We’re gonna be straight with you: Social Security has a really hard time making decisions. Well, it’s not so much the decision itself; it’s the volume of appeals that are part of the due process of filing a Social Security disability claim.
Social Security hearing wait times continue to rise despite many initiatives that Social Security has started to shorten them. It is no different at the Appeals Council level of the process. It, too, has a huge backlog.
A Request for Reconsideration of a Hearing Decision is the appeal that takes a denial at hearing to a higher level: the Appeals Council. Generally, this level is asked to review the hearing itself—the testimony of the claimant, representative, vocational or medical expert and the Administrative Law Judge—to see if anything was done that was contrary to the correct hearing process.
Recently, the Appeals Council instituted Priority Processing in hopes of reducing the backlog. Here’s a summary of that process, from a recent NOSSCR newsletter:
A list of the Appeals Council-level cases with newly submitted evidence is generated several times a week. A group of employees has started screening the listed cases to see if they meet any of the 21 circumstances below. If so, the branch chief receives the case and assigns it for priority processing. The circumstances are:
(1) Age 55
(2) Any indication or report of death
(3) Hospice, nursing care, or claimant cannot care for personal needs
(4) Intensive care unit for more than 3 days
(5) Hospitalization for more than 7 days
(6) Transplant notes (kidney, heart, heart/lung, liver or bone marrow, etc.)
(7) Transplant waiting list
(8) Cancer with poor or no response to treatment
(9) Cancer that has spread to other areas/
(11) Heart attack or myocardial infarction
(12) Stroke, or cerebral vascular accident
(13) Prescribed use of home oxygen
(14) Prescribed use of wheelchair
(15) VA disability rating of 70% or more
(16) Letter or notice approving other forms of disability payments
(17) Medical report(s) of a terminal prognosis
(18) Dialysis or End Stage Renal Disease (ESRD)
(19) Blood transfusion(s)
(20) Bed or home confinement
(21) Very rare, unusual, or compassionate allowance diagnoses
If you are currently waiting for an Appeals Council decision on your appeal and any of these 21 circumstances apply to you since your hearing, contact Social Security immediately with the appropriate documentation—or if you are represented by a law firm, contact them. If you are seeking representation, give us a call!
Robert L. Heller has practiced law in Ohio for nearly 40 years, devoting his entire career to helping disabled people in the Mahoning Valley to pursue needed benefits. A native of Warren, Ohio, Robert earned his undergraduate degree from Miami University of Ohio and his law degree from the University of Toledo College of Law. He also studied public administration at American University in Washington, D.C. He is admitted to practice in Ohio state courts, U.S. District Court for the Northern District of Ohio and Sixth Circuit U.S. Court of Appeals as well as a member of the National Organization of Social Security Claimant Representatives (NOSSCR).