Filing a claim for disability benefits is hard enough! Worse yet, in most cases, your initial claim gets (or will get) denied. By the point of your disability claim denial, several months will have likely already passed, so getting that denial notice can be both emotionally discouraging and financially devastating. If you’re in this situation now, or fear that you will be, don’t give up yet, though. You will still have options. And while 70% are denied at the initial level, those that stick with their claim are >75% to eventually be awarded.
Probably the first and most important thing you need to remember is that if you are denied you disability claim, you have 60 days to file an appeal after receiving your notice.
If you take one piece of advice from this step by step guide to the disability appeal process, please make it this. Get your appeal in asap. Do not lose your disability claim simply by not getting paperwork processed. There are many pieces of the disability appeal process to get right, as your options for further actions afterward only get more limited, don’t risk having to start from the beginning again.
The goal of this guide is to help you understand the disability hearing from the moment you decide to appeal to the moment you get a decision from the ALJ (social security judge). Your two greatest weapons in this disability appeal fight will be knowledge and someone to help you along the way – likely a social security attorney.
Here are the things you need to know about disability hearings: before, during, and after.
If You Don’t Show Up for Your Disability Hearing, You May Be Killing Your Claim
The first step in preparing for your disability appeal hearing is actually showing up for it. This may seem obvious, but it’s one of the most essential aspects of the process. You need to attend your own hearing. You won’t be legally punished for missing your hearing, but you can lose out on your chance to get the benefits you need, and you may have to start the entire process over from the beginning by filing a claim that you know has already been denied once.
If you can’t show up for your hearing, there are essentially two things that can happen. You can allow a representative to go in your stead or have the hearing attorney represent you. This can work, but it often leaves out an essential aspect of your case, which is your own testimony. Alternatively, the judge may issue an Order to Show Cause. This is an order in which you must write out a detailed explanation of why you missed the hearing and submit it to the judge. Should the judge deem your explanation valid, the hearing will simply be rescheduled to a later date. If your explanation doesn’t cut it, however, your case could be dismissed.
Your Disability Appeal Needs to Include Medical Records
Aside from actually showing up, medical records are likely the most important aspect of your case when it comes to disability benefits. Your medical records are the key piece of evidence that shows that your disability is making it impossible for you to work the job you’re used to or make enough for a living. That’s why it’s essential that you keep your medical records up to date with your case. While the Social Security Administration will always check your medical records themselves, the timing of this is essential.
The Social Security Administration checks your medical records via the initial claims examiner. The records aren’t really updated all that much afterward. That means that if you prepare nothing, your entire case will depend on your medical records from the time of your initial claim. Given the slow process of getting disability benefits, the records they’ll have on file for you will be out of date by the time you actually appear before a judge. With such limited information, the judge is less likely to rule in your favor and get you the benefits you need. After all, you’ll want to get disability benefits that are ongoing rather than only for a select period of time.
How Long It Will Take to Get Your Updated Medical Records for Your Disability Hearing
Having your updated medical records in hand by the time of your hearing requires a bit of timing. In most cases, you should receive a notice of your hearing date at least 75 days in advance. That’s the legal policy the hearing office is required to abide by. Once you receive that notice, it’s time to request updated medical records from your medical provider or providers if you have more than one. Don’t forget to make copies for yourself just in case anything happens to the ones you submit.
The reason you’re making this request at this point is that you have time to ensure that you have the most up-to-daterecords (and the records reflect your current impairments) when your hearing comes around. Requesting only the records you need will speed up the process significantly, ensuring that you get the records on time. The best way to make sure you’re getting the records you need is to look at your disability case file. These files are freely accessible to the person who filed the claim, so you can see exactly where the SSA left off with your case. Simply request records for all the developments after the date they left off. Depending on what state you’re in, this could also save you a bit of money, as some health care providers can charge for how many pages it takes.
Social Security Attorneys typically handle this records strategy and process.
Get Your Doctor’s Testimony Regarding Your Disabilities and Your Case for SSDI or SSI
Testimony from your doctor can be massively beneficial for your case. While the doctor doesn’t have to show up to the hearing, they can prepare a statement to be presented to the administrative law judge. Keep in mind that this statement isn’t literally a single-sentence statement. Most often, this testimony comes in the form of a detailed letter to be submitted as key evidence during the hearing process.
