3.5 Federal Court Review Flashcards
Case Scenario: Carlos exhausts all administrative appeals, including Appeals Council review, and decides to file a lawsuit in federal court. He files the complaint 90 days after receiving the Appeals Council denial.
Question: Is Carlos’s lawsuit timely?
Answer: No, Carlos’s lawsuit is not timely because the deadline for filing in federal court is 60 days from the date of receiving the Appeals Council denial.
Legal Explanation: Under 42 U.S.C. §405(g), claimants have 60 days from the presumed receipt of the Appeals Council’s decision to file a complaint in federal court. Missing this deadline typically results in dismissal unless good cause can be shown.
Key Takeaways for Section 3
Levels of Appeal:
Reconsideration.
ALJ hearing.
Appeals Council review.
Federal court review.
Filing Deadlines:
60 days from notice receipt for each appeal stage.
Hearing Procedures:
ALJs can issue OTR decisions or conduct hearings with testimony from claimants, medical experts, and vocational experts.
Representative Fee Cap (2025):
25% of past-due benefits or $7,200, whichever is less.