Social Security Disability Federal District Court

 

Step 5: Appeals Council Civil Complaint – Federal Court

If you are denied after the Appeals Council review, you may feel all hope is lost. However, there is actually one last option left for an appeal despite that less than 2% of all applicants file this request. If you disagree with the appeal council’s decision, you have 60 days after you receive a denial letter from the council to file a civil action/complaint with your local Federal District court. The complaint is an overview of allegations against the SSA’s decision to deny you benefits.

Unlike filing for any other part of the appeal process, there is a fee involved for filing a civil action in federal court. It is possible to request to have the fee waived if you can’t financially afford it but this is not guaranteed and you will need to provide evidence of your financial situation.

What happens now?

After you or your attorney/lawyer have filed a civil action or complaint, the district court will issue a summons to you. You are required to send the summons and a copy of the complaint to the defendant. The defendant is labeled as the current Social Security commissioner for the region you are located in; this due to the fact that federal law prevents individuals from suing the Social Security Administration (SSA) directly. The SSA has multiple offices that handle summons and complaints.

These offices are known as the Offices of the General Council (OGC) and are located in almost every region. Once the SSA’s office receives the complaint, one of their lawyers will have a limited amount of time to send a response. The response consists of the reasons why the Administrative Law Judge (ALJ) and Appeals Council (AC) were correct in their decision to deny you disability benefits.

No new evidence or documents will be considered. The federal judge will review the transcript of your hearing and the same medical evidence provided to the ALJ for that hearing. Once both sides have concluded the briefs and oral arguments, the federal judge will review the case to determine if the ALJ or AC made a legal error when they made the decision to deny you.

The Federal Judge will rule one of these verdicts:

Remand the case

This is when the federal judge decides to send you back to another hearing for additional review with an administrative law judge. The federal judge will request the ALJ to review certain issues that he or she believes were not given full consideration by the previous ALJ.

Uphold the decision

This is when the federal judge decides to uphold the original decision made by the ALJ and the AC. It is possible to attempt to appeal again with the federal circuit court but you’ll have a much lower chance for a positive outcome and the fee for a request becomes more expensive.

Change the decision

This is when the federal judge decides to overturn the decision made by the ALJ and the AC. The applicant is then awarded disability benefits. This decision is very rare and should not be expected.

Over 70% of the time, federal judges will uphold the original decision of the ALJ and the AC. The majority of the remaining 30% will be sent back for review with an ALJ and the few left are the ones who get approved for disability benefits.

Will I need an attorney or lawyer?

The appeals process for the federal district courts is legally complicated and can be quite frustrating. The federal judges who review cases look for legal mistakes made by ALJs and these mistakes need to be listed within the briefs. Without representation, you would have to write the briefs yourself and point out how your ALJ made a legal error while making his or her decision. This makes having a disability attorney almost necessary. A qualified disability attorney will file your civil complaint, prepare your briefs, and will engage in oral argument if required. If you want to have a fighting chance for a positive outcome, it is highly recommend you find a disability attorney before sending your request for federal review.

How long will it take to receive a decision?

After the hearing, it can take up to two years before the federal district court gives you an answer. This is due to the fact that federal district court judges have intense work schedules and are constantly busy. If you are approved, you will receive a large one-time lump sum check for the time you waited to be approved and will begin receiving your monthly benefit checks as well. If denied, your last option is to file an appeal with the federal circuit courts. This is very expensive and not in your favor.