In our last post we discussed the complex nature of Social Security Disability appeals and the case of one woman who applied for SSI benefits after her application for SSDI benefits was denied. An Appeals Council was still considering the woman’s SSDI appeal the year after the woman received SSI benefits, so it decided to consolidate the cases and remand them to an ALJ. The ALJ then denied the woman’s application after a 23-month delay.
The ALJ decided that the medical record did not support the woman’s diagnosis of spinal arachnoiditis and decided that she was not disabled because she retained the residual functional capacity to perform her past relevant work. The ALJ failed to mention the 23-month delay between the reopening of the case and his decision and also failed to make a finding that the SSA had been diligent in its investigation of the SSDI and the SSI applications.
The woman appealed the ALJ’s denial of her application and argued that the ALJ did not have the authority to reverse her award of benefits without finding that the SSA was diligent in its investigation into whether it should revise its favorable decision toward her.
The federal appeals court agreed with the woman and noted that the ALJ’s decision lacked regulatory support. The record contained no support for the proposition that the SSA was diligent in its investigation and therefore a reinstatement of the woman’s benefits was granted. It should be noted that the appeals court decision came 11 years after the woman initially filed for benefits and almost nine years after she finally received benefits for the first time. The length of appeals process is discouraging to many applicants but worth it considering the amount of benefits at stake.
Source: U.S. Court of Appeals, Ninth District, “Carrillo-Yeras v. Astrue,” No. 09-56515, D.C. No. 2:08-cv-05560-AN, Oct. 25, 2011