The Appeals Council is the third level of review in the SSDI appeal process

The Appeals Council is a unit within the Social Security Administration that reviews decisions made by Administrative Law Judges (ALJs). If an ALJ denies your claim or you disagree with their decision, you can ask the Appeals Council to look at your case again. The Appeals Council does not hold a hearing or take new testimony—it reviews the written record from your ALJ hearing and decides whether the ALJ's decision was correct.

The Appeals Council is based in Falls Church, Virginia, and handles cases from across the country. It is a separate body from the ALJ who heard your case, which means you get a fresh review by different decision-makers. However, the Appeals Council receives thousands of requests each year and only reviews a small percentage of them.

Key Takeaways

  • The Appeals Council reviews written records and prior testimony; it does not hold new hearings or let you present new evidence in person.
  • You must file a request for Appeals Council review within 60 days of receiving the ALJ's decision, or you lose the right to appeal at this level.
  • The Appeals Council denies most requests for review, either because it finds no legal error or because it chooses not to review the case at all.
  • If the Appeals Council denies your request or upholds the ALJ's decision, your next option is to file a lawsuit in federal district court.

How the Appeals Council decides which cases to review

The Appeals Council does not review every case sent to it. Instead, it uses a screening process to decide which requests deserve a full review. The Council looks for cases where the ALJ may have made a legal or procedural error—for example, if the ALJ ignored medical evidence, failed to follow the correct rules for evaluating your condition, or did not properly consider your age and work history.

If the Appeals Council finds that the ALJ's decision was legally sound and supported by the evidence in the file, it will deny your request for review without a full examination. This is called a denial on the merits. If the Council does decide to review your case, it will issue a written decision explaining why it agrees or disagrees with the ALJ.

The Appeals Council also considers whether new evidence you submit changes the outcome. If you have medical records, test results, or other documents that were not part of the ALJ hearing, you can include them with your request. The Council will decide whether this new evidence is important enough to warrant a full review.

The timeline for Appeals Council review

You have 60 days from the date you receive the ALJ's decision to request Appeals Council review. This important date is strict—if you miss it, you cannot appeal to the Appeals Council and must go directly to federal court if you want to continue. The 60 days starts when you receive the decision in the mail, not when the ALJ issues it, so check the date on the envelope.

Once you file your request, the Appeals Council typically takes 6 to 12 months to issue a decision, though some cases take longer. During this time, you will not receive updates unless you contact the Appeals Council directly. You can check the status of your case by calling the Social Security Administration's main number and providing your case number.

What happens if the Appeals Council grants review

If the Appeals Council decides to review your case, it will examine the entire file from your ALJ hearing. It will read the ALJ's decision, your medical records, any vocational informed testimony, and any new evidence you submitted. The Council may agree with the ALJ, reverse the decision, or send the case back to the ALJ for another hearing with new instructions.

If the Appeals Council reverses the ALJ's decision and finds that you are disabled, it will award benefits. If it sends the case back to the ALJ, you will have another hearing where the ALJ must follow the Appeals Council's instructions. This can mean reconsidering certain medical evidence, explore a different legal standard, or taking into account information the first ALJ overlooked.

What happens if the Appeals Council denies your request

Most requests for Appeals Council review are denied. The Council may deny your request because it finds no legal error in the ALJ's decision, or it may straightforward choose not to review the case without explaining why. Either way, the ALJ's decision becomes final, and you cannot appeal within the Social Security system anymore.

If the Appeals Council denies your request or upholds the ALJ's decision, you have the right to file a lawsuit in federal district court. You must file this lawsuit within 60 days of receiving the Appeals Council's decision. In federal court, you can argue that the Social Security Administration misapplied the law or that its decision was not supported by substantial evidence in the record.

How to request Appeals Council review

To request Appeals Council review, you must file a written request with the Social Security Administration. You can use Form SSA-561-U2, titled "Request for Review of Hearing Decision/Order," or you can write a letter explaining why you believe the ALJ made an error. Your request must include your name, Social Security number, and the date of the ALJ's decision.

Mail your request to the address listed on the ALJ's decision letter. Do not send it to the local Social Security office—it must go to the Appeals Council in Falls Church. Keep a copy for your records and consider sending it by certified mail so you have proof of the date you mailed it. If you have a lawyer or representative, they can file the request on your behalf.

You can also submit new evidence with your request. Include copies of any medical records, test results, or other documents that support your case and were not available at the time of your ALJ hearing. The Appeals Council will consider this evidence when deciding whether to review your case.

When you might want a lawyer for Appeals Council review

Many people hire a lawyer or representative to help with Appeals Council review. A lawyer can identify legal errors in the ALJ's decision, explain why the Appeals Council should review your case, and write a persuasive brief on your behalf. This is especially useful if your case involves complex medical or vocational issues, or if the ALJ's reasoning seems flawed.

Social Security lawyers work on contingency, meaning they take a percentage of your back pay if you win—usually up to 25 percent, capped at $7,200. You do not pay them upfront. If you cannot afford a lawyer, you may be able to find help through a legal aid organization in your area or through a disability advocacy group.

Frequently Asked Questions

Can the Appeals Council hold a hearing or let me present new evidence in person?

No. The Appeals Council reviews only the written record from your ALJ hearing. You cannot attend a hearing or testify. However, you can submit new medical records or other documents in writing, and the Council will consider them when deciding whether to review your case.

What is the difference between the Appeals Council and the ALJ?

The ALJ held your hearing and made the first decision on your claim. The Appeals Council is a separate body that reviews whether the ALJ made a legal or procedural error. The Appeals Council does not hear new testimony but examines the entire written record.

How long does Appeals Council review usually take?

Most cases take 6 to 12 months, though some take longer. You can check the status of your case by calling Social Security and providing your case number. The Appeals Council does not send routine updates.

What happens if I miss the 60-day important date to request Appeals Council review?

You lose the right to appeal to the Appeals Council. Your only remaining option is to file a lawsuit in federal district court within 60 days of the ALJ's decision. A lawyer can help you determine whether federal court is a viable path for your case.

Can the Appeals Council award benefits, or does it only send cases back to the ALJ?

The Appeals Council can award benefits directly if it reverses the ALJ's decision and finds that you are disabled. It can also uphold the ALJ's decision, deny your request for review, or send the case back to the ALJ for another hearing with new instructions.