Appealing an Unfavorable ALJ Decision to the Appeals Council

If you have received an unfavorable decision in your Social Security Disability case from an Administrative Law Judge (ALJ), you can appeal the case by asking for a review from the Appeals Council.  The Appeals Council (AC) is the administrative body within the Social Security Administration that is responsible for reviewing ALJ decisions.     

The Appeals Council is located in Falls Church, Virginia and it consists of 50 Administrative Appeals Judges and more than 50 Appeals Officers.  These Judges and their staff handle Social Security Appeals for the entire country.  If you file an appeal with the Appeals Council, you will not have to travel to Falls Church, Virginia or appear in person before these judges.  All the arguments made in your appeal to the AC must be made in writing.   

If you are in receipt of an unfavorable ALJ decision, you have 60 days to file an appeal with the Appeals Council.  This request must be done in writing using Form HA-520.  It is also advisable to consult with a Social Security Disability Lawyer before filing the appeal.  In most cases a Social Security lawyer will also file a brief on your behalf setting forth the reasons why the ALJ made an error in your case. 

Keep in mind that the Appeals Council will not rehear your case but instead, will determine whether the ALJ made an error in his or her decision.  Therefore there no no new testimony taken in your case and, in most cases new evidence supporting your appeal will not be allowed.  It takes a very long time for the Appeals Council to decide your case.  In many cases it is taking more than a year to hear back from the Appeals Council.

When the Appeals Council decides your case, it can take one of three actions: 1. Deny your request for an appeal, 2.  Remand the case back to the ALJ, forcing the ALJ to have a new hearing, 3.  Issue a decision and award you disability benefits.

If you wish to file an appeal with the Appeals Council, you can do this alone.  However, appeals filed without the assistance of a lawyer are often denied.  For this reason, it is a good idea to request a free initial consultation from a lawyer who handles Social Security Disability Law before deciding to go at it alone.

Social Security Disability Denials are the Highest Since 2008

Winning a Social Security Disability case is getting harder every day.  The latest figures issued by the Social Security Administration show how difficult in the past few years it has become for disability claimants to get their cases approved. 

 

Every spring the SSA releases its statistics from its previous fiscal year that show the percentage of disability claims approved and denied at every step of the process.  2013 figures show that the approval rate at the initial stage of the process went down to 33%, from 36% in 2008.  Moreover, cases granted at the hearing stage dropped to 48 % in fiscal year 2013, from a 63% approval rate in 208.  This represents a 15% drop in the cases won at hearings before administrative law judges! 

 

This latest statistics show why now, more than ever before, it is important to have an experienced social security disability lawyer on your side.  Hiring a lawyer can improve your chances of winning your claim, particularly in these tough times.

 

Don't let the campaign of misinformation against the Social Security Disability programs fool you.  There are more persons currently receiving Social Security Disability than ever before because of the Nation's demographics have changed (more persons are reaching 55 than ever before), not because judges and SSA adjudicators are becoming more lenient.  For this reason, I believe that it is essential that all Social Security Disability claimants hire a lawyer to represent them early on in the claim process.    

Tip of the Week: Keep Your CD-ROM or Request One

The Social Security Administration (SSA) keeps most of its disability claim files in electronic form.  (There are very few exceptions...  Once in a while, a claimant has a paper file.)  This gives the SSA the ability to create CD-ROMS with a claimant's file.  If you are representing yourself in a social security case, you must remember to ask for a copy of your file in CD-ROM format.  Moreover, if the SSA provides you with a disc, you must never loose it.  Having a copy of your files on disc can be very convenient when looking for an attorney, preparing for your hearing or, when you need to a appeal a judge's decision to the Appeals Council.   

At the hearing level, claimants are provided with a CD-ROM by staff employees.  It is important not to throw away the disc.  Keep the disc even if you get a favorable decision.  If your case is denied, the CD-ROM will be needed by any Social Security Disability lawyer who you may ask to evaluate the viability of an appeal.  If you get a favorable decision, you may also need the disc to be able to protect your benefits when the SSA reviews your case.  Moreover, I find that having a complete disc of your SSDI case can be extremely helpful in cases where the claimant also has a pending long term disability claim with a private insurance company.

