Request an Attorney Advisor Opinion to Speed Up Your Social Security Disability Appeal

If your case qualifies, you can request that an attorney advisor look at your records and make a decision on your benefits before your hearing takes place.

The disability process is long and can sometimes two years or more for the Social Security Administration (SSA) to make a final decision in your case. Fortunately, depending on the facts of your case, you may be able to get a decision faster by asking that an "attorney advisor" make a decision instead of an administrative law judge (ALJ).

Requirements for Attorney Advisor Pre-Hearing Decisions

In order to speed up the decision-making process, the SSA allows an attorney advisor employed by the SSA to approve certain disability claims prior to the hearing date. In order to have an attorney advisor review your claim, you must have filed a request for a hearing after being denied disability benefits. Also, the SSA requires one of the following reasons for asking an attorney advisor to review your case.

  • You submitted new evidence (since your last denial) that is material to your claim.
  • You prove that there is new evidence available to help your claim (if not submitted already).
  • There has been a change in the law or regulation that may help you win your claim, or
  • There was a mistake made in your file or there is some other evidence that a fully favorable decision can be made.

Here are some examples of situations where it may be appropriate to send a claim to an attorney advisor for review.

  • A disability claimant submitted new evidence, or has new evidence available, that shows the claimant may meet an impairment listing (meeting a listing will result in an automatic approval).
  • A claimant's condition was diagnosed as one that qualifies for a compassionate allowance after the application was denied (the diagnosis must be related to the basis of the original claim).
  • The claims examiner neglected to consider material evidence such as MRIs, x-rays, or lab results that would help the claimant meet or equal a listing.
  • A field rep or examiner erroneously concluded that a claimant doesn't meet the non-medical eligibility requirements for SSI or SSDI.
  • It is clear from the evidence in your file that you will be approved based on the SSA's medical vocational grid rules or special medical-vocational profiles.

For example, in one case, an older claimant with only limited education had worked for more than 35 years as a laborer but could no longer do his work due to a head injury. This should have resulted in an automatic approval based on the "worn out worker" rule, but the SSA failed to consider the rule and denied the claim. An attorney advisor issued a fully favorable decision.

Pre-hearing Review Procedure

The attorney advisor may request more medical evidence if it is needed or schedule a conference with you in order to get more information, if the decision is likely to be favorable. Once the attorney advisor has reviewed the new information in conjunction with the other evidence in your file, he or she may issue a favorable decision.

What Happens If Your Claims Is Fully Approved By An Attorney Advisor

If the attorney advisor decides to issue a fully favorable decision in your case, which means you will be granted disability going back to the date that you claim your disability began, the attorney advisor will send you and your attorney a letter that explains the basis for the decision. (For more information, see our article on the difference between fully favorable and partially favorable decisions.)

If, for some reason, you still want to have a hearing in front of an ALJ, you must send a letter within 60 days of receiving the attorney advisor's decision; otherwise, your hearing request will be dismissed. However, keep in mind that if you want to go ahead with your hearing in front of the ALJ, he or she can overrule the attorney advisor's fully favorable decision and deny all or part of your claim.

What Happens if the Attorney Advisor Cannot Approve Your Claim

If the attorney advisor cannot issue a favorable decision in your case, it will proceed to the hearing in front of an ALJ as scheduled.

Recently, the SSA has stated that attorney advisors can only fully approve disability claims that 1) a new National Screening Unit has selected as appropriate for the attorney advisor program, and 2) meet or equal a listing or fall under a grid rule or special medical-vocational profile. Otherwise an attorney advisor can only refer a case to an administrative law judge for an on-the-record review (see below) or aid the ALJ pre- or post-hearing.

What Happens If Your Claim Is Partially Approved By An Attorney Advisor

If the attorney advisor decides to issue a partially favorable decision in your case (meaning you are granted benefits, but starting at a later date than you claimed your disability started), the procedure changes. Your hearing in front of the ALJ will go ahead as scheduled, unless you advise the SSA, in writing, that you want to accept the attorney advisor's decision and that you wish to withdraw your request for a hearing. Also, the SSA will continue to review your claim until the hearing date to see if a different decision can be made.

Sometimes it's in a claimant's best interest to accept the partially favorable decision instead of risking that an ALJ will deny the claim altogether. An example of this is when there is not enough medical evidence to approve a claimant based on an onset date before the initial application date. You should speak to an experienced disability attorney to decide the best way to handle a partially favorable decision.

Getting Legal Help

If you think your claim falls into one of the above scenarios where it makes sense to request an attorney advisor opinion, you may want to consult with an experienced disability attorney to see if a requesting an attorney advisor opinion can help you get approved more quickly.

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