If the administrative law judge (ALJ) sent you an unfavorable or partially favorable decision after your Social Security disability hearing, make sure you examine the decision for factual or legal errors. If you find a significant mistake—also called a reversible error—that could change the outcome of your case, your next step should be to submit a request for review by the Appeals Council.
Some reversible errors that ALJs can make include ignoring an opinion from your regular doctor, not considering all your limitations when making a determination of your residual functional capacity, or asking incomplete questions of the vocational expert.
You can read more about the above errors in our article on common mistakes made by Social Security. Below are several additional mistakes an ALJ might make in your decision that would give the Appeals Council a reason to review your case.
While ALJs aren't required to reprint your testimony exactly when writing the decision, they're not allowed to mischaracterize or inaccurately summarize what you said at the hearing. For example, suppose you state at the hearing that your friend takes you grocery shopping once per month, but you need to use a motorized cart while at the store and can't unload your groceries due to pain. The ALJ can't summarize your testimony by saying, "The claimant stated she is able to go grocery shopping."
You can ask the Social Security Administration (SSA) to provide you with the audio recording of your hearing so you can compare what you actually said with what the ALJ claims you said.
ALJs are required to evaluate all the symptoms you have from your medical conditions and provide specific reasons why your symptoms do (or don't) cause disabling limitations. The SSA has regulations stating that it's not enough for the ALJ to just write "the claimant isn't disabled" or even "the claimant's alleged limitations are unsupported by objective medical evidence." ALJs need to discuss what evidence in the records they're using to justify their decision.
ALJs must consider the type, dosage, effectiveness, and side effects of any medications you're taking. Any limitations caused by these side effects need to be included as part of your residual functional capacity, a set of limitations reflecting the ALJ's opinion on what you can and can't do in a work environment. For example, if you're taking pain medication that causes you nausea and fatigue, the ALJ has to discuss these side effects and how they would affect your ability to work.
ALJs are required to make sure there is enough evidence in your record to fairly decide your case. Unlike a regular court case, where each side is responsible for finding their own evidence and presenting it, Social Security proceedings are inquisitorial, meaning that the ALJ has a duty to investigate the facts and develop the evidence supporting and opposing your case. If the ALJ thinks that the medical evidence in your case is unclear or insufficient to make a fully informed decision, the judge may need to re-contact your doctor or send you for a consultative examination with a doctor who helps the SSA make disability determinations.
For instance, somebody who is applying for disability due to borderline intellectual functioning will likely have evidence such as special education classes or difficulty reading and writing in their file, but no recent IQ test results. Because a low IQ can be extremely important in a disability case, the ALJ may be required to send the applicant for an intelligence test before deciding the case.
Social Security regulations and the reviewing federal courts set high standards for ALJ decisions, requiring a significant degree of detail and accuracy. ALJs strive to meet these standards, but they can (and do) make mistakes. Your chances at the Appeals Council will be improved substantially if you focus on specific, non-trivial mistakes of law and fact, especially those related to your doctor's opinions, your RFC, and vocational expert testimony.
Before trying to handle an appeal to the Appeals Council or federal court on your own, consult with an experienced disability attorney to get advice on what mistakes the ALJ might have made in your case.
Updated November 16, 2022