If a claimant for Social Security Disability benefits is denied by an administrative law judge after hearing it is possible to continue the disability claim, the next step in the process would be to file an appeal with the Social Security Appeals Council. The Appeals Council reviews whether the judge followed proper procedure and whether the decision was reasonable based on the evidence submitted. If an error was made, the Appeals Council can overturn the decision and approve the claim or remand the case back to the judge for additional proceedings.
If the Appeals Council does not overturn or remand the decision, they will deny the claim. To continue the case, Claimant and counsel will need to file for a hearing in federal district court. At this stage, the judge assigned to rule on the case has a limited scope of review. The judge may only determine if the Social Security Administration’s decision was supported by “substantial evidence” and if proper legal standards were applied in evaluating the case. This is a very limited scope of review. So long as the decision by the judge was not unreasonable, the claim will be denied on those grounds. Federal judges do not wish to second-guess the decisions of the Social Security Administration when it comes to these matters, and will only intervene if the decision is so bizarre that no reasonable adjudicator could reach that conclusion based on the evidence.
Federal judges are more likely to approve cases on “legal standard” grounds, as a major part of their job is to interpret and apply the law. If the Social Security Administration did not follow its own regulations in such a way that prejudices the claimant, a remand at the very least is necessary to rectify this error. If a claimant wins in federal court, the claim will likely be returned to the Social Security Administration for additional proceedings
If you have additional questions about the appeal process, consult with a Social Security Disability attorney for guidance.