The doctor’s statement shouldn’t merely describe the condition of your disability, but rather how it specifically impacts your ability to perform physical tasks. For example, if your disability prevents you from being able to lift more than 30 pounds at regular intervals, that should be explicitly stated in the letter. Restrictions like this are known as functional limitations. Not only can these be used to demonstrate that you’re incapable of properly performing your old job, but they can help when the Social Security Administration tries to determine whether or not there are any other jobs you could be doing instead.
Keep in mind that the doctor’s testimony doesn’t have to be presented on its own. While their authority is going to have the most sway with the judge, it never hurts to have some extra ammunition for your case. Consider getting letters from any friends and family as well that detail the limitations caused by your disability. They obviously won’t have the same medical jargon, but people close to you can describe in great detail how you’ve changed since the onset of the disability. Don’t forget to consider getting a letter from your employer as well, as their testimony tends to hold some significant weight.
How to Look Over Your Disability Case File
While you can look at your own case file to see where your medical records left off, that’s just the beginning. Before you move forward with the hearing, you should take a look at your entire case file to see if there’s any missing information anywhere. You’ll want to fill in all the blanks for the judge to ensure that you get the best ruling at the end of the appeal process. After all, if the judge doesn’t have any evidence demonstrating the ongoing nature of your condition, they’ll be less likely to rule in your favor.
There are a few key aspects of your case file you should look out for. The first is any missing medical records. All medical records that demonstrate the seriousness of your disability and how it prevents proper function allowing you to do your job are essential for your case. Second is any potential mistakes made by the claims examiner. Take a look at their reasoning for denying your claim, and see if it holds up to scrutiny. Often, finding out where they found missing pieces in your case is the clear spot to add more supplemental evidence.
Remember, your job at the hearing is to argue that the Social Security Administration was wrong to initially deny your claim for benefits. While you’ll need to be able to argue every aspect of your case, you’ll need to hone-in on the parts that the initial examiner felt were lacking. It can be useful to create a bit of a cheat sheet before the hearing with all the notes you’ll need about how to phrase your responses.
Hire a Lawyer to Fight for Your Disability Case in Court
Arguably the best thing you can do in preparation for a hearing is to hire a lawyer. Claimants with a lawyer on their side statistically have a far better chance of getting a favorable ruling than those without any expert representation. Keep in mind that the lawyer doesn’t solely exist just to make sure you get through the actual hearing and make arguments on your behalf. They’ll work with you throughout the entire preparation process to ensure that you have a solid case before the date of your hearing arrives.
One of the biggest obstacles to people hiring lawyers is the perceived cost. After all, claimants are trying to get disability benefits, meaning they don’t exactly have a wealthy estate to fall back on. Fortunately, reputable disability lawyers don’t charge unless they win your case. Even then, they can only charge a percentage of your back pay. For the most part, that percentage is around 25 percent, and it is capped at $6,000 in the majority of cases. Better still, this fee comes out of your award, so you’re likely to never have to write a personal check for this representation.
There is one more point to make on this, and it’s not always true. But the question may arise – that if you’re able to navigate yourself through this complex process, successfully, why are you unable to earn a living by doing it for others? There are several reasons to work with a lawyer or other advocate, but you are not required to do so and we hope this article helps you with whichever direction you choose to go.
What Happens at a Social Security Disability Hearing?
The idea of a Social Security disability hearing can be a daunting notion to those who have never stood before a judge before. The environment is so foreign to most people’s experiences that the entire ordeal can be overwhelming. When you’re suffering from a disability that prevents you from doing the work that’s your primary source of income, the sheer stress can make it difficult to represent yourself properly in a court and argue your case. Fortunately, there are ways to cope, and one of the best is knowing what to expect beforehand to make it easier to plan.
Being prepared for your Social Security disability hearing not only helps you cope with the intimidation of the process, but it can make it easier to plan your case and predict what kind of questions you’ll be asked. Here’s everything you need to know about what happens at a Social Security disability hearing.
Disability Hearings Often Occur in an Informal Atmosphere,
While this may be surprising, most hearings for disability cases are fairly informal. The judge may dress in their black robe and sit on an elevated platform, but the decorum and tradition of a typical courtroom aren’t as severely emphasized. In fact, your hearing may not take place in a courtroom at all. Depending on how far away you live from the hearing office, the site of the hearing could be something like a conference room at a hotel. Hearings can even be conducted through a video conference. Of course, all claimants have the legal right to an in-person hearing if they want.
