3.5 Federal Court Review Flashcards

1
Q

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?

A

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.

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2
Q

Key Takeaways for Section 3

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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.

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