After a Judge Denies Your Disability Claim: Appeals Council Review
After a judge denies a disability claim, the next step is asking the Appeals Council to review the decision, within 60 days of receiving it. The Appeals Council can deny review, decide the case itself, or send it back to a judge. Start by reading the decision itself.
A judge’s denial is a hard letter to get after this long. It is also the most detailed one you will receive: the decision states the judge’s findings and the reasons for them. That explanation is what an Appeals Council request responds to. This page covers reading the decision, what the Appeals Council looks for, how to request review, and what comes after.
Where this page sits
- Application
- Initial decision
- Reconsideration
- Hearing
- Appeals Council reviewYou are here
How to read an unfavorable disability hearing decision
Judges decide disability claims in five steps: whether you are working above the substantial gainful activity level, whether your impairments are severe, whether they meet a listed impairment, whether you can do your past work, and whether you can do other work. The decision says which step ended the claim.
An unfavorable decision can find that you have severe impairments and still deny the claim at a later step, based on the work the judge found you can still do. Look for that finding about your remaining abilities, the jobs the decision relies on, and how it treats each medical opinion. Those are the parts an Appeals Council request usually addresses.
Sources: 20 CFR 404.1520; 20 CFR 404.953.
What the Appeals Council looks for when it reviews a judge’s decision
The rules list five situations in which the Appeals Council will review a case:
- the judge appears to have abused their discretion;
- the decision contains an error of law;
- the findings are not supported by substantial evidence;
- the case raises a broad policy or procedural issue; or
- it receives new and material evidence about the period on or before the decision date, with a reasonable chance of changing the outcome, and you show good cause for not submitting it earlier.
That standard is why a request carries more weight when it points to specific problems in the decision, rather than restating that you disagree.
Source: 20 CFR 404.970.
How to request Appeals Council review
The request is due 60 days after you receive the hearing decision. You can start it online through Social Security, or complete the Request for Review of Hearing Decision/Order (HA-520) and fax or mail it to a Social Security office. Keep a copy of the request and proof of when you sent it.
Plan for this stage to take time, and keep seeing your providers while it does. Treatment records will matter again if the case goes back to a judge.
Sources: 20 CFR 404.968; SSA, Request review of hearing decision.
What the Appeals Council can decide
If the Appeals Council agrees with the judge, it denies the request, and the judge’s decision stands. If it decides to review the case, it either issues its own decision or sends the case back to a judge for further review.
What comes after the Appeals Council in a disability case
After the Appeals Council acts, the next step is a civil action in federal district court, filed within 60 days after you receive the Appeals Council’s notice. Downard & Associates does not handle federal court cases in-house; we refer them to a trusted affiliate firm.
Source: 20 CFR 404.981.
How Downard & Associates helps after a judge denial
We review the hearing decision against the record, identify the issues the Appeals Council is most likely to consider, and prepare the request and any written argument. If the case moves to federal court, we connect you with our affiliate firm.
Talk with Downard & Associates about your claim
Downard & Associates represents adults with SSDI and SSI claims in every state by phone and video, from applications through Appeals Council review. Sending an inquiry starts a conversation; it does not file anything with Social Security. We respond to inquiries within 3 business hours.
Representation before Social Security nationwide: 42 U.S.C. 406; 20 CFR 404.1705.
Questions people ask after a judge denies a disability claim
What if I missed the 60 days to ask for Appeals Council review?
You can ask the Appeals Council, in writing, for more time. The request has to explain why you did not file on time, and the deadline is extended only if you show good cause, such as a serious illness or a notice you never received.
What is a partially favorable decision?
It approves part of the claim and denies the rest, often by finding the disability began later than the date you gave. Asking for review of the unfavorable part has trade-offs, so talk it through with a representative before you file.
Will Downard & Associates take my case if a judge already denied it?
Appeals Council review is one of the stages we handle for adults with SSDI and SSI claims. We read the decision with you and tell you plainly what we see in it, including whether review is worth pursuing.
Sources: 20 CFR 404.968; 20 CFR 404.911.