1. What Does an Unfavorable ALJ Decision Mean?

An unfavorable decision means the ALJ determined:

• Your medical condition does not meet SSA’s definition of disability
• You can perform your past work or other work available in the national economy
• Your testimony or medical evidence did not sufficiently prove disability under SSA rules

You will receive a written decision explaining the judge’s reasoning, including a detailed analysis of your medical evidence, functional limitations, and vocational findings.

2. What Is the Next Level of Appeal?

If you disagree with the ALJ’s decision, the next step is to request a review by the Social Security Appeals Council.

3. Steps to Appeal an Unfavorable ALJ Decision

Step 1: Review the ALJ’s Decision Carefully

Read the entire decision thoroughly to:

• Understand why the claim was denied
• Identify evidence or testimony the judge cited as insufficient
• Determine any potential legal or procedural errors that may support your appeal

Step 2: File a Request for Review with the Appeals Council

You must file Form HA-520 (Request for Review of Hearing Decision/Order) within 60 days of receiving your ALJ decision. The Appeals Council:

• Reviews whether the ALJ’s decision was based on substantial evidence and correct application of SSA rules
• May approve your claim, deny your request for review, or remand (send back) your case to the ALJ for another hearing

Step 3: Submit Additional Evidence If Necessary

You can submit new, material evidence to the Appeals Council if:

• It relates to the period before the ALJ decision
• There is a reasonable probability it could change the outcome
• You show good cause for not submitting it earlier

Examples of good cause include:

• Evidence not available at the time of the hearing
• SSA action or misinformation prevented timely submission

Step 4: Wait for Appeals Council Review

The Appeals Council does not hold a new hearing but reviews:

• The ALJ’s decision
• The hearing record
• Any new evidence you submit

It may take several months to over a year to receive a decision from the Appeals Council.

4. What If the Appeals Council Denies Your Request?

If the Appeals Council:

• Denies your request for review, the ALJ decision becomes final
• Issues an unfavorable decision itself, it also becomes final

Your next step is to file a civil lawsuit in federal district court within 60 days of the Appeals Council’s denial. At this stage, it is highly advisable to work with an experienced disability attorney to navigate federal court procedures effectively.

5. Tips for a Successful Appeals Council Review

• Consult with a disability attorney to identify legal errors in the ALJ decision
• Submit clear, organized briefs outlining why the decision should be reversed or remanded
• Include new medical evidence only if it meets SSA’s strict submission requirements
• Respond to all SSA deadlines promptly to keep your appeal active

6. Alternative Options During Appeals

While awaiting an Appeals Council decision, consider:

• Reviewing eligibility for other benefit programs, such as SSI if you applied only for SSDI
• Filing a new disability application, though you should consult with your attorney to avoid conflicts with the pending appeal