Opening and reading these discs can be tricky.  They work in most Windows PCs.  However, in many instances the discs are encrypted in order to protect a claimant's privacy.  To open an encrypted file you usually need to write "ssa" in the space that says: "account name".  Your password to open the disc is usually the first four letters of the claimant's first name followed by a pound sign (#) and the last four digits of his or her social security number.

Another reason why you might want to get your disc it to make sure that all the evidence pertaining to your case has been submitted  to the SSA.  Very often, doctor's records are missing or improperly filed.  I have even seen situations where a claimant's records are mixed in with somebody else's.

 

There's a New Lawyer In the Ramos Family!

I am proud to announce that last Friday, my sister Teresita Ramos graduated from Boston College Law.  She is now the fifth member of my immediate family with a law degree!  Of all five, Teresita and I are the closest in age.  Most importantly, we both share a passion for advocating on behalf of persons with disabilities and/or chronic health conditions.

At her law school graduation, Teresita received a special award for her "Exceptional Pro - Bono Service".    Pro bono publico, “for the public good” is a term used to describe professional work done voluntarily and without payment as a public service.  Through out law school my sister spent an extraordinary number of hours providing free legal assistance to disabled children and their families.  Thank you Tere for all the work that you have done on behalf of disabled students!

During her years in law school, my sister developed an impressive resume.  She clerked for the U.S. Court of Appeals for the First Circuit and interned at Massachusetts's Disability Law Center, one of the most prestigious non-profit disability law groups in the Nation.       

After law school, Teresita will be working in in Lawrence, Massachusetts, providing legal services to low-income, immigrant Hispanic children with disabilities to address widespread denial of education rights, and empower parents to enforce their rights through culturally competent advocacy training.  This disability law work will funded by an "Equal Justice Fellowship" that she obtained.    

Teresita is starting her career as a disability lawyer at a crucial point in time when disability programs, particularly SSDI, are under constant political attack.  We need more strong advocates like her.  She comes to this area of the law with an outstanding resume.  She is fluent in five languages: English, Spanish, Portuguese, Italian and Chinese.  She has a B.A. from Wellesley College and a masters in foreign service from Georgetown University in Washington, D.C.  Soon, she will be fighting for the disability benefits of the working class men and women of Connecticut and Massachusetts, who often need a lawyer that can explain the legal process in their native language.  Her experience in D.C. will also come in handy when we go to lobby at the Capitol on behalf of Social Security Disability Claimants.  Those in government and in politics who lately, have been attacking our disability programs, better be ready for my sister Teresita!              

20 Things That Will Kill Your Disability Claim

Here is a list of things that will cause your claim to be denied.  Please read and understand this list carefully before you complete a "Function Report" or attend a Social Security Disability hearing.  If you have a problem with any items on this list, you might end up loosing your case.  I'm sorry to be so harsh but if you are doing any of the things mentioned below, you need to have a serious conversation with your Social Security Disability Lawyer.  Keep in mind that anything that you say to your lawyer is protected by the attorney-client privilege.  However, statements made by you to Social Security can and will be used against you.  Moreover, statements made by you to your doctor will be recorded in the medical record and will eventually end up as evidence in your case.

Obtaining disability benefits is getting harder every day.  Denials are up in every stage of the disability process.  Please read this list carefully and make an honest assessment of your particular situation.  Here it is:

1. Taking care of others: children, elderly or disabled
2.  Going on vacation
3.  Not taking your medication or not following prescribed treatment
4.  Missing doctor's appointments
5.  Using drugs and/or alcohol (with the exception of a very occasional drink or two)
6.  Saying silly things at doctor's appointments or things that contradict your claim
7.  Working a semiskilled or skilled job even when its part-time and it pays less than $1040 a month
8.  Working a light, medium or heavy duty job even when its part-time and it pays less than $1040 a month
9.   Doing Yard Work
10.  Preparing complex meals (meals than take more than 10 minutes to prepare)
11.  Doing any significant amount of chores at home (more than 20 minutes a day)
12.  Driving trips longer than 10-15 minutes
13.  Going shopping alone on a regular basis
14.  Not answering your phone
15.  Missing a Consultative Evaluation without a good reason
16.  Not being able to give to the point, short, straight answers to Social Security, the judge, your lawyer or your Doctors
17.  Purposely giving the wrong answer in an IQ test
18.  Making little effort in a physical evaluation
19.  Not remembering anything about your previous jobs
20.  Making false statements of any kind

