Your application for Social Security Disability Benefits has been denied. Do you know what to do next?

Working with a Foley & Wilson lawyer, you’ll have legal representation and guidance when applying for Social Security Disability benefits and appealing denied claims.

What does this mean for you? It means that you’ll be with a lawyer who will represent you throughout the process—a lawyer who knows you and who understands what you are facing, a familiar face and a reassuring presence.

  • Appeals Process

What do I do if I lose at a disability hearing; how do I appeal?

Even if you lose at a disability hearing, it does not mean that you should give up.

Your Foley & Wilson Social Security Disability lawyer can represent you during your appeal. The Appeals Process goes through two levels:

  • Appeals Council Level

An appeal is filed and the decisions of the Social Security Judges are reviewed by the Social Security Administration Appeals Council. At that time, your lawyer will present legal arguments to support your appeal and to challenge the Judge’s denial.

  • Federal Court Level

If the Appeals Council approves the denial, then your lawyer can file a law suit in Federal Court against the Social Security Administration—only lawyers can file in Federal Court. The Federal Court will review the denial and decide whether to send your case back for an additional hearing.

Don’t Let Government Lawyers Get Away With It: File A Reply Brief In Social Security Disability Federal Court Cases

Administrative law judge (ALJ) decisions denying Social Security Disability claims can be appealed to federal court after all administrative appeal remedies have been exhausted. This is accomplished by filing a civil action against the Commissioner of the Social Security Administration in United States District Court.

Despite the filing of a civil action, however, the District Court does not function as a trial court in these cases. It does not conduct a de novo review to determine whether the Plaintiff is entitled to disability benefits.

Instead, the District Court functions in an appellate role to determine whether the ALJ decision is supported by substantial evidence and whether any legal errors were committed.

In the Middle District of North Carolina, the District Court directs the Plaintiff to file a motion to reverse the decision of the Commissioner and a supporting brief after the initial pleadings have been filed. The Defendant is directed to file a motion to affirm the Commissioner’s decision, along with a supporting brief. These motions and briefs are filed pursuant to Federal Rule of Civil Procedure 7(b).

A United States Magistrate Judge reviews the motions, supporting briefs, and the administrative record and issues a recommended judgment to the District Court. A District Court judge then reviews any properly filed objections to that recommendation and issues a final judgment. In most cases, the District Court’s judgment either affirms the ALJ decision or reverses the decision and remands for a new hearing before the ALJ.

After the Defendant’s motion and brief are filed, Local Rule of Civil Procedure 7.3(h) allows the Plaintiff to file a reply brief. But should a reply brief be filed?

Some disability attorneys recommend against filing a reply brief out of concern that the District Court may not be favorably inclined towards such briefs. They argue that there is no need to file a reply because briefs filed by government lawyers are often of poor quality.

My view is that a reply brief should almost always be filed by the Plaintiff’s attorney. Why?

It is a tactical mistake to allow the government lawyers to get the last word before the Magistrate Judge issues a recommended judgment. Doing so concedes a definite advantage by allowing their responses to your arguments to go unchallenged. If the government lawyers expose weaknesses in your arguments, it is a sure tactical mistake to forego the opportunity of shoring up those weaknesses with a reply brief.

Filing a reply brief switches the advantage back to you by allowing your responses to the government’s arguments to go unchallenged. A good reply brief by the Plaintiff exposes the weaknesses in the government’s arguments. The Rules of Civil Procedure allow the government lawyers no further response and keep the Magistrate Judge’s attention focused on the weaknesses of their case.

Government lawyers often make incorrect legal arguments that are nevertheless tempting to the Magistrate Judge. For example, ALJs frequently fail to explain how the evidence supports the findings they make in disability hearing decisions. This is a violation of the Commissioner’s own policies and rules and, as a matter of law, is reversible error under applicable case law.

A common tactic of government lawyers representing the Commissioner is to argue that the ALJ decision should be affirmed because the evidence in the administrative record could have supported the ALJ’s findings. This is a harmless error argument.

The government lawyers ask the District Court to affirm an ALJ decision based on determining what the ALJ COULD HAVE DONE. But this exceeds the Court’s scope of review, which limits the District Court to reviewing what the ALJ ACTUALLY DID DO.

These arguments by government lawyers are post hoc rationalizations that attempt to provide belated justifications of the ALJ’s denial of a disability claim. Well-established case law prohibits the District Court from upholding a federal agency decision based on post hoc rationalizations.

Don’t let government lawyers get away with arguing un-challenged post hoc rationalizations. File a reply brief and demonstrate why the District Court cannot rely upon the government’s arguments. Seize the tactical advantage, scuttle the government’s arguments, and give yourself the best chance of winning your client’s case.

When Is A Motion For A Judgment On The Pleadings (Possibly) Not A Motion For A Judgment On The Pleadings?

When is a Motion for a Judgment on the Pleadings (possibly) not a Motion for a Judgment on the Pleadings? When it is filed in a Social Security Disability case in federal court. Why? Because a Motion for a Judgment on the Pleadings has no place in such a case. That is my opinion, at least. Let me explain.

