Federal court is the last recourse after the Social Security Administration denies a claim for disability benefits. This guide provides an overview of the appeal process.
Evaluating Whether to Appeal to Federal Court
After the Appeals Council denies a claimant's request for review, an appeal ends unless the claimant appeals to federal court. Typically, a claimant has 60 days to file a complaint in federal district court. The first question to ask is whether it makes sense to have an attorney for the appeal. The answer is almost always yes. Filing a complaint in federal district court involves (1) knowing the court's rules and deadlines and (2) being familiar with the legal issues that are most likely to lead to remand of the claim back to Social Security.
If a claimant does not already have an attorney for the claim, it makes sense to speak with an attorney that specializes in appealing disability denials to federal district court. Not every claimant's attorney handles federal court litigation. Most attorneys that specialize in Social Security disability appeals know of one or two attorneys that handle this type of work.
The next consideration is cost. The filing fee for a complaint in federal district court is $400. If a person cannot afford the fee, the individual has the option of asking the court to waive the fee. This involves completing an affidavit describing the person's income, expenses, debts, and assets. If the court finds that the person is unable to afford the fee and still meet the person's other expenses, the court can waive the fee.
What Makes a Case a Good Candidate for a Federal Court Appeal?
These are the top five reasons why federal courts remanded claims in 2015:
1. Treating source opinion rejected without adequate articulation.
2. Inadequate rationale for credibility finding.
3. Inadequate support or rationale for weight given consultative examiner's opinion.
4. Mental limitations inadequately evaluated when determining RFC.
5. New evidence presented on administrative appeal or review.
Also, if a person's "date last insured" has expired, then the person may not have the ability to file a new disability claim. Appealing to federal court may be the claimant's only option to keep pursuing a disability claim.
What Does the Process Involve?
A complaint seeking federal court review of Social Security's denial of a disability and/or SSI claim must be filed in the district where the claimant resides. After a claimant files the complaint, federal law requires that a copy and summons be served on the Commissioner through the U.S. Attorney's Office. The Commissioner will then file an answer to the complaint with a transcript containing all the evidence in the claim. At that point, the claimant typically has 30 days to file a brief. The Commissioner can then respond with a reply brief 30 days later.
The district court will not reweigh the evidence. To be successful, a claimant needs to show that the agency made a harmful legal error when it denied the disability claim. For example, if the administrative law judge did not evaluate an opinion from a treating doctor about the claimant's limitations, this is a legal error warranting remand. Failing to provide adequate and specific reasons for finding that a claimant's statements are not credible is another legal error that leads to remand.
After the parties have filed briefs, it can take a year or more for the court to issue a decision. There will not be another hearing at this stage, unless the court wants to hold oral argument.
What Happens if the Court Remands the Claim?
If the court agrees that the agency committed legal error when it denied the claim, it will most often send the claim back to Social Security for a new hearing. The new hearing may be in front of the same judge that heard the appeal the first time. The district court will typically give instructions to the Commissioner about what the ALJ should do differently to correct the legal error that led to remand. It can still take over a year after federal court remand before the remand hearing is held at Social Security.
If Social Security ultimately reverses its original decision, a claimant can potentially receive disability and/or SSI benefits going back to the original onset date or date of application. This is the benefit of appealing to federal court and why it is vital that a claimant have an attorney that specializes in this type of litigation.
Additional resources provided by the author
National Organization of Social Security Claimants' Representatives (NOSSCR)
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