The Appeals Council Process

If you receive an unfavorable hearing decision from an Administrative Law Judge, there is one more level of appeal within the Social Security Administration’s adjudication process. This final step is called Appeals Council, or AC, review. If you do not want to file an appeal with the AC, your other option is to re-file your claim, which means starting over by filing a new claim with your local Social Security office.

The most important thing to know about taking your claim to the Appeals Council is that, as of 2011, most people cannot both file a new claim and file an appeal with the AC. Because of the new Social Security Ruling 11-1p, you cannot have two claims for the same type of benefits pending at the same time. So for most people, when they get an unfavorable hearing decision they have to choose between appealing that decision to the AC or filing a new claim. Each option has different implications for your case. Talk to your attorney to see what he or she recommends before you make a decision.

If you appeal your case to the AC, you are sending your appeal to one national processing center where everyone in the United States of America has to send their case if they are unhappy with the outcome of their hearing. The headquarters for the Appeals Council is in Falls Church, Virginia, outside of Washington, D.C., but there are some satellite offices in other parts of the Washington D.C. area. The Appeals Council says it received over 128,000 requests for review in the 2010 fiscal year.

Because there is only one Appeals Council for the entire country, your appeal is likely to take over a year. The AC says that the average processing time for a case in the 2010 fiscal year was 345 days (Id.). The amount of time it takes to hear back from the AC can be a major consideration for claimants deciding whether to re-file their claim or appeal it.

Once the Appeals Council does finally adjudicate your case, there are three possible outcomes: you may get a denial notice, a remand notice, or a decision. Again, each of these documents has unique legal implications, and you should talk to your lawyer as soon as you get your Appeals Council notice.

The implications of each of those types of Appeals Council documents will be the topic of a later post, but for now, remember that if you are unhappy with the outcome of your hearing, there is a final step for administrative review. Although this step is likely to take over a year, it sometimes has legal benefits that make it better for your case than re-filing a new claim would be. Be sure you examine all of your options before you make a decision.