[Remastered] What Should I Do Next If I’m Denied by a Judge? | Understanding Your Social Security Appeal Options

0:21 What should you do after you've been denied by an administrative law judge. Some of you have gone through the disability process on your own or with the representative, And if you have a representative, consider yourself blessed. If you do it on your own, consider yourself blessed. But some of you have gone through the process, whether it be one denial and go before judge, of two denials, go before judge. May find yourself at a very interesting crossroad where you've been denied by a judge and now you have a tough decision in front of you. The next quick decision you have to make is do you appeal or do you go ahead and start all over again. Now, I'm going to tell you everybody's circumstances are a little different,

1:00 but I'm going to give you kind of a generalized overview of what you're possibly looking at. If you decide to start a new application, you're basically waiving your rights to any back pay period. That means whatever decision that judge rendered. Let's say the judge gave you decision today and he was he or she was rendering a decision based on your file going back to when you applied two years ago indicating you've been disabled for three years something like that. Well, guess what from the date of that judge's decision today, going backwards, if you file a new application, that period is gone, plain and simple, you basically would have foregone your ability to go and get that in the absence of anything weird. Maybe you know,

1:44 maybe there's some weird circumstances, maybe you can fully understood stand when you apply. Whatever the case may be, just know that in the grander scheme of things, if you decide to file a new application, you're going to forego or lose your ability to claim in the back pay. So then you decide, I'm going to go ahead and roll the dice and I am going to appeal this.

2:03 What is going to happen? Okay, keep in mind a couple of things. When you go before a judge, the judge is really in the best position to evaluate your medical evidence and take your testimony and take expert testimony. They have the advantage of everything before them that they need in order to make an informed decision. That's assuming that they have everything that they need when it goes to the appeal. Let me stop. If you appeal the decision, it goes to a body that reviews all the judges decisions, called the Appeals Council. Now, the Appeals Council is one more hearing level of appeals above your judges. Now you don't have to go to a hearing before that court, but this court reviews decisions made by judges. So that

2:56 means if you're wondering, is there's somebody who can overrule the judge that you just had and make a determination regarding your case and have it send back to the judge. Absolutely, and this called the Appeals Council. Now, keep in mind one of the three things happens when it's at the Appeals Council. They can either it's called a request for review of the alj decision. They can deny your request by basically saying the judge did nothing wrong. They can send it back to the court and say, you know what, judge, there were some errors that you need to fix. Or they can outright make a determination that you're disabled. Now let's go ahead and go down each one. First, the Appeals Council rarely makes a determination of outright disability because

3:39 they know the judges that the one you went before is in the best position to evaluate your evidence. The second option is they can say, you know what, judge, we don't necessarily believe or we don't think you applied the standards properly, or there's some things we have some concerns about. Do it again. Because most people don't know, you appeal the judge's decision. Every judge has two chances to get it right. Or they could just out and out say, you know what, sorry, we agree with the judge.

4:09 You didn't prove up your case. Now let's kind of back it up just a little bit more, talk about what the standard is. They're really doing a review to see whether the judge applied the law properly. They're not there to make an independent determination of whether they think you're disabled or not. The Appeals Council is solely there just to evaluate whether or not the judge made an error of the law. And this is where I tell people who are in this position it gets a little tricky.

4:40 The Appeals Council handles the hearing appeals for every court of Social Security in the country. It goes to one location, falls Church, Virginia, So that means it doesn't matter whether you would deny in Honolulu or Seattle or Miami or Portland, Maine. It does not matter. Or you've in San Antonio, Texas, or Chicago, Illinois, coast to coast, corner to corner. If you've been denied before a judge and you appeal it, it goes to the Appeals Council. In Virginia, it's one big, huge clearinghouse. And let me tell you a couple of things.

5:15 They are notoriously slow, because when you're handling that many cases, it takes a while. And when I mean slow, I think they're running about. They're running probably somewhere in the neighborhood about eighteen months or longer. So if you decide to appeal, recognize you're going to be waiting. Second of all, you're not going to be able to get access to them like you were at the lower level. They're not going to be as readily accessible to you. Then you're not going to be able to find out who the judge is. You're not going to be able to talk to any staff members. You'll be able to talk with some individuals that they have there to provide you some guidance, but they won't tell you anything else. They won't tell

5:51 you how close it is before somebody reviews it. They won't tell you if they need anything else, any extra information, nothing. They're there to purely review your case. So what are you doing in the interim? Not a whole lot. Now, is there anything you can do to strengthen your case at the appeals counsel? Absolutely? If you're still going to get in treatment that's relating to your condition, you may want to provide that social security the appeals counsel. Now, keep in mind the appeals counsel, because I've had this happen.

