Last Update: 9/08/05 (Transmittal I-3-36)
If a claimant is dissatisfied with an Administrative Law Judge's (ALJ's) decision or order of dismissal, the claimant may request the Appeals Council to review the decision or action. The claimant must submit any such request in writing by completing Form HA-520, entitled “Request for Review of Hearing Decision/Order,” or submitting a letter or other written document. The claimant may specifically ask for a review or may imply that he or she is requesting review. Implied request for review occurs when the claimant expresses disagreement or dissatisfaction with the ALJ's action or an intent to pursue appeal rights.
A claimant must file the request for review at a Social Security field office (FO), at a hearing office, directly with the Appeals Council, or at one of the following locations:
A claimant residing in the Philippines may file the request at the Department of Veterans Affairs Regional Office (RO) in the Philippines.
A claimant with ten or more years of service in the railroad industry may file a request for review at a Railroad Retirement Board (RRB) office.
A claimant residing in a foreign country may file a request with an office maintained by the Foreign Service of the United States Department of State.
The claimant or his or her representative must file the request for review within 60 days after the date of receipt of the ALJ's decision or dismissal. We presume that the claimant receives the notice of the ALJ's decision or dismissal five (5) days after the date of the notice, unless there is a reasonable showing to the contrary.
The Appeals Council will extend the time period for filing if the Council finds that the claimant had good cause for late filing of the request for review.
When a claimant requests review in a letter or other written communication and files it directly with the Appeals Council, the OAO Branch completes Form HA-520 and distributes the copies to the proper parties.
The claimant should submit any document(s) or other evidence the claimant wishes the Appeals Council to consider with the request for review. 20 CFR 404.975 and 416.1475 state that the Appeals Council shall give claimants a reasonable opportunity to file briefs or other written statements about the facts and law relevant to the case.
The request for review form (HA-520) advises the claimant that if the claimant:
has additional evidence, he or she must submit it with the request for review unless he or she requests an extension of time to submit it (see below);
needs additional time to submit evidence or legal argument, he or she must request an extension of time in writing, explaining the reason(s) he or she is unable to submit the evidence or legal argument with the request for review; and
neither submits evidence or legal argument with the request for review nor within any extension of time the Appeals Council grants, the Council will take its action based on the evidence of record.
Any party to an ALJ's decision or dismissal or the party's qualified representative may request review (20 CFR 404.932 and 416.1432). Any other individual may request review if that individual's rights with respect to monthly benefits, a lump sum payment, a period of disability, or entitlement to health insurance benefits may be adversely affected by the decision or dismissal. Certain individuals may file a request for review on behalf of a minor, a mentally incompetent claimant, or a claimant physically unable to file (20 CFR 404.612 and 416.315).
Refer to I-3-4 for further discussion on who may request review.
Ordinarily, we consider a request for review filed as of the date it is received in any Social Security Administration (SSA) office, including OHA hearing offices (HO's) and Headquarters, or the date it is received by an employee of SSA authorized to receive a request for review at a place other than an SSA office. We also accept as the date of filing:
the date the request is received at the Department of Veterans Affairs RO in the Philippines or by an employee of that Department in the Philippines authorized to receive such request at a place other than the RO;
the date the Railroad Retirement Board (RRB) receives the request, if an individual having 10 or more years of service in the railroad industry files the request; or
the U.S. Postal Service stamp cancellation or “postmark” date on the envelope in which the request is mailed to us, if using the date we receive it would result in the loss of the claimant's rights. If the postmark is unreadable or there is no postmark, we consider the request timely filed if we receive it by the 70th day after the date on the notice of the ALJ's decision or dismissal. We will also consider other evidence of when the individual mailed the request for review to us.
If the period for filing a request for review; i.e., 60 days after the receipt of the ALJ's notice, ends on a Saturday, Sunday, Federal legal holiday, or on any other day all or part of which is a non-work day for Federal employees by statute or Executive Order, we extend the time for filing to the next full workday.
If a claimant or other individual specified in I-3-4-5 does not file the request for review within the 60-day period, the individual must explain why in writing. If the Appeals Council concludes that good cause was shown, it will extend the time period.
In deciding whether good cause exists for a late filing, the Appeals Council will consider any information an FO or HO provides and any explanation for the delay the individual submits. The analyst must address good cause in the recommendation to the Appeals Council whenever the request for review is untimely. The Council must rule on whether the individual's explanation establishes good cause for the late filing of the request for review. If the Council finds good cause, it will include the following language as either the opening or second paragraph of remand orders, grant review notices, decisions and denial notices:
The request for review was not filed within the prescribed time limit (20 CFR 404.968 and 416.1468), but the Appeals Council finds that good cause is shown for the late filing (20 CFR 404.911 and 416.1411).
No further detail regarding the Council's good cause finding is required.
In determining whether an individual has shown good cause for missing the deadline to request review, the Appeals Council will consider whether the failure was the result of:
circumstances which impeded the individual's efforts to pursue the claim;
an action by SSA which misled the claimant;
misunderstanding as to the requirements of the Act resulting from amendments to the Act, other legislation, or court decisions; or
any physical, mental, educational or linguistic limitations (including any lack of facility with the English language) which prevented the individual from filing a timely request or from understanding or knowing about the need to file a timely request.
For example, in accordance with the Regulations at 20 CFR 404.911 and 416.1411, the Appeals Council may find good cause for failure to file a timely request when the failure resulted from one of the following circumstances:
The individual was seriously ill or had a physical or mental impairment, and the illness or impairment prevented the individual from contacting SSA in person, in writing, or through a friend, relative, or other person.
There was a death or serious illness in the individual's immediate family.
A fire or other accidental cause destroyed or damaged pertinent records.
The individual was actively seeking evidence to perfect the claim and did not complete the search before the time period expired.
The individual requested an additional explanation concerning the ALJ's action within the time limit, provided that within 30 days after receipt of the explanation the individual requested review.
SSA furnished the individual incorrect or incomplete information about the right to request review.
The individual or his representative did not receive notice of the ALJ's action.
The individual transmitted the request for review to another Government agency in good faith and within the time limit, but the request did not reach SSA until after the time period had expired.
The Appeals Council concludes that there were unusual or unavoidable circumstances which demonstrated that the individual was not aware of the need to file timely, or that circumstances prevented the individual from filing timely.
If the Appeals Council finds that the individual did not have good cause for the late filing, the Council will dismiss the request for review. Refer to I-3-4.