If the Social Security Appeals Council decides not to review or reverse your SSDI disability denial by an administrative law judge, you have the right to appeal the denial to federal court.
When you appeal to federal court, different rules apply. Until now, your disability application has been reviewed by the Social Security Administration (SSA), an agency with its own policies and procedures. At the federal level, you're essentially suing the SSA because you don't think they followed their own regulations correctly.
After you've received a decision from the Appeals Council, you have 60 days to appeal. You can do this by filing a civil complaint with the United States District Court for your geographic area. A civil complaint is a brief statement of facts and allegations that tells the court what your case is about.
If you haven't gotten an attorney yet, now is the time to do it. The SSA can't help you file a complaint for a federal court, and if you appeal the denial on your own, you have to follow the Federal Rules of Civil Procedure or risk having your complaint dismissed. The rules govern everything from who the defendant can be—in complaints against the SSA, this will be the current Social Security commissioner—to what kind of typeface and paper size you must use.
Once you've written your complaint, you have to file it with the proper court along with a filing fee (typically around $350). Use the federal district court locator to find the court for your area. For more information about the procedural rules for filing a federal complaint, you can visit the United States Courts website.
After you have filed the complaint, the district court will issue a summons. You'll need to serve the summons and a copy of your complaint to Social Security's Office of the General Council (OGC). Bring the summons and complaint to your local OGC—you can find the address and location here.
After the SSA has been served, an attorney for the OGC will file an "answer." An answer is essentially an explanation of why Social Security was correct in denying your claim. You'll then need to file an opening brief.
A brief is a legal document that explains your position in detail to the court. In an SSA appeal, the first brief filed by the claimant (you) is called an opening brief. In an opening brief, you should analyze the decisions of the hearing judge and Appeals Council in light of your medical evidence and testimony. Your goal is to persuade the federal judge that the SSA incorrectly applied their rules in your case—such as not properly considering the medical evidence—so your case should be reversed and remanded (sent back for additional administrative review).
You won't be allowed to offer any new evidence in an opening brief. But federal appeals are won or lost on the written opening brief, and they are an absolutely necessary part of the federal appeals process. For this reason, you really need to hire an attorney who is experienced in writing federal appeals briefs for disability denials.
Once the opening brief is filed, the SSA can then file a response brief. A response brief is the agency's chance to explain why you're wrong and why the decisions of the hearing judge and Appeals Council were correct.
You (or your lawyer) can then file a reply brief, which is one last chance to defend your position and point out weaknesses in the SSA's arguments. Sometimes the court will schedule oral arguments in person, but this is rare.
After the briefs have been filed and the oral argument—if there is one—has been held, the federal judge who heard your case will make a decision and issue a written opinion. The entire process usually takes at least a year.
The judge may decide to do any of the following:
Your best bet is to get a disability attorney who is familiar with both the Social Security rules and regulations as well as the Federal Rules of Civil Procedure. Your attorney can write persuasive briefs poking holes in the SSA's reasoning, and will make sure that all the relevant paperwork is filed on time.
Around 50% of disability denials are remanded at the federal district court level, but many of these cases involve the cessation of benefits following a continuing disability review. If you haven't already been awarded benefits and then had them stopped, your odds of success are lower.
The SSA publishes data on the reasons why federal district courts send disability cases back for further development. You can look at this data to see what your best arguments will be to win at the federal court level.
As of 2020, the top reasons federal courts send back disability cases to the SSA include:
Your lawyer will be able to determine which reasons apply in your case, as well as any other, less frequent mistakes that can get your case remanded from federal court.
If you receive an approval from the Social Security Administration, your attorney is typically restricted from collecting any more than 25% of any back due benefits awarded to you, up to $9,200. The agency will then withhold this amount from your award and pay it directly to your attorney.
But because federal district court appeals are more costly and time-consuming, if you get a favorable decision, your attorney can file a fee petition asking to be paid a reasonable amount. A recent Supreme Court decision suggests that, in cases where your attorney successfully argues your disability case in federal court, they can receive additional fees in excess of the agency's fee cap.
You may also be able to get your attorney's fees paid by the government under the Equal Access to Justice Act. Read more about how much lawyers cost in our article about Social Security disability attorneys and law firms.
Need a lawyer? Start here.