This blog post is designed to highlight the times in which it is possible to appeal a favorable decision and the risks associated with such an appeal. It is not uncommon for a judge to change an onset date or refuse to open a prior case when issuing an approval decision. These decisions are typically called “partially favorable” decisions; as they technically approve the claimant for disability, but some part of the onset date has been altered. This alteration usually takes the form of a change in onset dates, which reduces or may even eliminate the amount of owed backpay.
When you receive such a partially favorable disability decision it is common to wish to appeal. Such a decision, however, comes with great risk. Namely, upon appeal an appellate judge may decide that the administrative law judge actually made a mistake in approving the claimant in the first place and reverse the decision to a denial. Thus, the major risk associated with appealing a partially favorable disability decision is the potential for a complete loss of benefits and denial on your case. This outcome is not at all uncommon; and it is why we recommend proceeding with this decision with extreme caution.
The second potential risk associated with appealing a partially favorable decision is that the appellate judge may decide medical experts or providers do not have credibility. When this occurs, the onset date may be further amended to a future date in time; and you may continue with benefits, but lose even more backpay than you had the first time around.
While there always exists some degree of risk associated with appealing a partially favorable claim, some instances possess less risk than others. For example, if you were found disabled as a result of meeting or equaling a listing it is much more unlikely that your partially favorable appeal will result in a loss of benefits. The second situation is when a claimant is found disabled in accordance with the GRID rules. A chief administrative law judge once said, “if you grid you grid.”
To conclude, the appeal of a partially favorable decision, while it might appear to be a good decision, is a very high risk decision to make. We highly recommend that you speak with one of our representatives at Mission Possible to discuss the likelihood of prevailing on an appeal, and the potential risks associated with such an appeal.
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