How Do I Appeal an Unfavorable Administrative Law Judge Decision?

by Casaundra Johnson | May 08, 2019 | Workers' Compensation

What happens if the judge denies my claim? This is one of the most common questions clients ask, even before their hearing is scheduled or the judge makes a decision in their case. To answer simply, if the judge denies your claim you will have the option of filing an appeal. If you choose not to file an appeal to the Appeals Council, the judge’s decision will become final and you will only be able to reopen the case under very limited circumstances.

If you choose to file an appeal, you will have 60 days from the date you received the judge’s decision to file an appeal to the Appeals Council. This appeal, known as a Request for Review, can be filed by either completing Social Security’s standard form HA-520 or by writing to Social Security and requesting Appeals Council Review.

The Appeals Council is a panel of judges who will review your claim and determine whether the administrative law judge made an error in denying your case. Even if the Appeals Council disagrees with the judge and believes you are disabled, it can only grant your appeal if the judge made an error; you raise a broad policy or procedural issue that may affect the general public interest; or, in limited circumstances, you have new and material evidence from before the date of the judge’s decision.

Unfortunately, it typically takes about 12 months to get a decision from the Appeals Council and, on average, more than 70% of these appeals are denied. According to data provided by Social Security, the Appeals Council denied 86% of appeals decided in fiscal year 2017, granted 1% of the appeals, sent 9% of the appeals back to the hearing level, and dismissed 3%. While these statistics can be discouraging, your chances of winning at the Appeals Council level largely depend on the judge’s written decision and the facts of your case.

The Social Security Attorneys at The Bainbridge Firm are ready to assist in any aspect of the appeal process. Please feel free to walk into one of our 7 locations and seek help.

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