When a claim for Social Security disability benefits is denied by an Administrative Law Judge, the individual can file an appeal to the Appeals Council of the Social Security Administration. For the reasons set forth below, this layer of bureaucracy should be abolished.
1. The vast majority of appeals are denied. The following statistics are from the Social Security Administration.
2. The Government’s attorney refuses to defend the Appeals Council’s decision 15% of the time. See Achieving Greater Consistency in Social Security Disability Adjudication, p.73; also see Fn. 56, at http://www.acus.gov/sites/default/files/documents/Achieving_Greater_Consistency_Final_Report_4-3-2013_clean.pdf
3. A Federal Court reverses the Appeals Council’s decision almost 50% of the time. In order to understand the significance of this reversal rate, one must know the Standard of Review. Judicial review is limited to determining whether the decision is supported by “substantial evidence” and whether the correct law was applied. This is a very difficult standard for an appellant to meet. If there is any rational basis for the denial, a Federal Court will usually affirm. Yet, almost 50% of the time a Federal Court reverses.
4. The individuals at the Appeals Council denying 82% of the appeals are NOT Administrative Law Judges and have no experience conducting disability hearings.
5. The decisions of the Appeals Council are not public. There is no accountability.
6. It is taking 15 months for the Appeals Council to make a decision. During this period the disabled individual is prohibited from filing a new application for disability by SSR 11-1p. This 15 month period is a hardship on individuals who have no income, often have no health insurance, and are struggling to survive.
7. From a liberal standpoint, this so called “appellate right” is not meaningful and does far more harm than good. From a conservative standpoint, the Appeals Council is a waste of taxpayer dollars. It has evolved into a self perpetuating bureaucracy that costs millions of dollars to operate yet provides no service of value.
8. An independent study of Social Security Disability Adjudication recommended that the appellate function of the Appeals Council be terminated, concluding “[t]he appellate review function does not justify the added delay to often deserving claimants and the increased administrative costs attendant upon resolving in excess of a 100,000 appeals each year.” See Achieving Greater Consistency in Social Security Disability Adjudication, p. 77.
For the foregoing reasons, it is time to abolish the Appeals Council .