Monday, May 23, 2016

Screening Cases at the Appeals Council to Expedite Review

In order to contest a decision from a Social Security Disability Judge, a claimant must file an appeal with the Appeals Council (AC).  Usually an appeal before the AC can take more than a year.  Under some circumstances, staff from the AC is supposed to screen cases to determine which ones should be decided on an expedited basis.  To be quite honest, I am not sure of how good of a job they do at screening their cases.  In any event, here is the list of circumstances under which a claimant's case can be expedited:

(1) Age 55
(2) Any indication or report of death
(3) Hospice, nursing care, or claimant cannot care for personal needs
(4) Intensive care unit for more than 3 days
(5) Hospitalization for more than 7 days
(6) Transplant notes (kidney, heart, heart/lung,
liver or bone marrow, etc.)
(7) Transplant waiting list
(8) Cancer with poor or no response to treatment
(9) Cancer that has spread to other areas/
(10) Coma
(11) Heart attack or myocardial infarction
(12) Stroke, or cerebral vascular accident
(13) Prescribed use of home oxygen
(14) Prescribed use of wheelchair
(15) VA disability rating of 70% or more
(16) Letter or notice approving other forms of
disability payments
(17) Medical report(s) of a terminal prognosis
(18) Dialysis or End Stage Renal Disease (ESRD)
(19) Blood transfusion(s)
(20) Bed or home confinement
(21) Very rare, unusual, or compassionate allowance diagnoses

If your case falls under any of these circumstances, it is a good idea to notify the Appeals Council. Supposedly, the AC automatically screens for claimants over 55.  Nonetheless, whenever I file an appeal of someone who is over 55, I try to state it in a very visible way on the very first paragraph of the brief.  To verify that the Appeals Council knows a client meets one of the 21 circumstances, call the Congressional and Public Affairs Branch at 1-877-670-2722 or fax Appeals Council Ombudsman Terry Jensen at 703-605-8691.