The Appeals Council (AC) is the final level of administrative review for claims filed for benefits under the Social Security Act. The AC’s jurisdiction generally begins after an administrative law judge (ALJ) makes the decision to dismiss a claim. The AC will review decisions upon written request by the claimant or their representative. The AC can also review decisions on their own authority, without being requested to do so by anyone. The AC also has a quality assurance function and administers remands issued by the federal courts.
The AC, located in Falls Church, Virginia, is comprised of administrative appeals judges, appeals officers, and support staff. The AC has dozens of branches. The branch with jurisdiction over a particular claim is based on the last two numbers of the claimant’s Social Security Number. After evaluating a claim, the Appeals Council may deny, dismiss, or grant review of the claim. A denial means that the Appeals Council found no reason to disagree with the ALJ’s decision, and therefore the ALJ’s decision becomes the final decision on the claim. A claim will be dismissed if the AC determines it did not have jurisdiction; for example, if a request for review is filed more than 60 days after the ALJ’s decision.
If the AC grants review, they will then issue a favorable or unfavorable decision, remand the case to the ALJ for further proceedings—or they may choose dismiss the claim, since it was denied by the previous ALJ. The overall likelihood of a favorable outcome on a claim at the AC is relatively low. In the AC’s 2018 fiscal year, they approved 1% of claims, dismissed 4%, remanded 10%, and denied 85%. If a claimant disagrees with the decision of the Appeals Council, they may seek further review in Federal District Court.
