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Medicare: Do You Know All You Should?

Appeals - Step Three: Appeals Council Review

This is one of the last steps of your appeal. It is a last resort and involves a review of only the documents and other papers in your file. Usually this includes a review of the transcript of your hearing before the judge, along with any witness testimony who appeared before the judge.

If you discover that your file does not have certain information which would be helpful, you should review Step One which discusses how to think about providing certain information to the judge. It is critical that all information which is helpful to your case be in your file, including all relevant records, transcripts of testimony taken before the Administrative Law Judge, and any exhibits given to the Administrative Law Judge. All of these should be present so that this Council can review your case. Remember that there is no hearing or opportunity to appear before them in most instances. As a result, it is extremely unlikely that your decision by the Administrative Law Judge will be overturned. In fact, because of the necessity of preserving your earlier record, you may wish to present your case to an attorney, even before the Administrative Law Judge to make sure everything is done properly.

Finally, you can always investigate your rights concerning a lawsuit with a lawyer if you are still not satisfied. Most lawsuits in administrative matters require that you "exhaust your administrative remedies" before you file a lawsuit. This means that you must have carefully followed all of the administrative procedures, even if you did not think they were fair or right, in pursuing your claim. Your attorney can further discuss this with you.

Medicare: Do You Know All You Should?
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