Winning a Social Security Disability federal court appeal requires a claimant to follow the procedural rules for appealing at the federal court level. Additionally, the claimant should identify the errors the Social Security Administration (SSA) made when deciding his or her claim. Because of how legally complicated the appeals process for federal courts is, people are recommended to find an experienced disability attorney before sending their request for federal review to increase their chances of a positive outcome.
Here is more on how to win a Social Security Disability federal court appeal.
The Federal Appeals Court Process
Appealing disability denials at the federal court level can be complicated and confusing. Winning federal court appeals requires one to have some basic understanding of this stage of appeals, which is different from the other stages.
Appealing the denial of disability benefits in federal court is the last level in the appeals process available to claimants. The four SSDI appeal levels are:
- Reconsideration
- Administrative Law Judge (ALJ) hearing
- Appeals Council review
- Filing a claim in federal court
Before reaching the federal court appeal level, one will have applied for disability benefits and been denied, requested for reconsideration and been denied, taken the claim to an ALJ and received an unfavorable decision, and asked the Appeals Council for a review and been denied or gotten a negative result.
If a claimant receives a negative decision from the Appeals Council or the Appeals Council refuses to review the claimant’s case, he or she has 60 days to appeal to Federal District Court. If the Appeals Council sent the person’s case back to the ALJ for rehearing, but the ALJ still denied the person benefits, the person will have 65 days from the date on the denial form to appeal.
The appeals process at federal court starts with the claimant filing a complaint with the U.S. District Court in his or her area. If a claimant resides in Chicago, for example, he or she will file the complaint in the U.S. District Court for the Northern District of Illinois. The complaint tells the court what a person’s case is about by providing a rundown of why the person is appealing the SSA’s decision to deny the person benefits.
After the SSA receives the person’s complaint, the agency’s attorney will file a response known as an answer, which provides the court with the reasons why the SSA believes the claimant is not entitled to disability benefits. The claimant will then file an opening brief that will explain his or her position to the court.
The written opening brief can make a claimant win or lose a federal appeal, making it crucial for the person to have an attorney experienced in writing such briefs. Such an attorney will know how to appeal a denied claim correctly at the Federal District Court stage.
The SSA will have a chance to file a response brief to attempt to refute the claimant’s arguments and explain why the negative determination was correct. At this point, a claimant or his or her lawyer may file a reply brief to highlight flaws in the agency’s argument.
The district court judge will review the documents and may make a decision after that or, in some cases, request an oral argument of the case. An oral argument will require the claimant or his or her lawyer to argue the case before the federal judge. The attorney representing the SSA will also have the chance to argue why the person should not be awarded benefits.
Based on the evidence presented, the judge can make one of these three decisions:
- Uphold the ALJ’s and Appeals Council’s decision
- Remand (send back) the case to the SSA for additional review
- Grant the person disability benefits
Tips for Winning a Social Security Disability Federal Court Appeal
Several elements are crucial for winning a Social Security Disability federal court appeal.
Submitting Appeal Requests at the Right Time
People should file their federal appeal within the allotted 60 days after receiving the Appeals Council denial. The entire appeal could be dismissed if one requests an appeal after more than 60 days. The SSA is likely to close the person’s case, making the person have to start the disability application process. A closed case may reflect poorly on the new application.
Identifying the Errors Made When Processing the Disability Application and Appeal
The federal court is only looking for errors in procedure to reverse the denial of a person’s disability benefits, so a person will need to find problems in how the SSA handled his or her claim. That requires knowing the legal issues that will most likely make a federal court judge remand the claim back to the SSA. The top reasons for federal courts remanding cases of claimants to the SSA for further review from 2010 to 2020 included:
- Discounting the medical opinions of a treating physician without adequate explanation: A hearing judge is not supposed to accept one medical opinion and give less weight to another arbitrarily. ALJs must specify why they favor one medical opinion over another when writing their decision. For instance, if an independent third-party consulting physician is asked to give an opinion about the claimant’s condition and the ALJ gives this physician’s opinion more weight than the opinion of the claimant’s doctors, then the ALJ is required to explain the substantial evidence that supports the decision.