Most people seeking Social Security Disability benefits have disability hearings before administrative law judges that work for the Social Security Administration. A person whose claim has been denied after a hearing, and who has exhausted his administrative appeal remedies, can seek court review of that denial.

Section 405(g) of the Social Security Act allows a person in this situation to file a civil action against the Commissioner of the Social Security Administration in United States District Court. It provides that the District Court “shall have the power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the Commissioner of Social Security….”

A civil action against the Commissioner of Social Security begins the way all civil actions begin. The Plaintiff files a complaint and a summons and complaint are served on the Defendant. The Defendant then files an answer. The rest of the proceedings, however, are different.

The Commissioner provides the Court with a transcript of the administrative record, which contains all of the evidence that was considered by the administrative law judge that denied the Plaintiff’s disability claim.

In the Middle District of North Carolina, the District Court issues an order directing the Plaintiff to “file a motion for a judgment reversing or modifying the decision of the Commissioner of Social Security, or remanding the cause for a rehearing,” along with a supporting brief. The Defendant is directed to “file a motion for a judgment affirming the decision of the Commissioner” with a supporting brief.

There usually is no hearing before the Court in the Middle District. The Court issues a judgment based on a review of the motions and briefs and a review of the evidence in the administrative record.

I always file a Motion to Reverse the Decision of the Commissioner of Social Security because that is the language used in the Court’s briefing order. The government attorneys that represent the Commissioner, however, normally file a Motion for a Judgment on the Pleadings.

Are the government attorneys filing a correct motion? I do not think so. Why? I have three reasons:

First, a Motion for a Judgment on the Pleadings is based only on the pleadings: the complaint, answer, etc. When ruling on such a motion, the Court must consider only the assertions made by the parties in the pleadings, without review of any evidence. There must be no genuine issue of material fact and the moving party must be entitled to judgment as a matter of law.

In a Social Security Disability case, however, the Court must consider evidence in the administrative record, which is beyond the scope of the factual matters asserted in the pleadings. Remember, section 405(g) of the Social Security Act directs the District Court to base its judgment on the both the pleadings AND the transcript of the administrative record. The Court is not authorized to issue a judgment based solely on the pleadings.

Second, there are often genuine issues of material fact in Social Security Disability cases. For example, I recently had a case that centered on the factual issue of whether the Plaintiff could use his congenitally deformed hand to grip. I argued that the medical evidence demonstrated that my client could not grip with his claw-like hand that is missing multiple fingers. The government attorneys argued the opposite. There was a genuine dispute regarding a material fact in this case.

Third, a Motion for a Judgment on the Pleadings is a pre-trial motion. The District Court in a Social Security Disability case, however, functions as an appellate court. It is charged with reviewing the evidence in the administrative record to determine whether the hearing decision of the administrative law judge is supported by substantial evidence and whether any legal errors were committed.

The District Court does not conduct a de novo review of the Plaintiff’s disability claim, so there is no trial. It customarily does not even hold a motion hearing in the Middle District. So the Court does not function as a trial court, despite the fact that the case originates as a civil action.

Why does the Middle District allow government attorneys to file Motions for a Judgment on the Pleadings in Social Security Disability cases? Maybe because there is a lack of uniformity in the way that United States District Courts in different judicial districts process Social Security Disability cases.

The Federal Rules of Civil Procedure do not address civil actions in Social Security Disability cases. Likewise, the Local Rules of Procedure for the Middle District, for example, do not set forth specific rules for these cases. A civil action in a Social Security Disability case is a hybrid combination of a civil action and an appellate case.

Courts in some districts allow Motions for a Judgment on the Pleadings, some require Motions for Summary Judgment, and some allow Motions for a Judgment Reversing the Decision of the Commissioner. Some District Court judges hold motion hearings. Most do not.

But as I have already stated, I do not believe that the Social Security Act allows a judgment on the pleadings and the District Court always considers evidence outside the pleadings before issuing a judgment. So is a Motion for a Judgment on the Pleadings filed by a government attorney really a Motion for a Judgment on the Pleadings?

Rule 12(d) of the Federal Rules of Civil Procedure provides that when a Motion for a Judgment on the Pleadings is filed and “matters outside the pleadings are presented to and not excluded by the court, the motion must be treated as one for summary judgment under Rule 56.”

Because the District Court bases its judgment in a Social Security Disability case on its review of the evidence in the administrative record, it effectively treats government Motions for a Judgment on the Pleadings as Motions for Summary Judgment.

I am not sure, however, that a Motion for Summary Judgment is appropriate in a Social Security Disability case either. Rule 56(a) of the Federal Rules of Civil Procedure provides that the Court shall grant summary judgment only if the moving party can show “that there is no genuine dispute as to any material fact.”

As we have seen, civil actions in Social Security Disability cases often involve disputes between the parties about material facts. But that’s a potential topic for another day.