Most individuals who file for either Social Security disability (SSD) benefits or SSI disability benefits will be denied on their initial application and will need to appeal. It takes two levels of appeal to get to a disability hearing in front of a judge, and often it can take up to a year or more to get your hearing date. After waiting so long to get an ALJ hearing, you'll want to be well prepared for your day in court.
What are the three most important things you need to win disability benefits at your hearing? Medical evidence, medical evidence, medical evidence.
Gather Up-To-Date Medical Records
The most important aspect of hearing preparation is to gather additional medical records, to ensure that when your hearing date arrives, your most recent medical records are in the file and a giant gap doesn't exist in your medical documentation.
In most instances, the Social Security Administration (SSA) will not gather additional medical records on your behalf before your hearing. While the initial claims examiner will get up-to-date records when he or she first evaluates your claim, when your case file is transferred to the hearing office (the Office of Disability Adjudication and Review, or ODAR), all "case development" will typically stop. That is, no records will be gathered on your behalf and no additional review work will be done. And your case will usually sit and wait for many months before it is actually assigned to a judge and then scheduled for a hearing. On the day the hearing is set for, you will appear before the judge, who will decide your claim based on the medical evidence contained in your file. But after all the time it took for your hearing date to be scheduled, your medical records will no longer be current enough for a judge to use to approve disability benefits for you.
If you are lucky, an ODAR staff attorney might review your file and decide to develop the case further (that is, get additional medical records). While this does not happen very often, it could happen if your case is selected for an "on the record review." You can request an on the record review, or sometimes an ODAR hearing officer initiates an on the record review.
How to Get Updated Medical Records
As soon as you become aware that your hearing has been scheduled, you should request your most recent records from all of your medical providers. (ODAR is obligated to give you at least 20 days advance notice, but will often give you at least 30 days notice prior to your hearing.) Once you receive these records, you should keep a copy for yourself and submit copies of these records to ODAR.
To avoid duplication, don't request ALL of your medical records. Instead, take the opportunity to review your disability case file (you are allowed to do this) and find out where the Social Security Administration left off; that is, get the dates of the last records the agency has. By doing this, you can significantly narrow the time-frame for the records you need to request yourself (which might significantly reduce your costs, since many medical providers will charge you for copying costs).
Get a Statement from Your Doctor
An important piece of medical evidence is your doctor's opinion. So to prepare for your disability hearing, it's imperative that you get supportive statements from the doctors who have treated you in the past. What is an effective supportive statement? Not a short letter that states "my patient is severely disabled and unable to work." To be effective, your doctor should write a detailed letter (called a medical source statement) explaining exactly what work activities you cannot do (that is, your functional limitations, such as being unable to sit or stand longer than 20 minutes, unable to lift more than 20 lbs. frequently, and so on). It is then up to the SSA to decide whether are any jobs that you can do. Better yet, rather than writing a letter, ask your doctor to fill out an RFC form like the SSA uses; see our RFC Download Page for a sheet to bring your doctor.
You can also ask relatives, caregivers, and former employers to write letters for you pointing out your limitations. For more information, see our article on letters from family and friends.
Review Your Case File
You are allowed to request your entire case file from Social Security before you go to your hearing. You should take advantage of this and review the file to see if there were missing medical records or mistakes in the claims examiner's reasons for denying you benefits. Reviewing your file, especially the technical rationale, will also help you prepare arguments as to why Social Security was wrong in denying you benefits. For more information, see our article on reviewing your Social Security file to preare for appeal and our series of articles on advanced strategies for winning at disability hearings.
When You Have an Attorney
If you are represented by a disability attorney, you should have to do little more than simply arrive at a scheduled hearing date, because your lawyer should have already requested and submitted your most recent medical records and medical source statements and prepared you for questioning by the ALJ. (If you aren't represented by an attorney, read our article on how a disability lawyer can improve your chances of winning an appeal.)
Either way, it always helps to know what to expect at the hearing. For more information, read our article on what happens at a disability hearing.