- Failing to consider an applicant’s symptoms sufficiently: If the ALJ conducting a hearing has doubts about the symptoms a claimant testifies to, the judge should include the substantial evidence supporting the conclusion in the written decision. Failure to provide an adequate explanation may result in the federal district court judge sending the case back for rehearing.
- Not identifying or discussing one of the treatment providers: The ALJ’s written decision should address all the evidence that a claimant presents in the case. The federal court can send a claimant’s case back for reconsideration if the opinions or records of one of the treating physicians are ignored without comment.
- Inadequately evaluating an applicant’s exertional or mental limitations: A claimant’s disability can result from mental or physical limitations. A federal judge can remand a claimant’s case if the ALJ is found to have underestimated how much a physical or mental impairment limited the residual functional capacity (RFC) of the claimant.
A person will need to identify the legal issues above or any other legal, factual, and analytical mistakes that the ALJ made that the Appeals Council did not correct. People can easily miss the biggest legal issues in their case if they do not have an experienced disability attorney representing them. A skilled disability attorney can identify such issues or errors in a claimant’s case and know how to present them before the federal judge to help emphasize that the claimant was improperly denied benefits.
Submitting Good Evidence
To successfully appeal denied claims, claimants will need to ensure that their appeals have sufficient evidence of the procedural errors or wrongdoing that occurred when their applications and appeals were being processed. For claimants to ensure they present good evidence and supporting legal arguments, it is essential for them to work with attorneys who know the rules and regulations of the federal court as well as the Social Security disability system.
Documents Disability Lawyers Prepare for Your SSD Appeal
A disability lawyer files a claimant’s civil complaint. The lawyer also prepares a claimant’s briefs. Without representation, claimants have to write the briefs themselves, pointing out how ALJs made an error when making their decision.
The Federal District Court does not hold claimants to a lower standard because they are not lawyers. Therefore, the claimants would be expected to file the same complex legal briefs comprising tens of pages outlining their position. Most fighting in the federal appeals process takes place in writing through the written briefs submitted by the claimants and the SSA. Failing to explain their position properly could lead to denial of their claim.
Consequently, it is necessary to have a qualified disability lawyer who can file the opening brief and reply brief for a claimant.
If the Federal District Court needs an oral argument in addition to the documents, the attorney will argue the claimant’s case in front of a judge to show the claimant was wrongfully denied benefits. The attorney will explain the claimant’s medical condition and cite the relevant laws that can help the applicant be awarded benefits.
With regard to the medical conditions of claimants, disability attorneys help ensure a case has the supportive medical evidence essential for federal court approval, such as medical source statements. These provide documentary support about what a claimant’s limitations are and what doctors think the claimant is capable or not capable of doing.
Should You Appeal Your Case in Federal Court?
Moving a disability appeal to a federal court can be highly beneficial for claimants. Considering it may have taken a long time, even years, for a claimant to get to this stage, starting the application process over again after the Appeals Council denies a claimant a case review or disability benefits may not be in the claimant’s best interest. Starting the application process erases the possible back pay the person could get for the whole period he or she was waiting on his or her claim.
A federal court appeal keeps a claimant’s case alive and preserves the original disability application date. Consequently, when the benefits are ultimately approved, the person may get a larger payment for the back benefits based on the time that has passed since he or she applied.
Nevertheless, the specifics of a case may make it better for a person to reapply for benefits. For example, a person’s medical condition may have worsened significantly, or he or she may have developed new conditions. Since one cannot introduce updated information to a federal judge, starting a new disability application could be a good option in such a case.
It is also worth mentioning that the federal court level may cost people money, as the federal court requires people to pay a fee to file their disability cases. People who cannot afford the fee can have it waived if they ask for the waiver in writing and provide evidence of why they cannot afford it.
Each case is different, so it is essential for claimants to have an individual assessment of their situation. An experienced Social Security disability lawyer can help people determine their best option depending on the details of their case. If the lawyer considers appealing to federal court to be a suitable option, the lawyer will help the claimant meet all the Social Security disability appeal requirements at the federal level.