The informal nature of these hearings also creates several other factors you should be aware of. For example, these hearings can be relatively short. Typically, they last anywhere between 15 minutes and an hour, but rarely go longer than that. Additionally, you’re not expected to dress up like you would for a standard court appearance. In fact, it’s recommended that you wear the clothes you would normally wear, provided the clothes aren’t particularly revealing and don’t include any hats. Judges won’t be impressed with any claimant dressing up for the situation, so there’s no need to stress about this point.
A Disability Hearing Will Begin With Initial Questioning
To begin a hearing, the judge will introduce everyone in the room into the record. That includes the judge, you, an assistant who keeps a record of the hearing, and potentially your representative, along with any witnesses. After introductions are out of the way, the judge will proceed to question you about your claim. These questions will relate directly to your disability and how this disability prevents you from doing your job correctly.
It’s important to remember that the judge isn’t your enemy. You’re not arguing against a prosecutor, and the judge is not out to prove that you aren’t disabled. These questions are designed to show the judge the extent of your disability and how it limits your normal functionality. Their goal is to acquire all the necessary facts to make the correct decision in your case.
When answering these questions, it’s important to be honest and direct. There’s no room for exaggerations or modesty. Honestly state the extent that your disability affects your ability to work. It’s often helpful to use specific examples. Imagine you work in a warehouse, for example, where you’re regularly expected to lift 30-pound boxes. Your disability has prevented you from being able to handle that kind of weight. Specifically stating your previous ability to lift 30 pounds regularly and your inability to do it after your disability paints a clear picture of the limitations you’re facing.
If You Have a Disability Attorney, They Will Have an Opportunity to Ask Questions in Your Hearing
After the initial questioning is over, the judge will ask your representative if they have any additional questions to ask you. This will be something that you and your attorney have already discussed beforehand. They may ask you some additional questions to help solidify the impact of your disability on your job. Your attorney may also use this moment to submit additional evidence if necessary, solidifying your medical records and functional limitations.
If you have any witnesses or experts for your case, this is where your attorney will be able to ask them questions. An attorney taking care of this part for you makes it easy to keep witness testimony organized. You can have several different kinds of witnesses come in, though usually there’s no more than one or two. For example, you may want to bring in a doctor or family member who can vouch for your limitations. Given the schedule of most doctors, however, a medical source statement will suffice in most cases.
Expert Witnesses Often Include Medical and Vocational Experts
The hearing will almost always feature expert witnesses, including medical experts and vocational experts. Both the judge and your attorney are free to ask them questions. These witnesses are there to determine whether your disability is preventing you from work. These two witness testimonies can work together to create an accurate picture of just how debilitating your disability really is. The medical expert can confirm your disability’s effects based on submitted medical records, while the vocational expert can testify to exactly how much is expected of a worker in any given job.
The judge will often spend more time with the vocational expert. Remember, the judge isn’t there to doubt that you’re disabled. Their job is to determine the extent to which your disability affects your work. Their questions are often framed as hypothetical scenarios in which the vocational expert details what kind of physical requirements there are for the given job. The vocational expert can also provide valuable insight about your ability to find sustainable employment based on the skills and experience you have.
At the Disability Hearing’s Conclusion Here’s What You Can Expect
After the judge has heard all the testimony and seen all the evidence, they will usually give you the chance to add anything to the case if you want. Alternatively, you can always request more time to speak if you like. Keep in mind, however, that most of these hearings last anywhere from 15 minutes to an hour in length. Adding any new information or supporting evidence can be very helpful, but simply dragging on the hearing with statements you’ve already made won’t help anything.
After you’ve said your final piece, the judge will end the hearing. In most cases, they’ll let you know that their decision will be coming to you by mail in about three to four weeks. In some cases, however, you might get lucky and receive a bench decision. Bench decisions are rulings that the administrative law judge makes at the end of the hearing, so you’ll know whether your claim was accepted or denied before you leave. This is uncommon, however, and even when it does happen, the ruling still isn’t official until you receive the written notice in the mail three to four weeks later.
