Once denied by Social Security, the person seeking disability benefits appeals and requests a hearing before an administrative law judge. If the ALJ also denies the benefits, the claimant asks for a review by the Appeals Council.
The Appeals Council is a group of judges headquartered in Falls Church, VA, with offices also in Baltimore and Washington, DC. The average waiting time for the Council's decision is about 14 months.
Here are the 3 possible actions that the Appeals Council may take:
Refusal to Reconsider - 75 percent. The Council refuses to reconsider your case, effectively denying your appeal. (The case may now be taken to US District Court for further appeal).
Remand - 22 percent. The Council sends your case back for further action by the administrative law judge - usually another hearing.
Direct Award - 3 percent. In a very small percent of cases, the Council reverses the administrative law judge's denial and makes a direct award of benefits to the claimant. This is, obviously, the most favorable decision the Council can make.
Unfortunately, most people give up on their case long before it reaches the Appeal Council stage. Therefore, many individuals who should receive Social Security disability benefits do not. Keep in mind that favorable action by the Appeals Council (remand or direct award) potentially awards your benefits back to the date you first became disabled. Therefore, a large payment of back pay may be due.
