I wanted to share the frustration that I experience with an increasingly common delay in payment for disability claims.
Here’s the scenario: After two or two and a half years of fighting, a client finally receives a favorable hearing decision from an Administrative Law Judge. Then comes the horrible news that despite their favorable decision, their disability benefit is once again in jeopardy because it has been “picked up” by the Appeals Council for review.
Normally, a case would get to the Appeals Council if a person lost in front of the Administrative Law Judge and requested review of that decision. However, the law says that the Appeals Council has the authority to review favorable decisions as well, on their “own motion”. The concept is that they are doing a type of quality control so that rogue judges are not awarding undeserving cases.
The challenge is that for my clients, review by the Appeals Council has meant at least a two month additional wait until they get their benefits. For someone who has been out of work for years, this can be excruciating. There is also an added layer of anxiety that the Appeals Council could potentially send the case back to the Administrative Law Judge for a supplemental hearing which could change the outcome of the case.
I appreciate the quality control aspect of the “own motion” review, but it breaks my heart when deserving people who have already been waiting years and years are told to simply keep waiting while their case clears one last administrative hurdle.