Most individuals who file for either Social Security disability (SSDI) benefits or SSI disability benefits are denied on their initial application and will need to appeal. In most states, 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.
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.
The Social Security Administration (SSA) will not always 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, development of your case generally stops. That is, medical records are not likely to be gathered on your behalf and no additional review work is likely to be done. (The hearing office recently changed its name from the Office of Disability Adjudication and Review, or ODAR, to the Office of Hearings Operations, or OHO.)
If you are lucky, a staff attorney at the hearing office 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 a hearing officer will initiate an on the record review.
If you are unlucky, on the day the hearing is set for, you will appear before the judge, but your medical records will no longer be current enough for a judge to use to approve disability benefits for you.
As soon as you receive a Notice of Hearing telling you the date on which your hearing has been scheduled, you should request your most recent records from all of your medical providers. The hearing office is required to give you 75 day notice prior to the hearing. (In the past, the hearing office was obligated to give you just 20 days' advance notice. )This should be enough time to see your doctor and obtain up-to-date medical records, or even have new testing done, if required.
Once you receive your updated medical records, you should keep a copy for yourself and submit copies of these records to the hearing office.
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, in some states, medical providers are allowed to charge you for copying costs).
An important piece of medical evidence is your doctor's opinion. So to prepare for your disability hearing, it's imperative that you get an up-to-date supportive statement from your doctor. To be effective, your doctor should write a detailed letter (called a medical source statement) explaining exactly what work activities you cannot do (for instance, being unable to sit or stand longer than 20 minutes or being unable to lift more than 20 lbs frequently); these are called your functional limitations. It is then up to the SSA to decide whether there are any jobs that you can do despite your functional limitations. If your doctor prefers, rather than writing a letter, you can ask your doctor to fill out an RFC form like the SSA uses.
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.
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 prepare for appeal.)
Note that if the medical records requested by you or your lawyer have not arrived by the time of a hearing, a judge will usually acquiesce to "holding the record open" to allow for the receipt of these records.
If you are represented by a disability attorney, your lawyer should request and submit your most recent medical records and medical source statements. Your lawyer will also prepare 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.)