STAGE FOUR
- Sometime after a hearing (usually a period of weeks or months), the ALJ issues a decision on the disability claim.
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If the decision is an approval, the claimant receives two letters:
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First, a Notice of Decision letter from the judge (at the Office of Hearings and Appeals)
- Second, a Notice of Award from the social security office.
- In the case of approvals, the Notice of Decision letter may be fully favorable or partially favorable. In either case, an approval of the Disability claim has been made. The difference has to do with the onset date, or when the disability is decided to have begun (referred to as the Date of Onset).
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The Date of Onset is very important since it determines how much in past due benefits, or back pay, a claimant may receive. Depending on the date of onset, a person could receive several hundred dollars in social security back pay, or several thousand.
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This onset issue is also a good reason to have representation. A knowledgeable and experienced Claimant's Representative can argue for the most favorable onset date possible based on the medical evidence. Obviously, this can have a huge financial impact on the disposition of a case as well as on a Claimant's life.
- While the Notice of Decision is a decisional letter, the Notice of Award sent from the social security office discusses benefit amounts: how much the claimant will receive in monthly benefits, how much the claimant is owed in back pay benefits, and when those benefits will commence (though, whenever Social Security tells you your benefits will begin, take this with a grain of salt. Their forecasts are seldom very accurate).
- If, however, the disability case is denied at the hearing level, the letter received from the ALJ will be titled Notice of Decision--Unfavorable.
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Social Security Disability claims that are denied by ALJs may be appealed to the APPEALS COUNCIL, a body that reviews the denials of ALJ's. Such appeals are often an uphill battle, though, since percentage-wise, few ALJ denials on Disability cases are overturned. Not surprisingly, it is at this point that some Representatives will advise a Claimant to start over with a brand new claim.
- However, Claimants with strong cases can be confident since it is at the ALJ hearing level that a claim for disability benefits has the very best chance of winning.
*Nationally, more than half of all that are heard by Administrative Law Judges are approved AND many Qualified disability Representatives win monthly benefits and backpay for 80-90 percent of their claimants, making representation a useful option.
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