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Jul 20, 2014

Problems At The Appeals Council

     An e-mail I recently received: 
Does anyone have an alternate AC [Social Security's Appeals Council] Fax number. I'm trying to fax a request for AC review and have used the standard fax number with no luck. I called the AC to verify that's the correct number and it is. They even gave me a backdoor fax number that isn't working. I'm just trying to find some alternatives. Thanks in advance!
     If you're sending anything to the Appeals Council, you pretty much have to fax it since you can't count on them opening and distributing their mail. The overtaxed fax machines at the Appeals Council are nothing new. And no, we can't file requests for Appeals Council review over the internet. 

13 comments:

  1. The AC, thanks to budget constraints, is just becoming a laughable waste of taxpayer time and money; except for handling improper dismissal, it's useless.

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  2. I have two alternate fax numbers that I fax requests for review to and they accept them going to these numbers:

    (703) 605-8021
    (703) 605-7201

    I almost always have trouble getting them through using the main number.

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  3. I know they say not to, but just submit it by ERE or ARS- at least you have a confirmation that SSA has your appeal at that point.

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  4. So what does the Appeals Council do exactly besides deny almost 90 percent of review requests -- which means the chance of getting an AC review is not much better than "a snowballs chance in hell." Does the Appeals Council add enough value to justify its cost?

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  5. I had a new one the other day, confirming that there are no holds barred at the AC. An under-50, unrepresented client at hearing appealed the ALJ's sed-RFC denial. The AC remanded challenging the ALJ's sed-RFC, suggesting BDD/CE's light/med RFC was more well-supported, thus robbing the now OVER-50, unskilled claimant of the one thing he could've used in a new app: an ALJ decision pegging his RFC at sed.

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  6. Appeals Council - Accountable to no one and just cleared to increase their staff probably to conduct even more own motion denials of favorable ALJ decisions, many involving claimants in pay. The GAO has slammed them, but Congress does not understand what they do. At Issa’s recent hearing one of his republican committee members did not even know what the DDS did - assuming they adjudicated most of their cases face to face. No way congressional review will grasp the AC mission, and that is apparently fine with SSA.
    Must be an interesting job up there. Two years ago an appeal with merit had at least a 20 percent chance of remand. Now, I suspect it is rubber stamp time, probably overtime and heaven knows what the reviewers and medical staff are scoring in salary. So an appeal sits for a year (more than enough time to damage if not ruin deserving claimants) until it is denied, without any explanation. What let the heck; let the courts pick up the debris. That is another 5- 7 years. This is one of the most distasteful parts of the program and I wish someone had the guts to out this ever-growing Star Chamber.

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  7. I think some of the posters in this thread are delusional.

    A claim at the AC has already been denied at least twice (DDS, ALJ) and possibly three times (reconsideration). What kind of reversal rate from the AC do you think is acceptable. 10% seems awfully high to me, yet you are complaining that it is too low.

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  8. 20 - 25% remand rate for last 20+ years and now 10%? I'd say political is a more accurate word than delusional.

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  9. @ 8:48.

    Every time I hear someone say something like, well, that's not how it used to be, it makes me laugh.

    That argument has no merit in any situation. Was the 20-25% remand rate correct for those 20+ years. Maybe. Maybe the ALJ's and DDS's were truly incompetent during that period and such a high remand rate was actually supported by the law. Probably not, but maybe.

    Even if that was the case, isn't it possible that a "new wave" of ALJs are no interpreting the law more correctly and making better/correct decisions at the hearing level and more training at the DDS level is resulting in better decisions?

    I dare you to name ANY other form of appeals (in any forum, legal or otherwise) that has a 25% overturn rate at the third (or sometimes fourth) level of appeal. Even the current 10% rate that you indicate is so high as to be laughable.

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  10. Maybe indeed. Maybe 25% reverse rate points to the incompetence below and the 10%, above. While he may not be demonstrative of circuit judges, Seventh Circuit Judge Richard Posner is certainly as knowledgeable and articulate as any in the country. His consistent observations from 2012 to 2014 regarding SSA appeals and the incompetence they portray are relevant here. One need not look far to read or hear Court of Appeals’ judges’ frustration , indeed exhaustion by “ the quality of the Social Security decisions they were repeatedly hearing on appeal.” A new wave of ALJs indeed.

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  11. @ 11:28

    Posner is certainly a great mind and terrific adjudicator, but his criticism is a little misguided. Remember ALJ's produce around 500 decisions (or more) per year. Of course, they may be lacking and may seem insufficient when compared to a typical dist. court decision. However, let's compare, how many decisions does Posner issue in a year? 50. I'm not sure of the exact number, but it's clearly not close to 500. Additionally, he has a dedicated legal staff of at least one career clerk and likely has several short-term clerks that went to law school at Harvard, Yale or Stanford. Give that kind of firepower and time to an ALJ and they will produce quality decisions. In the meantime, let's accept the fact that the decisions may be lacking in legal diligence. That does not mean that the decisions are incorrect. Harmless error is a real thing. OF the decisions I read, I can find errors in law in almost all of them. However, very few of those errors would result in a different decision.

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  12. @6:53

    Most ALJ decisions are not just lacking compared to a district court decision; they are lacking compared to a competent undergraduate analytical essay or research paper. Yes, there is the persistent failure to apply the SSA disability program's own rules as you suggest. But there is also the failure to apply basic principles of sound reasoning; misrepresentation of the evidentiary record; demonstrable lack of empathy for poor and working-class people with serious health problems; frequent use of inappropriate tone when discussing claimant credibility; and a lack of comprehension of the medical issues involved.

    Further, the evaluation of a disability claim is not that complex compared to federal court litigation. SSA disability is a single area of law with simplified evidentiary and procedural issues. District court judges have to issue authoritative rulings within many different areas of law and involving more complicated fact patterns, evidentiary issues, and procedural issues. SSA decision writers simply do not understand the rules they are applying, and ALJ’s either don’t know the rules, either, or they don’t bother to check their subordinates’ work.

    As for your assertion that very few errors would result in a different decision, that depends very much on a particular AO or AAJ’s subjective opinion about how they would rule on a case. AO’s and AAJ's often rely on subtle post hoc rationalizations to justify denying review even in cases where the claimant might be found disabled by some other decision maker who could weigh the evidence differently. That goes a long way towards explaining why the AC’s decisions are so often reversed by the federal courts.

    And Posner really just expects the SSA to adhere to basic principles of administrative law, including principles of due process. The AC demonstrates very little interest in ensuring that claimants' due process rights are protected.

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  13. Anon @ 6:53 - Nailed it! One of the most astute comments posted.
    While I believe most ALJs struggle to do the right thing with a formidable workload, a dysfunctional and unaccountable AC gives the outliers at 80-90% a pass. The specter of a Decision Writer assuming what is “harmless” error, someone who never interacts with the lives that are destroyed, is ghastly.
    The circuit courts’ remands used to drive SSA nuts. In The early 1990s training and Process Unification initiatives (which SSA seems intent on destroying – see recent death of AP opinion), were a reaction to the increased number of Circuit Court decisions against the agency.
    Now SSA is on track to inherit a commissioner who is in over her head and will never be an innovator. Combine this with congressional committees more interested in political dog and pony shows and you get “taxpayers” shouldering immense financial loss and undue hardship to the most vulnerable amongst us. The only option left is to hold representatives and senators accountable, as in contacting and educating them. Perhaps some staffer will hand a note to a lawmaker during a hearing that makes a difference. It is time folks know what havoc the Appeals Council continues to wreak.

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