The Appeals Council is overturning favorable decisions

Most social security disability claimants are not aware of the existence of the Appeals Council. But lately, more and more are taking notice, as the Appeals Council increasingly seems to be exercising its right to review hearing decisions, including favorable decisions, and make its own decision.

Currently, the Appeals Council is made up of approximately 70 Administrative Appeals Judges, 56 Appeals Officers, and several hundred support personnel. The Appeals Council is physically located in Falls Church, Virginia with additional offices in Crystal City, Virginia, and in Baltimore, Maryland.

As the last administrative decisional level, the Appeals Council renders the Social Security Administration’s (SSA’s) final decision, usually because a claimant or his attorney has requested that it review an unfavorable decision.

But under Social Security rules, the Appeals Council has the right to look at cases that no one has appealed. That means the Appeals Council can decide to review a favorable decision and overturn it, which is bad news for claimants and their attorneys. The rules mandate that the Appeals Council must send a claimant and his representative written notification of its intent to review a case on its own motion by certified mail no later than the 60th day after the date of the hearing office’s action.

Here in Oregon, a number of us are seeing this happen. When it does, it causes dismay and hardship for claimants who waited years for their “day in court” – only to have a favorable decision overturned by a group of folks they will never see or speak with.