If you lose at the hearing stage before an Administrative Law Judge (ALJ)
, the next step in most states is to file a request for review by the Appeals Council. You can file an appeal
at your local Social Security Office. There is a specific form for this that has a section that asks why you feel the
decision was not correct. The space provided is minimal. If you don't have an attorney at this point
you should probably consult one. This form is not usually adequate to state your objections to the opinion of the ALJ
in the SSDI or SSI decision. A lawyer who has handled many hearing appeals
will be able to write a brief and point out the areas were the ALJ has made reversible mistakes. The arguments
that can be made to get a decision reversed or remanded (sent back to ALJ for a new hearing) are numerous and differ
from case to case. One commonly used argument is that the Administrative Law Judges decision was not supported
by substantial evidence. This basically means, without getting too technical, that the ALJ's decision
was not supported by the medical evidence in the file. Even if you just submit the form the Appeals Council will review
it to determine if it should be sent back or reversed but having a good brief from a lawyer would almost certainly help.
If you lose at the Appeal Council stage the only option left is to file in US District Court. SSA
is planning on getting rid of this step in the process and has begun testing in the Boston area. I will update this
site as the changes are made.
Update: It looks like SSA will be keeping the Appeals Council in some form
when the new changes are implemented. I will continue to update you as I learn more. Well, I have learned that
it looks like SSA has decided not to continue the pilot program in the Boston area and that it will not be implemented throughout
the rest of the country. It appears that the Appeals Council will be around for a while longer.