Key Takeaways
- The Disability Appeals Council (DAC) is a critical step in the Social Security Disability (SSD) and Supplemental Security Income (SSI) appeals process if you disagree with an Administrative Law Judge (ALJ) decision.
- In Oregon, the DAC handles appeals after ALJ hearings, but wait times and approval rates can vary significantly compared to other states.
- You must file your request for review with the Appeals Council within 60 days of receiving your ALJ decision.
- Understanding the DAC process can improve your chances of success and prepare you for possible next steps, including federal court review.
If you’ve applied for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits in Oregon and received an unfavorable decision from an Administrative Law Judge (ALJ), you may feel overwhelmed and uncertain about your options. The next step is often to request a review by the Disability Appeals Council (DAC), a crucial but sometimes confusing step in the appeal process.
This guide will walk you through everything you need to know about the Disability Appeals Council in Oregon: how it works, how to file, what to expect, and how it fits into your overall disability benefits journey.
What is the Disability Appeals Council?
The Disability Appeals Council (DAC) is the federal agency responsible for reviewing decisions made by Administrative Law Judges in Social Security disability hearings. It is part of the Social Security Administration (SSA) Office of Disability Adjudication and Review (ODAR).
Role of the DAC
- The DAC reviews ALJ decisions upon request by the claimant.
- It can either deny the request for review, meaning the ALJ decision stands, or it can grant the request and either reverse or remand the case for further proceedings.
- The DAC does not hold hearings but makes decisions based on the existing record and any new evidence submitted.
When the DAC Gets Involved
You only involve the Disability Appeals Council if:
- Your initial disability claim was denied at the field office.
- You requested reconsideration and were denied again by the Disability Determination Services (DDS) in Oregon.
- You had a hearing before an ALJ and the ALJ denied your claim.
- You are now dissatisfied with the ALJ’s decision and wish to appeal further.
How the Disability Appeals Council Process Works in Oregon
Step 1: Receiving the ALJ Decision
In Oregon, ALJ hearing decisions can take 12 to 16 months or longer due to backlog. Once you receive the ALJ decision, carefully review the findings and rationale. The decision will include instructions on how to request a review by the DAC.
Step 2: Requesting Review by the Appeals Council
You must file your request for review within 60 days of receiving the ALJ decision. The request is typically made using Form HA-520-U5, Request for Review of Hearing Decision/Order or by a written statement explaining why you disagree with the ALJ’s decision.
You can submit your request:
- Online via your my Social Security account at SSA.gov
- By mail to the Appeals Council office
- By fax or in person at your local SSA office
Step 3: Wait for Appeals Council Review
The DAC will review your case based on the existing record and any new evidence you submit. The Appeals Council has 90 days to make a decision, but actual wait times can be longer, especially in Oregon.
Step 4: Appeals Council Decision
The Appeals Council can:
- Deny your request for review: The ALJ decision stands and is final.
- Grant your request and issue a new decision: Rare, but possible if they find clear errors.
- Remand your case to an ALJ: This means sending your case back for further review or a new hearing.
If the Appeals Council denies your request or issues an unfavorable decision, your next option is to file a lawsuit in federal district court.
Oregon-Specific Information About the Appeals Council
Wait Times and Backlogs in Oregon
According to the SSA’s latest data, Oregon experiences longer than average processing times for ALJ hearings and Appeals Council reviews due to staffing shortages and high volumes.
| Step | Oregon Average Wait Time | National Average Wait Time |
|—————————|————————-|—————————|
| ALJ Hearing Decision | 14-16 months | 12-14 months |
| Appeals Council Review | 6-9 months | 4-6 months |
| Total Time from Initial Claim to DAC Decision | 22-26 months | 18-20 months |
Data Source: SSA.gov, Office of Disability Adjudication and Review, FY 2023
Approval Rates at the Appeals Council Level in Oregon
The Appeals Council grants review in approximately 10-15% of requests nationwide. In Oregon, the rate of favorable decisions or remands by the DAC tends to be slightly lower, around 8-12%.
| Outcome | Oregon Percentage | National Average |
|————————–|——————-|——————|
| Requests Denied | 88-92% | 85-90% |
| Requests Granted (Remand or Reverse) | 8-12% | 10-15% |
This means most claimants will not have their case fully approved at the DAC level and may need to consider further appeals.
What Happens After the Appeals Council Decision in Oregon?
