Why is my case being “remanded” and what does this mean?Posted October 13, 2015 by Premier Disability Services, LLC® If a claim is denied by an Administrative Law Judge (ALJ), the next level of appeal for a claimant is the Appeals Council. If a claimant submits a request for review to the Appeals Council, they will review the request to determine whether to grant, deny, or dismiss the request. If the request for review is granted, the Appeals Council will either overturn the denial or remand the case back to the ALJ. The chances of having a claim overturned by the Appeals Council are very low. As a result, the more likely path to success for a claimant who appeals to the Appeals Council is to have their case remanded.
1. What is a remand?
The term remand means, “to send back,” and that is exactly what the Appeals Council will do if they feel the ALJ’s decision was not supported by substantial evidence or contained errors of law. When a claim is remanded back to the ALJ, the Appeals Council will send the claimant a written notice with the heading, Notice of Order of Appeals Council Remanding Case to Administrative Law Judge. This notice will state that the Appeals Council has sent the case back to the ALJ. In addition, this notice will detail what mistakes the ALJ made and it will give the ALJ specific instructions.
2. Is a remand good for a claim?
The answer is a resounding yes. While the goal is to receive an award of benefits at a claimant’s first hearing, that is not always possible. For claimants who are denied benefits after appearing in front of an ALJ, a remanded hearing means they get a second chance to establish their disability. Also, as mentioned above, the Appeals Council will also include specific instructions for the remanded hearing that the ALJ is required to follow. These instructions can often put the ALJ in a narrow box of what they can and cannot do at the next hearing. As a result, we have found that remanded hearings have a very high success rate.
3. Will I appear in front of the same ALJ?
The short answer is yes. Unless the ALJ who decided the previous claim is unavailable for some reason, the remanded hearing will be in front of the same ALJ. This can be a challenge, especially in situations where you appeared in front of an ALJ who is particularly unfriendly to claimants. Regardless of the Judge, the Appeals Council’s instructions must be followed. Also, most ALJs likely do not want to have their decision result in a second remand. As a result, ALJs are going to be extremely cautious and make sure the file is completely developed before they make the decision to deny a claimant the second time. This often bodes well for a claimant’s chances of being awarded.
4. What are some common reasons a claim is remanded?
There are multiple reasons a claim may be remanded. One example is when a Judge determines that a claimant has severe mental impairments but then factors in only physical impairments when making the decision. The Appeals Council may remand the claim back to that ALJ to properly account for the limitations associated with the mental impairments in the decision. Other common issues that justify a remand include:
• The claimant submitted new evidence supporting their disability during the period before the ALJ’s decision
• The ALJ failed to consider a medical opinion from a claimant’s treating source
• The ALJ committed a procedural error, such as failing to ask a claimant’s representative if they object to the Vocational Expert testifying
5. How would a claimant improve their chances of being remanded?
A good claim for the Appeals Council does not necessarily depend on the number of appealable issues, but the quality of issues. This means that the identification of strong appeal issues becomes very important. It is very beneficial to hire an experienced Representative who knows the types of issues that can be successful at this level. Remember, an appeal to the Appeals Council can sometimes take 18-24 months before they make a decision. That decision may be a denial. That is a long time to wait if there were little chance for success in the first place. It is sometimes better for claimants to file a new application rather than pursue an appeal. An experienced Representative can help weigh these options.
By: Devon Brady of Premier Disability Services, LLC®