SSD Disability: Social Security Disability Request for a hearing before an administrative judge

The disability hearing is very different from any other step in the social security disability claim system. It is different in the respect that, for the first time since filing for disability, a claimant will actually get to meet the individual who is deciding the outcome of their claim. However, it is also different in several other regards. For example, though a claimant can obtain representation at any step of the process, the hearing, too, is the first opportunity for the representative (attorney or otherwise) to meet the decision-maker (who, in this case, would be a federal ALJ, or administrative law judge).

In being able to meet the disability judge, both the claimant and their representative have the opportunity to present new evidence (though, typically, this is submitted prior to the hearing), point out deficiencies in prior denials of the case at the initial claim and reconsideration levels, and argue the merits of the case (i.e. how the medical evidence warrants an approval of benefits based on the claimant's mental or physical limitations and the vocational factors that apply). For these reasons, among others, the hearing level represents the best chance, for those who have been previously denied, of being approved for social security disability or SSI.

And because this is true, a claimant who has been scheduled for a disability hearing or simply has a pending request for a hearing should ensure that their case receives the best possible preparation and development.

Here are a few answers to basic questions about social security hearings for disability benefits.

1) When can you file for a social security hearing? Though, statistically, the hearing represents the best chance of ultimately winning benefits after a disability application has been denied, a claimant is not allowed to immediately request a hearing after the initial denial. Instead, claimants are required to first file something known as a request for reconsideration. The reconsideration is the first appeal and the reconsideration process is no different than the disability application process. Reconsiderations, like disability applications, are handled by disability examiners who work in state disability processing agencies where disability claims are decided for the social security administration.

As with applications, reconsiderations involve gathering and reviewing medical evidence and rendering a decision based on social security rules and disability criteria. However, unlike disability applications, reconsiderations are denied at a significantly higher rate. Where approximately seventy percent of applications are denied, approximately eight-five percent of reconsiderations are denied. This fact makes the reconsideration appeal step seem rather useless to most claimants and attorneys. However, after a reconsideration has been denied, a claimant may file a request for a hearing before an administrative law judge.

2. What are the odds of success at a disability hearing? Actually, quite good. About half of all SSD and SSI disability claims that are brought before judges are approved. For those with representation, the percentage is even better, a little over sixty percent. Why are more cases won where attorneys and non-attorney representatives are involved? Typically, this is because disability representatives know how to prepare cases, in terms of gathering medical evidence, and know how to succesfully argue the merits of a case, based on knowledge of the federal disability system (including concepts such as substantial gainful activity, closed periods, unsuccessful work attempts, residual functional capacity, and the medical vocational grid, the rules of which determine many disability determinations).

3. Are you required to have an attorney for a disability hearing? No, and in fact, you, as a claimant are not required to have representation at any step of the process, from initial claim to reconsideration to disability hearing to appeals council, and even to federal court (a non-attorney cannot represent you in federal court, but you can represent yourself in federal court). Will you benefit from having a disability attorney at a hearing? Let's put it this way. Your case may be good enough to be allowed by a judge, regardless of whether or not you are represented. There are those cases, it's true, that are winners from the word go at the hearing level. But...most cases are won because judges are given what is needed to win a case---medical documentation and a solid argument that the case meets the social security definition of disability.

So, you're not required to have a representative, but if you want to enhance your chances of winning your claim, its not a bad idea to get one.

4. How long does it take to get a disability hearing? Depending on where you live and how bad the hearing backlogs are in your state, it may possibly take up to two years to get a hearing scheduled after the request has been made. For this reason, claimants who get denied should always file their appeals immediately. I.E. don't add any more time on to the process because the process is already long.

5. Where are disability hearings held? For the most part SSD and SSI disability hearings are held are hearing offices, as long as the hearing office is not so far away from where the claimant lives that it presents a hardship to the claimant to get there. However, there are instances in which a claimant cannot reasonably be expected to travel the necessary to get to a federal hearing office. In those cases, satellite offices are sometimes set up in areas closer to the claimant, such as a conference room at a local bank.

6. How do you prepare for a disability hearing? This is potentially a very long answer, but it can be boiled down to this: knowing why the case was denied on the prior decisions and then either presenting a rationale as to why those decisions were incorrect, or why the situation has changed, medically, since then.

Preparing for a disability hearing involves getting medical records, statements from doctors, and reviewing a claimant's work history to ascertain if they can go back to their past work, or do some form of other work. If they can do neither, they should meet the definition of disability used by SSA and be approved.

7. What is considered for a decision at a disability hearing? This is the shortest answer on this page: medical records (which include treatment notes, lab reports, admission and discharge summaries, and residual functional capacity) and vocational factors (which include a claimant's age, education, skills, and the types of work they did in the past).