How the Social Security Disability Appeals Process Works

 Posted on November 11, 2015 in Denied Social Security Benefits

It usually takes years before Social Security Disability Insurance applicants start receiving benefits. In many cases, claims are initially denied and must go through an extensive appeals process. After an administrative law judge (ALJ) denies a claim, the applicant must first seek an internal review with the Social Security Administration's Appeals Council. If this body still rejects the claim, the applicant can turn to the federal courts for relief. The courts do not have the power to directly award disability benefits, but they can order Social Security to reconsider your case.

When Must SSA Consider New Evidence?

A common problem in disability cases is the emergence of new information after an ALJ has conducted a hearing and rendered an initial decision. In such circumstances, the applicant may present additional evidence to the Appeals Council, which must then determine if it is “new and material” and “relates to the period on or before” the ALJ's decision. If the Appeals Council accepts the new evidence, it is added to the record, which is then reviewed in its entirety. The Appeals Council will overturn an ALJ's decision to deny disability benefits only if it is “contrary to the weight of the evidence.”

It is important to understand the more limited role of the courts when reviewing an Appeals Council decision. The courts will not retry a case or re-weigh any evidence you presented to Social Security. The court's function is simply to review whether Social Security followed the law. For example, if the Appeals Council allows you to submit new evidence but ultimately decides that is not enough to reverse the ALJ, the courts will not second-guess that decision. If, however, the Appeals Council refuses to consider new evidence it was legally required to, the courts may order Social Security to reconsider your case.

Recently, the U.S. Seventh Circuit Court of Appeals, which oversees all disability cases from Illinois, addressed this subject. In this case, a disability applicant sought review of the ALJ's denial with the Appeals Council. She submitted additional evidence in the form of treatment notes from her doctors. These notes, she contended, undermined the ALJ's conclusion that her medical condition was improving, thereby justifying denial of her disability claim.

The Appeals Council rejected the woman's appeal without discussing the new evidence. The only mention of the treatment notes came in an appendix to the Appeals Council's decision. The Seventh Circuit said the Appeals Council's lack of explanation amounted to a rejection of the evidence. This was wrong as a matter of law, the court said, as the treatment notes clearly constituted “new and material” evidence. Accordingly, the court returned the case to the ALJ for reconsideration.

Do Not Fight SSA Alone

Navigating the lengthy appeals process is just one reason no disability applicant should go up against the Social Security Administration alone. An experienced Chicago Social Security Disability attorney can help guide your claim from start to finish. Contact Pearson Disability Law, LLC, today, to speak with someone about your case today.

Source:

https://scholar.google.com/scholar_case?case=6053440819139793192