If the Appeals Council denies your request for review or issues an unfavorable decision, your next option is to file a lawsuit in the United States District Court for the District of Oregon. This step is complex and requires legal expertise.
Federal District Court
- The court will review the entire record de novo.
- It cannot receive new evidence but can order a remand for further proceedings if the SSA made legal errors.
- The court process can take 1-3 years or more.
Because of the complexity, many claimants hire a disability attorney to represent them at this stage.
Tips for Navigating the Appeals Council Process in Oregon
1. Meet All Deadlines
Missing the 60-day deadline to request DAC review means you lose the right to appeal further within SSA.
2. Submit New and Relevant Evidence
If you have new medical records or opinions not previously reviewed by the ALJ, submit them with your DAC request. The Appeals Council will consider new evidence if it is material and relates to the period under review.
3. Understand Why the ALJ Denied Your Claim
Use the ALJ decision to identify weaknesses in your case. Focus your Appeals Council request on legal errors or overlooked evidence.
4. Consider Legal Representation
Navigating the DAC and federal court appeals can be overwhelming. Hiring an experienced Oregon disability attorney or advocate can improve your odds and relieve stress.
5. Stay Organized and Keep Copies
Keep copies of all forms, letters, and evidence submitted. Use certified mail or electronic submission to track deadlines.
Common Reasons the Appeals Council Will Remand Cases
The Appeals Council typically remands cases for these reasons:
- The ALJ did not fully consider all medical evidence as required by the SSA Blue Book Listings.
- The ALJ failed to properly evaluate your residual functional capacity (RFC).
- The ALJ’s credibility findings were not supported by substantial evidence.
- New and material evidence was submitted that could change the outcome.
- Procedural errors occurred during the hearing.
How to Request Review by the Disability Appeals Council in Oregon: Step-by-Step
1. Carefully Review the ALJ Decision: Understand the findings and the reasons for denial.
2. File Your Request for Review: Use Form HA-520-U5 or submit a written request within 60 days.
3. Include New Evidence: If available, attach new, relevant medical records or statements.
4. Submit Request: Online through my Social Security account or mail it to the Appeals Council address provided on the ALJ decision notice.
5. Confirm Receipt: Keep proof of submission, such as certified mail receipts.
6. Wait for DAC Decision: Monitor your my Social Security account or contact the SSA for updates.
Resources for Oregon Disability Claimants
- Social Security Administration Office in Oregon:
Portland SSA Field Office
1220 SW 3rd Ave, Room 100
Portland, OR 97204
Phone: 1-800-772-1213
- District Court for Oregon:
U.S. District Court for the District of Oregon
1000 SW 3rd Ave, Portland, OR 97204
Phone: (503) 326-8000
- Oregon Disability Determination Services:
P.O. Box 14020
Salem, OR 97309
Phone: 1-855-673-0755
- Official SSA Information on Appeals Council:
Frequently Asked Questions (FAQs)
1. What happens if I miss the 60-day deadline to request Appeals Council review?
Unfortunately, missing the 60-day deadline generally means you lose your right to appeal within SSA. You can try requesting an extension, but these are rarely granted without a very good reason.
2. Can I submit new medical evidence to the Appeals Council?
Yes, but the new evidence must be relevant to your condition during the time period under review and should not be duplicative of evidence already considered by the ALJ.
3. How long does the Appeals Council take to make a decision in Oregon?
While the official timeframe is around 90 days, in Oregon it often takes 6 to 9 months due to backlogs.
4. What are my options if the Appeals Council denies my request?
Your next step is to file a civil lawsuit in federal district court. This is a complex process that benefits greatly from attorney representation.
5. Can I request a hearing before the Appeals Council?
No, the Appeals Council does not hold hearings. It reviews the record and any new evidence you submit.
Final Thoughts and Next Steps
The Disability Appeals Council is a vital part of the Social Security Disability appeals process in Oregon, offering a last administrative review before federal court. Understanding the process, deadlines, and what to expect can reduce the fear and confusion many claimants feel after an ALJ denial.
If you’re facing an unfavorable ALJ decision and considering an appeal to the DAC, I strongly recommend consulting with an experienced Oregon disability attorney. Legal professionals can help you navigate complex rules, gather the right evidence, and present the strongest possible case to improve your chance of success.
Written by Michael T. Hargrove, former SSA Claims Examiner and Disability Benefits Consultant.