You'll receive a letter in the mail from the Appeals Council letting you know what they decide.
There are several advantages and disadvantages that you should consider before making the decision to file a request for review (formal appeal) by the council.
Receiving a partially favorable decision means the judge agrees with you that you're disabled, but doesn't agree with when you became disabled. Partially favorable decisions don't affect your ongoing disability benefits, but you'll receive less in back pay, and you might have to wait longer to receive Medicare (if you're eligible).
If you choose to appeal a partially favorable decision in order to get an earlier onset date, consider these differences from appealing unfavorable decisions:
If you're trying to decide whether to file a new application or request review by the Appeals Council, you'll save a lot of time and energy by consulting an experienced disability attorney. The Appeals Council doesn't often overturn ALJ decisions, so you can increase your chances of success with an attorney on your side who can write a brief to the council about how and why the ALJ made errors of law.
Updated August 8, 2022