Appeals Council Review of Favorable Decisions

The Appeals Council (AC) has a staff of about 60 people reviewing un-appealed hearing level favorable decisions.  The AC takes about 60 days to review the case, and then either allows payment of benefits, or notifies the claimant of an adverse determination, including remand or “corrective” decision.  In other words, the AC can issue a fully favorable, partially favorable, or unfavorable decision.  Apparently, only 1-2% of cases are reviewed by the AC.  The process is somewhat frustrating.  For example, right now I have a case at the Appeals Council that we filed over 13 months ago, and the AC has not assigned an Analyst to review the decision.  On the other hand, I have another case where a fully favorable award was made just a few weeks ago – the AC has already assigned an Analyst to review the decision.  In other words, a decision that has been approved by a Judge is being randomly reviewed, while another case that we appealed over a year ago is gathering dust.  The resources used to review favorable decisions might be better spent reviewing the cases that were actually appealed.


About tngainjurylawyer
Serious Injury Lawyer in Tennessee and Georgia.

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