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Author Topic: What to do after denied by Appeals Council  (Read 12759 times)

Bonzai

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What to do after denied by Appeals Council
« on: February 13, 2013, 08:46:15 am »
I spent a lot of time researching this topic, as I fully expected to be denied by the low approval rate ALJ I had for my remanded hearing, and possibly the Appeals Council on the second time around.  I think being prepared for all eventualities is important.

So you get the dreaded news that the Social Security Appeals Council has declined to your request to review your case, or they reviewed it and affirmed the ALJ's denial.  You may give up your claim entirely, you can file a new claim starting with an effective date of one day after the ALJ's denial, and/or you can file suit in US Federal Court against the Social Security Administration.

If you decide to give up your claim entirely, then you are through with the process and SSA wins.

If you file a new claim starting with an effective date of one day after the ALJ's denial, then your accumulated dates prior to that will be lost, impacting primary insurance amount, back pay and Medicare eligibility.

If you file suit in US Federal Court against the Social Security Administration, then you are taking the last step in the entire appeals process.  If you don't have an attorney by this point, you will need to retain one who is able to represent you in Federal Court.  A brief must be filed within 60 days containing the complaint you have against the Social Security Administration.  And then you will wait again.  There are three possible outcomes for your suit: 1) The judge finds Social Security wrong, and benefits are awarded.  2) The judge finds Social Security made errors, and remands your case back to Social Security for additional processing.  3) The judge agrees with Social Security and denies benefits.

In 2011 Social Security released SSR11-1p, which states that someone cannot file a new claim for the same title and for the same type of benefit as the pending (appealed) claim.  This only applies up to the Appeals Council level, and not to the Federal Court level.  So if you and your attorney file suit in Federal Court, there is nothing to prevent you (provided that you are not past your Date of Last Insured) from also filing a new claim with Social Security.  Since a new claim is likely to be processed quicker, and if you win, then it 'may' have influence on the Federal Court judge's decision.

Best wishes in whatever you decide to do!   :Main18:
« Last Edit: February 13, 2013, 06:54:00 pm by Bonzai »
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Trajector Media

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Re: What to do after denied by Appeals Council
« Reply #1 on: February 13, 2013, 12:11:38 pm »
Very informatito....(wonder what Cris is going to do with that)...It is spanish for informative I believe..Thanks for sharing :)
« Last Edit: February 13, 2013, 05:55:19 pm by Criszilla »
I speak from experience not expertise.

NorthernWolf

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Re: What to do after denied by Appeals Council
« Reply #2 on: February 13, 2013, 12:21:51 pm »
Ditto on the thank you.  That was a much easier version to read and interpret than most sites you find.  I'm still torn on what to do myself,  but this makes it easier for me to think about it.


Thanks
Mike



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As Capt. Binghamton would say, " I could just scream !!!

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No animals were harmed in the making of this film, however one was mildly irritated.

Floating

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Re: What to do after denied by Appeals Council
« Reply #3 on: February 13, 2013, 03:03:35 pm »
 :Forum13: Bonzai

Bipolarbear

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Re: What to do after denied by Appeals Council
« Reply #4 on: February 13, 2013, 03:13:29 pm »
Amazing posting Bonz, you would make a really fantastic writer, you have a wonderful way of explaining stuff without confusing the reader!!!
My manic self would run around making promises that my depressive self couldn’t possibly fulfill.
Then the shame of not coming through on the promises I’d made only pushed me deeper into depression, creating a vicious circle of darkness and disgrace.
That's how my Bipolar self plays out.

cynderella

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Re: What to do after denied by Appeals Council
« Reply #5 on: February 13, 2013, 04:39:50 pm »
 :Main01: Well explanation Bonzi.

Criszilla

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Re: What to do after denied by Appeals Council
« Reply #6 on: February 13, 2013, 06:03:29 pm »
Very informatito....(wonder what Cris is going to do with that)...It is spanish for informative I believe...

@Marci:  Not!  It's "informativo".  And don't forget to rrrroll the rrrrrr.  :Main06:

@Bonzai:  Muchas gracias!
  :Main14:

Trajector Media

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Re: What to do after denied by Appeals Council
« Reply #7 on: February 13, 2013, 08:58:25 pm »
Nothin' slips by you.
« Last Edit: February 13, 2013, 09:02:05 pm by Criszilla »
I speak from experience not expertise.

sman1109

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Re: What to do after denied by Appeals Council
« Reply #8 on: February 17, 2013, 03:21:07 pm »
thanks, was a little confused if the dual claim could be filed at the federal court level. now sure of it.

lawyer didn't mention that, he probably will abandon me if that happens anyway since his incentive is over.

fairfairblue

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Re: What to do after denied by Appeals Council
« Reply #9 on: March 12, 2013, 02:28:39 pm »
Thank you Bonzai, this is very informative.  My attorney notified me that we would be filing a new claim.  We will be meeting next week.  I have a question regarding the new claim.  Does it specifically have to be the date after the denial of the ALJ?

Rayandnay

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Re: What to do after denied by Appeals Council
« Reply #10 on: March 12, 2013, 02:36:43 pm »
Amazing posting Bonz, you would make a really fantastic writer, you have a wonderful way of explaining stuff without confusing the reader!!!
Bonzai is amazing

bigbabie55

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Re: What to do after denied by Appeals Council
« Reply #11 on: March 12, 2013, 11:31:45 pm »
Amazing posting Bonz, you would make a really fantastic writer, you have a wonderful way of explaining stuff without confusing the reader!!!
Bonzai is amazing
Yep ! :Forum14:
Blessings! :heart:
Bigbabie

sman1109

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Re: What to do after denied by Appeals Council
« Reply #12 on: April 07, 2013, 06:30:13 am »
same here will be filing a new claim while this one goes to federal district court.

the bad news is work credits usually run out, so it will only be an SSI claim while my SSDI claim is pending

Bonzai

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Re: What to do after denied by Appeals Council
« Reply #13 on: April 07, 2013, 07:04:54 am »
...  I have a question regarding the new claim.  Does it specifically have to be the date after the denial of the ALJ?

The Alleged Onset Date of the new claim can be any date after the ALJ's denial, but the day after the denial is the earliest date that may be used.

There is yet one other option I forgot to mention in my original post.

You may file again asking Social Security to have your original claim 'reopened' within twelve months for any reason or four years, if you have good causeGood cause is new and material evidence pertaining to the time period of the original claim or an error was made.

See:
http://www.ssa.gov/OP_Home/cfr20/404/404-0989.htm
http://www.ssa.gov/OP_Home/hallex/I-02/I-2-9-40.html
"If one of these engines fails, how far will the other one take us?"
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Re: What to do after denied by Appeals Council
« Reply #14 on: April 07, 2013, 07:01:21 pm »
Informative post Bonzai :Kudos06: :Forum21: :Forum22: