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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.

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5 comments on “The Appeals Council is overturning favorable decisions

  1. This has happen to my Wife. Fully favorable Overturned By them. Its amazing how much they put you thru. And then get your hopes up only to Tear you down again. Its getting to the point my Wife will be committed For extended period of time due to this added Stress and Depression! She gotten more Panic attacks and He other conditions become worse every time we talk to SSA or our attorneys!

    • Hello, I noticed you comments and was curious how your case is going? I too was given a fully favorable decision after my hearing and was so excited only to find out a month later that the appeals council overturned it because of lack of medical evidence.

      I can not find any info about this process and what are the chances of approval at this point. so i was just wondering how you case is going. Is it resolved and if so what did you have to do?

  2. May I ask how they “decided to choose” her file?

    I applied July of 2011 got denied my hearing was November of 2012 and the Administrative Law Judge decision was found favorable in jan of 2013; however, I was RANDOMLY SELECTED to be reviewed by the Appeals Counsel.

    I’m so sorry about your wife. What happens now? I will pray for her!

  3. Im sorry for your family.. Im 31 and ive been havin seizures since the age 11. I was receiving benefits until 2000, I have been tryin for 13yrs to get my benefits back. I have been hospitalized bout 25 times in the passed 5 yrs alone. I broke my foot having a seizure, third degree burns on my right arm I had my hair shaved at the top I hit my head on the tv… I feel yo pain, how much information do u need?

  4. After fighting for years we finally won in court!!! Only to find out 3 weeks later that the Appeals Council decided to review my case. I just found out about an hour ago, I didn’t know that it was a possibility for them to overturn the judges decision??? Now I’m totally stressed out all over again and I’m getting ready to have my 11th surgery in 4 days and after I heal from that one in 3 months they are going to operate on me again 8~( My family and I are totally freaked out about all of this and the possibility of them overturning my favorable decision…. I will keep you posted as it progresses.

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