As I noted in my recent post, we have seen a dramatic increase in the number of favorable hearing decisions that are picked up for review by the Appeals Council. If you received a favorable decision from an Administrative Law Judge that is selected for review by the Appeals Council, you are probably wondering what the potential outcomes are for your case.
The best possible outcome is that the Appeals Council decides to leave the ALJ favorable decision untouched. This simply means that the Appeals Council examined the decision, found it was legally sufficient, and then allows it to proceed for calculation of a Notice of Award. It typically takes at least sixty days for the Appeals Council to make this determination. This results in a claim being “on pause” for at least two months, but ultimately the favorable outcome is not overturned.
The Appeals Council can also remand the case to the hearing level, which means the case will be sent back to an Administrative Law Judge with instructions to collect more evidence, typically in the form of a new hearing.
There is little that can be done during the waiting for an answer from the Appeals Council. However, if 110 days have gone by since the favorable Administrative Law Judge decision and the Appeals Council has not yet issued a decision, we can request that interim benefits be paid while we wait for a decision.