When an administrative law judge (ALJ) makes a favorable disability or blindness decision on a case, the Appeals council (AC) may decide on its own motion to review the decision or reopen the decision. It may do this because an office protests the ALJ's decision to the AC, or because quality assurance sampling of ALJ decisions causes the AC to question the ALJ's decision. When the AC decides to review or reopen a decision, the claimant receives a notice that tells them about the favorable ALJ decision, that the decision is being reviewed or reopened, and that benefits will be delayed while the case is under AC review or reopening. The notice also tells the claimant that there is a limit to how long benefits can be delayed.
Section 1631(a)(8) of the Social Security Act (the Act) requires the Social Security Administration (SSA) to pay prospective monthly Federal benefits to the claimant if the Commissioner of SSA (Commissioner) has not made a final decision within 110 calendar days after the date of the ALJ decision. These “interim benefits” start with the month in which the 110th day falls , and end with the month in which the final decision is made. The law also provides that any interim benefits paid will not be considered overpayments, unless fraudulently obtained. These requirements apply to both Title II and Supplemental Security Income (SSI). Both Title II and SSI can be paid as interim benefits. For SSI, only Federal SSI money is paid as interim benefits. Federally administered state supplementary payments are not paid as interim benefits.