You’ve been denied THREE times: at the Initial Level, the Reconsideration Level, AND the Hearing Level. Where is there to go from here?
The Appeals Council is up next! However, buyer beware.
Cases that are denied by an Administrative Law Judge (ALJ) can be appealed to the Appeals Council. This is a paper review of your case by a panel of judges. You do not typically go to a hearing and the Appeals Council does not review your case the same way the ALJ did.
The Council is looking specifically for errors the ALJ made when he/she applied the SSA disability rules. They are not determining the merits of your disability or how ill you are. They can choose to review your appeal or choose to deny it, stating they see no critical errors made by the ALJ. If they choose to review it and decide the ALJ did make critical errors, they will detail what errors those were and send it back to an ALJ to review again. It could be the same ALJ you had the first time!
The Council can take a long time. Sometimes this can be up to 18-24 months to get an answer from them. Around 20% of the time the Council will remand a case (send it back for another review) to the ALJ. The benefit to appealing to the Appeals Council is that if they remand your case back to the ALJ, the ALJ will look at your case again from the very beginning. You protect all the backpay your originally filed for. However, if the Council doesn’t remand your case, or the ALJ looks at it again and still denies it, you have lost time in filing a new case.
SURPRISE! The ALJ said you ARE disabled, and you won your case. Now, several months later, you get a letter from the Council saying they disagree with this award and are remanding your case back to the ALJ anyways! This is a very tough pill to swallow, and does not happen often, but certainly can.
Taking your case to the Appeals Council on your own is allowed, but because of the technical issues regarding the law that these cases are based on, using an attorney creates a much higher chance of success.