Receipt of a notification that the Appeals Council is reviewing a fully favorable ALJ decision can be very disheartening, since claimants often wait over 2 years to finally have their cases decided by a judge. The Appeals Council reviews favorable ALJ decisions on its own motion in very few cases. Moreover, the decision to review a case on its own is usually determined by a random process. This process is more specifically described in 20 CFR 404.969.
If you are one of the few unfortunate claimants whose fully favorable decision is being reviewed by the appeals council, here is quick guide of what to expect in this process:
- The Appeal Council has 110 days to make a decision on your case. During this period of time the claimant will not be paid benefits.
- If the Appeals Council does not make a decision within 110 days, the claimant is allowed to receive "interim benefits". The claimant will not have to pay back these interim benefits in the event that the case is eventually lost.
- In the Appeals Council reviews the case, it can make one of three determinations: 1. determine that the ALJ was right in grating you benefits 2. Send the decision back to the judge to be corrected or, 3. the Appeals Council can decide on its own that the ALJ made the wrong decision and deny you benefits without a new face to face hearing with an ALJ.