What are Social Security acquiescence rulings?

Recently a bankruptcy attorney working at the Nicholson Law Center mentioned that she had been searching the internet for information about Social Security and had found an “acquiescence ruling.” Although the term “acquiesence ruling” is unfamiliar to many (if not most) Social Security recipients, they can sometimes have a significant impact on the process of applying for (and being approved or denied for) Social Security benefits. The following hypothetical example illustrates what an acquiescence ruling is, and the effect that a ruling could have on the policies and procedures of the Social Security Administration.

Imagine that Augustus “Gus” Hand is 45 years old and has worked continuously for the last 10 years at an auto parts factory near Dayton, Ohio. Gus has multiple sclerosis, and until recently, he had managed his condition and remained able to work as the result of certain therapies prescribed by his doctors. Over the last several months, Gus’s condition has grown worse and forced him to stop working.

Because Gus cannot return to his factory job, and because he is now physically unable to take any other gainful employment, Gus decides to apply for Social Security Disability Insurance (“SSDI”) benefits. In order to qualify for SSDI benefits, Gus must establish: (1) that he has been employed for at least five of the last ten years; (2) that he has paid FICA (“Federal Insurance Contributions Act”) taxes; and (3) that he is “disabled” as the Social Security Administration defines it. According to the applicable definition, Gus would be disabled if he is unable do the work that he used to do; if he is unable to adjust to other work as the result of his medical condition; and if his medical condition has lasted for a minimum of one year (or is expected to last for a minimum of one year).

Based on the Social Security Administration’s guidelines, Gus qualifies for SSDI because: (1) he was employed for all 10 of the last 10 years; (2) he was a full-time, regular employee, meaning that FICA taxes were automatically deducted from every paycheck he received; and (3) his medical condition qualifies as a disability under the rules of the Social Security Administration. Gus submits his application for SSDI benefits. He researched eligibility for SSDI before completing the application, so he fully expects that he will be approved to receive benefits.

Much to Gus’s surprise, however, his application is denied. Gus has the right to appeal the denial, however. Gus hires an attorney who focuses on Social Security law to represent him throughout the appeal process.

In Ohio, the first step in the SSDI appeal process is a review by the Bureau of Disability Determinations (“BDD”). BDD analyzes the medical documentation that Gus provided with his application and, in this case, instructs Gus to have an independent physical examination. In Gus’s case, BDD decides that the initial denial was correct. Gus decides to proceed with the next step, the “Reconsideration”.

In the second step, Gus and his attorney appear at a hearing before an administrative law judge. The administrative law judge is an employee of the Social Security Administration with detailed knowledge of the applicable laws and regulations. Gus’s attorney argues his case before the judge, explaining that Gus is entitled to receive SSDI benefits under the official guidelines. A representative of the Social Security Administration also appears at the hearing to argue in favor of BDD’s decision. As happens in many cases, the administrative law judge upholds the determination of BDD and denies Gus’s claim for benefits. Gus refuses to give up, however, and continues his appeal to the next step.

In the third step, Gus’s attorney submits a legal brief on Gus’s behalf to the Social Security Appeal Council. Likewise, the Social Security Administration submits a brief in support of the administrative law judge’s decision. The Appeal Council reviews the briefs submitted by both sides and issues an opinion upholding the administrative law judge’s decision.

At this point, Gus can accept the Appeal Council’s decision, or he can appeal to the U.S. District Court for the Southern District of Ohio, which is the federal trial court responsible for hearing cases in the part of Ohio where Gus lives. Gus decides to take his case to court.

In the U.S. District Court, Gus’s attorney argues Gus’s case to a federal judge. The attorney explains that the Social Security Administration’s own rules, along with applicable federal laws and regulations, indicate that Gus is entitled to SSDI benefits. A lawyer for the Social Security Administration also presents his case to the judge, arguing that the Appeal Council reached the correct decision. The federal judge rules in favor of the Social Security Administration, so Gus appeals his case to the U.S. Court of Appeals for the Sixth Circuit, which is the federal appeals court responsible for reviewing the decisions of a group of federal courts that includes the U.S. District Court for the Southern District of Ohio.

The proceedings in the Sixth Circuit Court of Appeals are similar to those in the District Court, except that a panel of three judges hears the arguments and issues a decision. Finally, Gus prevails, and the Sixth Circuit issues a decision stating that Gus is entitled to receive SSDI benefits. In its decision, the Sixth Circuit also makes a modification to one of the guidelines applicable to BDD’s evaluation of claims for SSDI benefits.

As the result of the outcome of Gus’s case before the Sixth Circuit Court of Appeals, the Social Security Administration sends instructions to BDD that explain what BDD must do in order to comply with the Sixth Circuit’s decision. Basically, these instructions are an “acquiescence ruling.”

Of course, very few SSDI appeals last as long as the example. Most applications for SSDI benefits are denied, and BDD only rarely overturns an initial denial. As a result, many appeals reach an administrative law judge. If your application for SSDI benefits has been denied and you want to exercise your legal right to appeal that denial, then talk with an attorney, like John T. Nicholson, who practices Social Security law.