We have talked many times about the Social Security disability process from the initial application stage to a hearing before an Administrative Law Judge (ALJ), but we don’t often talk about something that may come after the ALJ hearing, the Appeals Council. Many people have misinformation or no information about what the Appeals Council’s function is.
The Appeals Council is a phase of the disability process where those claimants who receive unfavorable decisions from an ALJ (they lose their case) have recourse to disagree with the ALJ’s decision.
The Appeals Council does not hold another hearing, but decides whether or not to review an ALJ decision. If the Appeals Council finds errors with the ALJ’s decision they have the option to take action.
Most of the time the Appeals Council will deny a review because it did not find any errors with the ALJ’s decision, but occasionally the Appeals Council may reverse an ALJ decision and approve benefits for a claimant or remand the case back for a new hearing before an ALJ. This is rare, but it does happen.
Most claimants believe that if their case is pending at the Appeals Council that the Appeals Council will continue to look at new medical evidence, but this is not the case. The Appeals Council will only consider new medical evidence if the evidence was relevant before the ALJ issued the unfavorable decision.
This may seem unfair, but remember the Appeals Council is reviewing the ALJ decision, not deciding whether someone is disabled or not. Although they may reverse an ALJ decision outright, they would only due so if there was clear medical evidence indicating the claimant was disabled that the ALJ overlooked or ignored.
To learn more about the Appeals Council process and what is considered at this level, click here.