"Scrap the Cap": Its Time to Eliminate the Social Security Payroll Tax Cap

Did you know that any earnings above $117,000 per year are not subject to Social Security taxes?  Most people don't realize that there is a cap on FICA taxes and that contributions are not made on income beyond this amount.  Once the $117,000 mark is reached, the wealthy stop paying into the system.  This means that, if you are like the vast majority of Americans who make less per year than $117,000, you pay pay a higher percentage than the 5.6 percent who make more.

Opponents of Social Security, particularly of its disability program, make it seem like cutting benefits for the elderly and/or the disabled is the only way to fix Social Security.  However, there is a far more rational proposal that would improve Social Security's solvency: eliminate or --at the very least-- adjust the cap to bring more revenue into the Social Security Trust Fund.

Obviously, the current Social Security Disability program can be preserved, but this can only happen if we defend it.  

Even though eliminating the Social Security cap is not a new idea, somehow the concept has been forgotten in the journalistic coverage of  the debate.  The ongoing campaign of misrepresentations, distortions and outright lies by Fox News has not helped either.

Just a few weeks ago, a new bill was introduced by Sen. Jeff Merkley (D-Ore.) to increase the annual cost-of-living adjustment for Social Security.  The Senator proposed to pay it by raising the Social Security payroll tax rate of the wealthiest Americans (those making over $250,000).  Senators Bernie Sanders (I-Vt.) and Rep. Peter DeFazio (D-Ore.) have also introduced similar bills.  It is also important to note that President Obama made a similar proposal during his 2008 election campaign.  The Chief Actuary of the SSA has indicated that these proposals would reduced the program's long term short fall by 80 percent.

Economists estimate that only about 1 in 18 workers would pay more if the cap were eliminated completely. Moreover, just 1.4 percent (1 in 71 workers) would pay more if the tax were applied to those who make over $250,000. 

As the Social Security Disability programs comes under attack, the campaign to "Scrap the Cap" by having the wealthiest Americans pay the same as the rest of us --deserves our strong support. 

Take Action for Lupus Awareness Month!

May is Lupus awareness month, and as many of you probably know, the fight to end this terrible disease is extremely important to me.   Please consider participating in the events that the Connecticut Chapter of the Lupus Foundation has scheduled for this month.  I am urging all the friends and readers of the Connecticut Social Security Disability Lawyer Blog to make a donation during our Lupus walk on Sunday May 18, 2014 in West Hartford.  I will be raising funds with a team organized by the Board of Directors of the CT LFA.  Please let me know if you can contribute.  Here is a list of events for this month:

1.       Sunday, May 4. The CT Chapter will be featured on the Kim Zachary Show , “Talk of the Town”, WDRC Radio,  6:30 a.m.

2.       Wednesday, May 7, Legislative Advocacy Day at the State Capitol, Room 310, from 10:00 a.m. to 12 noon. Representative Tony Hwang is expected to present a proclamation from the Governor to the Chapter. Although this is the last day of the Legislative Session, we’re hoping that a number of our legislators stop buy our reception. Last year nearly 30 legislators came by to show their support.

3.       Thursday, May 8, there will be a meeting with the Urban League of Southern CT in Stamford to discuss how we can work together to increase support and raise the awareness of lupus in the African American Community.

4.       Saturday, May 10 – World Lupus Day. World Lupus Day focuses on the need for heightened public awareness, improved patient healthcare services, increased research into the causes of and a cure for lupus, enhanced physician diagnosis and treatment of lupus, and better epidemiological data on lupus globally.  

5.       May 12^th:  WRTC interview to talk about the West Hartford walk

6.       May 15 -  NBC Connecticut interview

7.       May 16 – Put On Purple Day. Please show your support…wear something purple

8.       Sunday, May 18, “Walk To End Lupus Now”, Blue Back Square, West Hartford, West Hartford…check in 9:00 a.m., start time ,10:00 a.m….please make every effort to attend.