Appeals Explained-Request for Review of the Hearing Decision/Order

After a hearing before an Administrative Law Judge (ALJ) in a Social Security case, the ALJ will issue a written decision regarding the individual's claim for benefits. If the individual is dissatisfied with the ALJ's decision, they may request a review of the decision by the Appeals Council.

To request a review of the ALJ's decision, the individual must submit an SSA form called the Request for Review of the Hearing Decision/Order by the Appeals Council. This form must be submitted within 60 days of receiving the ALJ's decision.

In the form, the individual must explain why they believe the ALJ's decision was incorrect and provide any additional evidence they want the Appeals Council to consider. The Appeals Council will review the ALJ's decision, the evidence presented at the hearing, and any new evidence submitted by the individual.

Based on its review, the Appeals Council may do one of the following:

1. Deny the request for review: If the Appeals Council determines that the ALJ's decision was correct and that there is no new evidence that would change the outcome, it may deny the request for review. If the request for review is denied, the ALJ's decision will be considered the final decision of the SSA.

2. Grant the request for review and issue a decision: If the Appeals Council determines that the ALJ's decision was incorrect or that there is new evidence that could change the outcome, it may grant the request for review and issue its own decision.

3. Remand the case to the ALJ: If the Appeals Council determines that the ALJ's decision was incorrect and that further development of the evidence is necessary, it may remand the case back to the ALJ for a new hearing and decision.

It's important to note that the Appeals Council's decision is the final decision of the SSA, unless it is appealed in federal court.