If your application ("claim") for Social Security disability benefits has been denied after reconsideration review, you can request that an administrative law judge (ALJ) hold a hearing to determine whether you're disabled. You have your best chances of winning disability benefits at the hearing level—approval rates nearly double from those at the initial application stage.
Yes. An "on-the-record" (OTR) decision is a favorable ruling by a Social Security disability judge that's made without a hearing. OTR decisions are based on the written medical evidence that the judge reviews before a hearing—OTR is actually short for "on the (medical) records."
Anybody who appeals a disability denial to the hearing level can request an OTR review. (20 CFR §404.948.) But to get an OTR approval, you must have enough medical evidence for the judge to find that you're disabled without the need for hearing testimony. (A similar strategy is to request an attorney advisor opinion.)
Disability attorneys and their clients are usually thrilled when a judge issues an OTR decision. Having an OTR approval doesn't really have any downsides. Here are some reasons why getting an OTR can be to your advantage.
While having an OTR decision is a desirable outcome, judges have been issuing them much less frequently in recent years. Still, it's worth requesting an OTR review if you have exceptionally strong medical records. (See below for a discussion on what files to include with your request.)
Depending on the judge and the strength of your case, you might get an on-the-record decision within a few weeks (rarely) or several months (more common). You might find that your OTR is approved the week or even the day before your scheduled hearing, which can make the time-saving aspect of an OTR feel irrelevant. But because the judge won't need to collect more evidence or write the decision—which can add months to your wait—you'll still be able to start receiving disability benefits more quickly.
Requesting an OTR decision doesn't have any impact on your hearing date. The Social Security Administration (SSA) won't postpone your hearing if you ask for an on-the-record decision. If your OTR request isn't approved, you'll attend the hearing as scheduled.
After your application for disability benefits is denied at the reconsideration level, you have the right to request a hearing. You have 60 days from the date of your denial notice to file your hearing request, after which Social Security can review your claim "on the record." You might get an OTR review in one of two ways:
If you ask for an OTR decision from Social Security, you can help speed up the process by submitting your request at the best time. Typically, this is after your case has been assigned to an ALJ but before you've received a hearing notice.
Because the judge is the person who will decide your claim, it doesn't make much sense to request an OTR decision before you know who the ALJ is. And if you wait until your hearing has been scheduled, it might be too late for the judge's office to use your time slot for another hearing. (Keep in mind that OTR decisions are intended to increase efficiency by reducing the amount of time ALJs spend conducting hearings.)
You should submit a short "brief"—a summary of your medical evidence and argument for why you should be approved for disability—to the Office of Hearing Operations (OHO) that is handling your case.
Make sure you address your brief to the ALJ handling your case (for example, "Dear Judge Madrigal"). If you don't know the name of the judge, send it to the OHO office with the heading "To Whom It May Concern." Don't forget to put your name, birthdate, and Social Security number at the top of your brief.
Your procedural history is the legal timeline of your claim. In this section, you should focus on important dates relevant to your case, such as the date you filed your initial application, the date you filed your reconsideration request, the dates you received denial letters (both initially and on reconsideration), your alleged onset date, and your date last insured, if known.
You should also state the type of disability benefit you're applying for, whether it's Title II (Social Security Disability Insurance, or SSDI), Title XVI (Supplemental Security Income, or SSI), or both. If you aren't sure about dates or titles, ask your disability attorney or contact your OHO office to find out.
Your medical evidence is the cornerstone of your disability case. Social Security needs documentation that you fit the agency's definition of disability before you'll be awarded benefits, and most judges approve OTR requests only when the medical records overwhelmingly meet the definition. Therefore, the bulk of your brief should discuss your medical history, with specific references to the exhibits in your disability file when possible.
Draw the ALJ's attention to any objective evidence of your medical impairments, such as MRIs, lab tests, and physical exams. If your file doesn't contain many objective signs of your illness— especially if you're being treated for a mental health disorder—emphasize the long-standing nature of your symptoms and your consistent history of seeing a doctor for treatment. Mention all the methods you've used to manage your conditions (such as medications or counseling). Describe why the treatments are or aren't effective and any side effects you experience.
Consider asking your treating physician or psychologist to complete a residual functional capacity form to include with your OTR request. Your residual functional capacity (RFC) is a set of physical and mental restrictions that's a key factor in determining disability.
If your doctor thinks that your impairments cause functional limitations (like being unable to lift more than 10 pounds or follow simple instructions), point these out in your brief. Social Security finds doctors' opinions to be much more persuasive if they explain the basis for any limitations included on the form, so encourage your doctor to cite to any medical tests or imaging whenever possible.
Virtually every disability case contains some unfavorable evidence that could be used against the applicant. It's important to recognize "bad facts" in your case and tackle them head-on in your OTR brief. For example, if the medical evidence indicates past drug or alcohol abuse, you can say that you've been clean for several years or you can mention that you're enrolled in a recovery program.
Other "bad facts" you should address include:
Usually there's an innocent explanation for these bad facts, so use your OTR request as an opportunity to give your side of the story. Judges appreciate candor when it comes to difficult topics—and when you're honest about facts that don't paint you in the best light, it's more likely that the ALJ will trust your statements about other aspects of your disability claim.
You always have the right to represent yourself during the disability determination process. But because Social Security rules are complicated, having an experienced lawyer or non-attorney representative can be very helpful when requesting an on-the-record review. Consider some of the following benefits of hiring a legal professional to help you get an OTR approval.
In short, if you think your medical records are strong enough to win you an approval in an OTR review, it makes sense to talk to an attorney or disability advocate.
One of three things may happen after you or your representative requests an OTR decision:
Your disability claim can't be denied after an OTR review—only a judge can issue a denial, and only after a hearing.
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