Believe it or not, even after a fully or partially favorable decision from the Administrative Law Judge (ALJ), you may still have your case reviewed once again, and you actually do run the risk of your case being denied.
In other words, the denials and wait times never seem to end.
The Appeals Council, the body that reviews ALJ decisions, can on its own motion, review a case even if the claimant does not appeal. The review can be the result of a number of things: (1) there could a protest within the Social Security Administration itself; (2) by simple random selection; or (3) or because your case has issues within it, which increases the chance of errors.
If you do receive a notice from the Appeals Council that even though you were given a favorable decision by the ALJ, it really is not a time to panic. Oftentimes, the decision itself is reviewed and about two months later, the case is then approved and benefits can begin. Further, if after 100 days you have not received a decision, you can begin to receive benefits. As long as there was no issue of fraud, even if you are eventually denied, you will not be required to pay back what money you received.
If your case is denied (again, even after receiving a favorable decision from the ALJ), you would likely need to appeal the decision. The ALJ was the one who interviewed you and listened to your story and reviewed your medical evidence. He or she was the best one to assess your physical and mental capabilities, and thus his or her decision is the one that should be given a considerable amount of weight.
We represent Claimants throughout Texas and California fighting for their Social Security disability benefits. Feel free to always call us at: (888) 780-9125.