Social Security Disability Appeal Process
Step 3: Appeal Hearing In Front Of ALJ
If an applicant puts in a request for reconsideration and is denied again, they have the option to appeal in front of a judge at a hearing. Applicants have 60 days to file a request for an appeals hearing after they receive the reconsideration denial letter. If one does not file a request for a hearing within the given time frame, they will need to start the application process over from the beginning. This stage represents the claimant’s best chance to obtaining disability benefits. Once the request for a hearing is filed it can take up to one year to receive a hearing date. This is due to the backlog of applications and is why completing the initial application correctly is crucial.
Your disability hearing will be heard by an administrative law judge (ALJ). Administrative law judges resolve disputes between government agencies and people affected by the decisions of those agencies in court. In other words, the decision for an applicant to be approved for disability benefits is no longer in the hands of the SSA and is up to the ALJ assigned to the case.
Before the hearing, the ALJ will review the current evidence provided and prepare for the case. During the hearing process the claimant and potential representation will have the opportunity to explain how the claimant’s residual functional capacity inhibits them from working and engaging in substantial gainful activity (SGA). The ALJ will review any additional updated evidence that is brought before them.
Once the disability hearing has concluded and the Judge has reviewed all evidence, a determination on the claim will be rendered but not stated during the proceedings. This determination will be sent via mail to the claimant and can take up to three months to receive.
A vocational expert (VE) is a professional who is contacted with the SSA to testify at your appeals hearing to determine your ability to perform any type of work and will calculate which jobs (if any) in the labor market you are capable of handling. A vocational expert has large influence over the outcome of your disability case and is highly knowledgeable about the current labor market and the skills needed to carry out particular jobs.
The ALJ primarily needs to know two things:
- Are you capable of performing any job you had in the past 15 years?
- Are you able to transfer your current skills to another job in the labor market?
The vocational expert will evaluate your disabling condition and will determine if your condition prevents you from working a previous job you had in the last 15 years and from transferring your skills to another occupation. If the vocational expert deems you are incapable of both factors, more than likely you’ll be awarded disability benefits. However, if the vocation expert states you are capable of performing some kind of work, you’ll probably be denied benefits unless you or your representation can argue otherwise.
After the vocational expert makes his or her statement, you or your attorney will have the chance to cross-examine the vocational expert. This is when having a qualified, experienced disability advocate or attorney becomes extremely beneficial. Your disability advocate or attorney will attempt to counter the vocational expert’s claim that you are capable of performing said jobs by asking hypotheticals based on your medical documentation. These hypotheticals are meant to convince the vocational expert that you are truly unable to perform any job. Attempting to cross-examine the vocational expert by yourself without representation is quite difficult and rarely results in an approval. If you would like experienced representation at your appeals hearing, feel free to contact the Disability Care Center.
Witnesses at your Disability Hearing
You are allowed to have witnesses testify for your disabling condition at your hearing. These witnesses generally include family members, employers, caretakers, doctors, and medical specialist. Final case decisions are typically based on medical documentation and doctor recommendations so it is best to choose individuals who are most familiar with your condition.
You should bring no more than 2-3 witnesses if you feel they can help your case and have knowledge about the limitations caused by your condition. Too many witnesses can overwhelm the ALJ and may lead to evidence being repeated.
It is extremely important your witnesses are knowledgeable about your condition. The witnesses will not be present when the ALJ first questions you and if your witness says something different or contradictory to what you said, it may negatively affect your chances for approval. Although it is unusual for your main treating doctor to show up as a witness, it’s definitely possible and can significantly improve your chances. The law gives your main treating doctor “controlling weight” or the most influence over the final decision to award you benefits. Otherwise if your doctor can’t show up, have him or her write a recommendation stating that your condition prevents you from achieving SGA and then ask a physician, medical specialist, and/or caretaker who has first hand experience with your condition to be a witness at your hearing.
Chances of Approval
When you file an appeal with the Social Security Administration (SSA), you will have around a 50% chance of being awarded disability benefits. You can increase your chances of approval with the same methods used in the reconsideration stage.
Make sure your provide your hearings office with any new or updated documentation regarding your disability condition. This is extremely important in the appeals stage since your hearing can be scheduled up to a year in advance. Conditions can worsen or improve within that time span and it is necessary to document these changes for the hearing.
The other way to increase your chances of approval is to seek out qualified representation. Having a qualified disability advocate or attorney represent you at your disability hearing can improve your chances by almost 20%.
Do I need representation?
While it is not necessary to have representation during the appeals hearing, it can significantly improve your chances for approval. A qualified disability advocate can:
- Ensure the hearing is properly held and completed
- Gather all required, updated medical documentation
- Ensure the necessary questions are asked
- Help prepare your witnesses and yourself for the hearing
- Use of personal knowledge of the ALJ
- Argue on-set of disability for a larger back-due benefits check
- Cross-examine the vocational expert
How long will the hearing process take?
When you file a request for an appeals hearing, it can take up to one year to receive a hearing date. This is due to the backlog of applications and is why completing the initial application correctly is crucial. After the hearing, it can take another 6 weeks to 4 months before you receive a decision from the judge. Although this stage requires more waiting time than the previous stages, you have a much greater chance of approval for disability benefits during the appeals hearing.