Appeals Council: Standard of Review; What Happens next

If someone’s case has been denied by an Administrative Law Judge (“ALJ”), he or she may appeal that decision with the Appeals Council (A/C). The Appeals Council is a centralized body in Falls Church, VA which handles all disability appeals throughout the US.

The Appeals Council does not review a case the same way an Administrative Law Judge does. The ALJ reviews a case as “de novo”, meaning “fresh,” “new,” “starting over.” The ALJ is not bound by any prior determinations made before at the state agency levels of review.

The Appeals Council, however, will apply a more deferential standard once the ALJ has made his/her decision. The A/C typically does not review the case “de novo.” Therefore, some say, that it may be more difficult to win at the Appeals Council level of review than to win at the ALJ level of review.

If your case has been denied by an ALJ, and legitimate mistakes were made by the Judge, or, if significant evidence was missing, then often, the best next step is to appeal your case to the Appeals Council for review. For additional questions about your, or a friend or family member’s disability case, please feel free to contact us at 404-373-1649.

The regulation concerning Appeals Council Review is 20 CFR 416.1470 and states:

(a) The Appeals Council will review a case if—

(1) There appears to be an abuse of discretion by the administrative law judge;

(2) There is an error of law;

(3) The action, findings or conclusions of the administrative law judge are not supported by substantial evidence; or

(4) There is a broad policy or procedural issue that may affect the general public interest.

(b) In reviewing decisions based on an application for benefits, if new and material evidence is submitted, the Appeals Council shall consider the additional evidence only where it relates to the period on or before the date of the administrative law judge hearing decision. In reviewing decisions other than those based on an application for benefits, the Appeals Council shall evaluate the entire record including any new and material evidence submitted. It will then review the case if it finds that the administrative law judge’s action, findings, or conclusion is contrary to the weight of the evidence currently of record.

Proud of our Clients for speaking out against Predatory Lending at the Georgia State Capitol

Speaking out against Predatory Lending in Georgia
Speaking out against Predatory Lending in Georgia

Tony and Glenda Compton are former Social Security clients of Affleck and Gordon. In January of 2015, they received a check in the mail for $720 from Republic Finance. Glenda thought the check was a joke and told Tony not to cash it. Unfortunately, he did so anyway without realizing what he was agreeing to. By cashing the check, he unfortunately agreed to a loan that would have the Comptons paying astronomical interest rates and fees.

One of the purposes of these checks is to prey on Americans in tough financial times and get them hooked on these loans. Almost immediately after cashing their initial check, the Comptons started getting calls from Republic Finance. The Comptons were offered a lower interest rate and few hundred dollars more if they agreed to refinance the debt. In doing so, they accrued even more fees which outweighed any reduction in the interest rate.

The Comptons dutifully paid back their loan in monthly installments from February of 2015 through April of 2016. The payment started at $126 per month, but by April of 2016, the payment had grown to $170 per month. At that point, the Comptons could no longer afford to pay the loan back. In total, they had already paid back $1656. When the Comptons stopped paying, Republic Finance sued them in Magistrate Court for an additional $2,483.50 on what was originally only a $720 loan.

The Comptons first met Tom Affleck, founding partner of Affleck and Gordon, and asked him to help with a Social Security disability case thirty years ago. Since then, they have remained both friends and clients. As a result, when they knew they needed help, the Comptons brought their lawsuit to our Griffin office. Harry Brenner (one of our attorneys) listened to their story and brought the paperwork to Joel Thrift (another attorney in our office) to see if we could help. Joel and Allison Affleck (a third attorney at Affleck and Gordon) helped draft an answer to the lawsuit, and brought in another attorney, Matt Wetherington, to help on the case. That case is still pending in Henry County Superior Court. Shockingly, we discovered that it is not technically illegal to send people “live checks” in the mail to entice them into a bad loan. There may be some defenses to this suit, but it’s also possible that the loan is entirely legal. When we started researching magistrate court lawsuits in counties where Republic Finance has offices, we found thousands of other lawsuits against people who had cashed the same type of checks and could no longer afford to pay.

In hopes of further helping the Comptons, and warning other people of the danger of these checks, we reached out to Channel 46 news. Harry Samler, with Channel 46, came out to the Compton’s house and interviewed Mr. and Mrs. Compton. Ms. Compton is so likable, and her story so compelling, that Channel 46 ran a series of stories on her. Elena Parent with the Georgia Senate saw the stories. Senator Parent’s concern led her to sponsor a bill to make sending unsolicited checks to people’s homes illegal. A committee meeting was held on her bill yesterday (February 22, 2017) and the Comptons were invited to testify.

Ms. Compton was rock star at the hearing. To support the Comptons, Joel and Allison also attended the hearing. Joel introduced himself, and the Comptons, to the Senate committee and answered questions from the Senators. It was Ms. Compton’s compelling story that again won over everyone in the room, both Republicans and Democrats. The questions from our Georgia legislators were all sympathetic and seemingly indicated that they believed Senator Parent’s bill should pass. We’re hopeful that this practice will be outlawed.

It took a concerted effort by Harry, Allison, and Joel to get to this point. It also took the Comptons’ friendship, and trust in our firm, after the work Tom Affleck and his firm put into their Social Security disability and Workers’ Comp cases many years ago. We know they were nervous about yesterday and are lucky that we could be there in support. We will continue to work to make sure that no one else is tricked by one of these checks in the future.

To see more about the story, click here:

For more information, please see our Videos page or call us at 404-373-1649.

Injured On The Job? You’re Being Watched!

It goes without saying that if you’re injured on the job and out of work there’s a good chance that you’re being watched.  Generally, it begins with an activities check by the workers’ comp insurance company to see if you are doing anything out of the ordinary instead of at home resting. Sometimes, it’s your employer who’s convinced you’re a fraud trying to rip off their company for its insurance, and demands surveillance.

When you are going to the doctor’s office, don’t go running from the car door to the doctor’s door or do anything that is contrary to your work restrictions such as jumping down from the exam table just in case the “company doctor” is watching and documenting every movement or the insurance company has hired a private investigator. Now don’t get me wrong. I’m not saying that you have to become a hermit and stay indoors 24/7 and only come out for your doctor’s appointments. I’m just saying to follow your doctor’s work restrictions and be careful in your movements and activities.  Otherwise, that private eye will capture some damaging photographs or video of you helping your friend in his restaurant or gas station when you are out on a workers’ comp disability claim and next thing you know you will be faced with charges of workers’ comp fraud. Even if you think bowling is good exercise for your back injury, it probably wouldn’t play well in court and you could lose your weekly disability checks.

Oftentimes, workers’ comp insurance companies use surveillance reports to suspend workers’ comp checks or deny claims outright.  If your workers’ comp claim is denied or your workers’ comp checks stopped, you need to contact an Affleck & Gordon lawyer to help you fight for your rights.