Appeals Council Scolds ALJ

Friday, January 2nd, 2009

When the Appeals Council (the “AC”) remands a claim for Social Security Disability (“SSD”) benefits to an administrative law judge (“ALJ”), the decision is usually very terse, rarely more than a page or two. Today I received a five page remand order for one of my clients who is a former teacher.

I was retained after a federal court remanded this SSD case to ALJ Iris Rothman. The claimant’s prior attorney was ambivalent about representing the claimant because ALJ Rothman inexplicably refused to review the case objectively. Sure enough, ALJ Rothman denied the claim a second time despite overwhelming medical and vocational evidence.

Reading between the lines the AC made it clear that ALJ Rothman’s latest decision was devoid of any merit. First, unaware that ALJ Rothman has retired, the AC ordered that the matter be assigned to another ALJ. Second, the AC repeatedly remarked what the new ALJ would need to do IF the evidence that the claimant met three visual listings was rejected. In other words, the AC was indicating that the claimant met at least one of the listings. If a listing is met, then the claimant is deemed disabled without any further evaluation. Third, even if the claimant did not meet a listing, the AC noted that ALJ Rothman’s decision contradicted “grid rule” 202.06, which required that the claimant be found disabled.

Regardless of whether your hearing is before a good or bad ALJ, if you believe the denial of your SSD benefits was wrong seek a second legal opinion. While the legal process for reversing an erroneous benefits decision may take some time, benefits should be approved as long as there is supporting medical and vocational evidence

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