6:21 You'll go to a hearing and then five or six months later you get a great assessment by a doctor and he says you're disabled. You send it up to the appeals counsel and you're thinking, ah, it's a slam duck. Keep in mind they want to know. When they get that information. They typically will consider it, but they're going to ask themselves three questions. Is this new? Well, if you just got it, it is, is it material? Is it really? Yes?

6:43 It relates to your condition, so that's true, But is there a good reason why it wasn't it before? The judge? Now you can make the argument that, well, this doctor's first doctor, I've run across who's actually done an assessment, and they may take that in consideration. However, sometimes they are a little leary about any medical records that come out after the judge's decision, because they're going to say, this is not something that was before the judge and now you're saying, well, it's not good enough reason to get it before the judgement, not necessarily the case. The other thing you can do is you can make arguments to the Appeals Council as to what the judge did wrong.

7:17 Now let me tell you, and I'm just going to share this what you were out of the gate, and this is why I would strongly encourage you looking for a representative in your area. Just because you look in the decision of the judge and you disagree with the judge's decision, that may be your basis for requesting a review, but you've got to be able to specifically identify to the Appeals Council what exactly did the judge get wrong. Now, if the judge basically said I don't think you're as disabled as you are, I disagree, well, of course you disagreed.

7:48 That's why you're appealing. But you gotta be more specific is there something in particular, do you think that one particular doctor should have been given more weight than other doctors. Then not only you can't just say that, you have to show. You've got to be able to do a critical analysis of the evidence in your file and show this. Now, I'm going to tell you bluntly two things. One, even if you do that, there's no guarantee you're gonna get a win by the Appeals Council. And Secondly, if you don't know exactly what the judge did wrong from a legal standpoint, you're basically rambling. And I'm not trying to say that you can't figure it out, but let's be real here. Sometimes what the judge may have done wrong

8:28 may be so hyper technical that if you're not familiar with it, you're not really helping your situation out at all. So just keep that thought in the back of your mind. Now, if by some chance they deny the appeal at the Appeals Council, your next course is to go into federal court, and that case you can still go by yourself, but again the standard is much temper because at this court, the United States District Court, you're suing the Commission of Social Security in the United States, district court is making a good determination of whether there was error of law.

9:01 Same type of principle, a little bit different in the federal court ranks than appeals council because you're basically dealing with the courts in your region as opposed to one big court that's a clearing house for the entire country. Here's the thing that you need to understand. If you get denied by a judge, make sure you have an understanding as to why they denied you. A lot of times, and I'm not trying to be funny, because the Social Security Administration has created this process so that you can handle it on your own, but the simple fact of the matter is is that a lot of times people are as intimately familiar with the nuances as to why a judge determined that they're not disabled. Now, don't get

9:40 me wrong, there are going to be instances when the judge just gets it flat excuse my friends, flat ass wrong, and you're looking at it and you can tell they've messed it all the way up. An appeals counsel will notice that they messed it all the way up. However, judges do this on a regular basis so they can write their decisions in certain ways that clearly demonstrate and supports their assertion that you are not disabled. If you don't know how to identify what specific nuances in your decisions where they screwed up and identify it to the appropriate parties, whether it be the appeals Council or in federal court, you're probably gonna have a tougher time being able to demonstrate the court or that the judge made

10:21 an error of law. Know this. If you lose in court before judge, be prepared because the next steps, whether it be the appeals counsel or going to federal court, you may be fighting that case for another year and a half to two years. But that's a decision that you need to make, and make sure you reach out to someone who could possibly represent you if you don't know all the nuances so that you can make an informed decision. Trust me, the disability process is tough enough.

10:49 The last thing you want to do is be in a situation where you think you know what's going on in terms of why a judge did something and you appeal it and you have no clue where to start past the past facts