Tips for Claimants Going to an SSD Hearing

Nationwide, only about 30% of all initial disability applications are approved, which means that an average of 70% of those applying for disability will be faced with a tough decision: Give up, file a new claim, or appeal the decision.

The first option, giving up, isn’t really an option, although unfortunately many applicants choose to go this route. It isn’t a worthwhile option because most people who file for disability are doing so because they are no longer able to earn a living wage, and their medical condition isn’t getting any better. Sooner or later, most disabled people will have to have some sort of financial help, so giving up is no long-term solution.

Unless you have some strong new medical evidence the second option, filing a new claim, isn’t a great idea either—filing the exact same claim with the exact same agency isn’t likely to be a success. An exception to this rule, however, might be if you were given a technical denial, perhaps because you made too much money at the time you filed to be eligible for benefits. In such a case, your medical records would not even have been evaluated.

The third option, appealing your denial, is really the best chance you have of "overturning" a disability examiner’s unfavorable decision. However, be prepared for the fact that your first appeal, the request for reconsideration, is also likely to be turned down. This is arguably due to the fact that the same agency that turned down your initial claim, the state disability determination services (DDS) agency, will be in charge of deciding your reconsideration appeal. State disability examiners rarely overturn denials, and in fact only about 15% of all first appeals are successful.

However, the reconsideration appeal is an important step in the process of winning disability benefits because even if you lose you gain something important: The opportunity to have your case heard before a federal administrative law judge (ALJ), who is not employed by DDS. Regardless of if you are eligible for social security disability (SSD) or supplemental security income (SSI), or both, your best chance of being approved for benefits, if you were denied previously, is at the hearing level.

During a disability hearing you have the opportunity to present your case and to answer any questions the judge may have regarding your medical impairment and how it affects your ability to work. It is typically the only time throughout the entire disability determination process in which you can meet the individual who will decide your case face-to-face. Disability examiners do not meet with claimants in person, and make their decisions based solely on medical information in your file.

ALJs also provide the claimant with an advantage in that, unlike state disability examiners, they give consideration to the opinion of the claimant’s treating physician, particularly if that physician has submitted an RFC form for consideration. An RFC form details the claimant’s residual functional capacity, or what activities/actions they are, or are not, capable of performing in light of their impairment.

The primary drawback to the social security disability hearing is that it can take so long to be scheduled for one. However, the good news is that more than half of all disability hearings are won by claimants who were previously denied benefits by DDS (about 40% of all disability hearings are decided in favor of the claimant when he represents himself; 60% if the claimant is represented by an attorney).

These are good odds. However, winning an appeal before a judge is not a given - a considerable number of those who go before an administrative law judge are unsuccessful in their bid for benefits. Here 's what you can do to help ensure that your case is ready to be heard.

1. This advice may seem trivial, however so many disability claimants do not plan for reliable transportation or even bother to make sure they know when and where their disability hearing is being held. Whether you are representing yourself or you have a representative, you should be on time for your hearing. Remember, the administrative law judge is forming an opinion of you from the moment you arrive at your hearing. Also, administrative law judges work on a schedule, consequently you may be to late to have your hearing. If you have to reschedule your disability hearing you may be adding months to the overall processing time for you disability claim. Which, of course, means that you will be waiting longer for disability benefits.

2. If you plan to represent yourself at your administrative law judge hearing, you should review your disability claim file in advance of your hearing. You can do this by requesting your disability file either on CD or if there is a paper disability folder available for your disability claim you can review it at your local office (if you plan on reviewing your disability paper file, you need to call your local office and make an appointment to see your file). Once you have your disability file be prepared to answer any questions the administrative judge might ask you with regard to your disabling condition or your work history. For instance, you should be prepared to answer questions about the limitations imposed upon you by your disabling condition or conditions and how they have prevented you from performing normal activities of daily life (including work).

3. If you are representing yourself, you should be sure that you understand why your previous application and appeal for disability benefits were denied by DDS. This means taking the time to review your disability case file in depth, so that you can form a proper rebuttal to the disability examiner's determination that you are still able to perform gainful work activity in spite of your disabling condition or conditions. This may be difficult as there are many things that help an examiner make their decision, which may not be easily understood by an average person, who is not familiar with Social Security disability regulations.

For example, there are medical vocational guidelines that may rule out an individual from performing their past work (meaning that an individual is unable to perform any of the work they performed in the past), however these same rules may indicate that an individual is able to perform other types of work. Consequently, the individual would be denied on the basis of the ability to do other work.

4. After waiting one or more years for a disability hearing and a chance to speak to an administrative judge, do not sabotage your future by failing to do everything within your power to be prepared for you hearing. Approximately two thirds of all disability claimants who reach an administrative law judge hearing are approved for disability, and according to current statistics your chances of winning disability benefits are improved by at least twenty percent if you have proper representation. Generally, it takes a good lawyer or representative who is familiar with all Social Security disability regulations and guidelines to challenge a denial by DDS. And it could mean the difference between winning and losing your social security disability benefits.

After waiting one or more years for the chance to speak with an ALJ, do not sabotage your future by failing to do everything within your power to plan for your disability hearing.

Social security disability benefits
social security disability benefits