An important part of being an effective attorney for the disabled is to be willing to sue the Social Security Administration in Federal District Court when it refuses to follow its own rules. Such an appeal to the Federal Court can be the critical last resort for a disabled individual.
As way of background, the decisions by the Administrative Law Judges (ALJs) at hearing are reviewed by a group of Judges in Virginia called the Appeals Council. If you are denied at a hearing, you must then file an appeal to the Appeals Council.
Unfortunately, it has been my experience that the Appeals Council will often sit on a case for 12 to 24 months only to send out a form letter giving little information as to why it did not accept your arguments concerning the mistakes made at hearing. Over the years in my disability practice, I have seen many cases where the ALJ at hearing misstated the evidence in record, ignored favorable evidence from treating doctors or simple applied the wrong provisions of the law. Yet, even after pointing out this error, the Appeals Council often decides to deny claims.
If you have received a denial by the Appeals Council, it will be titled NOTICE OF APPEALS COUNCIL ACTION. Should you decide to fight this claim any further, then you will need to file an appeal to the Federal District Court. In these appeals, you sue the Social Security Administration. If you can convince a Federal Judge that the ALJ at hearing failed to follow Social Security Administration’s law and regulations, then the Federal Court has the authority to order the SSA to give you a new hearing or, in some cases, award you benefits.
How Long Do I Have To File An Appeal?
If you receive a denial from the Appeals Council, then you have only 60 days from the date on the denial to file your appeal, though it is possible to ask for additional time from the SSA to file an appeal.
Do You Need A Lawyer For An Appeal ?
Yes. Unlike the administrative levels where the Administration is technically “non-adversarial” and there is some assistance in helping the claimant develop the record, appeals to the Federal Court follow an classical adversarial legal model. In other words, when you sue the Social Security Administration, the U.S. Attorney’s Office is going to defend the case and fight to see that your appeal is denied. Strong advocacy by an attorney is essential to prevailing in before a Federal Judge.