Speeding Up the Disability Decision Process
If you want your hearing to go by as quickly as possible, there are a few strategies you can try to speed up the process. Hearings are scheduled more than two months in advance, so you should make sure you’re well-prepared for the hearing itself, knowing clear answers to the kinds of questions they’ll be asking. Specifically, you’ll need to be able to describe your disability, your job and how your disability prevents you from doing your job correctly with actual examples.
If you do decide to appoint a lawyer or representative for your case, do it far in advance. They’ll need time to review all your evidence and supplementary materials as well as go over with you the best way to make your case to the judge. Appointing a representative at the date of your hearing can lead to postponing the date because the representative won’t be able to get all the necessary materials in time.
A major aspect of the evidence you’ll be presenting is your medical records. While this was included in your initial claim, the Social Security Administration is going to be working off of these records alone. If you want to keep your records up to date, you’ll need to request the records regarding the period of time since you made your claim. Make sure you submit these records at least five business days before your actual hearing. In some cases, this alone is enough to get a favorable decision by an administrative law judge, so you won’t even have to bother with a hearing.
Finally, just make sure that you show up to your hearing. While missing a hearing may not automatically cause your case to be dismissed, it is a possibility. If unforeseen circumstances make it impossible for you to attend, you should contact the judge as soon as possible to explain why. Sometimes, the judge may order you to submit a written explanation. If the explanation is sufficient, your hearing will be rescheduled. If not, your case will be dismissed.
After Your Social Security Disability Hearing, What You Can Expect
Typically, getting your disability appeal decision takes about 60 days, but this can vary quite a bit based on a variety of different factors. The administrative law judge (ALJ) on your case doesn’t have a specific time limit requirement, to get your results back to you. That means it could potentially take around six months for them to make a decision and complete the process, though other, more timely judges could make a decision more quickly.
While the time it takes to get your results back can vary quite a bit, you can always check the status of your case online thanks to the Electronic Records Express. Your disability status will read as “pending decision,” “in review,” “complete,” etc. If you find that 60 days have passed and your claim is still in the pending phase of the process, you’ll probably be waiting quite a while for your results to arrive.
Here’s What It Means If Your Disability Judge Requests Medical Evidence
One of the biggest obstacles to getting timely results is outstanding medical information. The administrative law judge will need to have all the necessary medical records to make a decision. Any delays in getting these medical records to them can prolong the process and delay your results.
Alternatively, the judge may decide that a consultative examination is required to make a decision. Whatever the case may be, the judge won’t even start the decision process until they have all the necessary medical information. This can be especially troubling if the judge requests more medical evidence and even additional examinations by a doctor paid for by Social Security.
The good news is that you’re free to make additional arguments while waiting for your results in light of any new evidence or testimony you’d like to present that you didn’t at the initial hearing. While these pieces of evidence can slow down the timeline of getting results, they can make your case stronger. Keep up your hopes, ultimately, waiting a bit longer for approval is still going to be faster than getting denied and having to appeal.
What do You Do If You are Approved or Denied for Your Disability Appeal
Ideally, after your hearing, your claim would be approved. Upon approval, you will receive written notice, but that’s not the end of the process. You can’t just wait for the benefits to start rolling in. Instead, you’ll have to notify a Social Security representative that you haven’t been involved in any significant gainful employment (work) since your claim was first filed.
Alternatively, your claim can be denied. When this happens, your file is held at the Social Security office in case you want to make an appeal. The written notice of your denied claim should also contain all the instructions you need to follow should you decide to appeal. Remember that one of the most important factors for making an appeal is filing all the paperwork on time.
What to Make of the Disability Judge’s Decision
When you receive your notification of the administrative law judge’s decision, it will come in one of three forms: a fully favorable decision, a partially favorable decision, or an unfavorable decision. An unfavorable decision is one in which your claim is denied. And while the two other decisions are better than a denial, you need to know difference as your next steps may be different between a partially and fully favorable decision.
A fully favorable decision is one in which the judge approves your claim and agrees with the stated onset date in the initial claim as well as future benefits payments moving forward.
A partially favorable decision, on the other hand, is one in which the judge moves the onset date to a more recent date. This happens based on their evaluation of the submitted medical evidence.
Put simply, a partially favorable decision simply reduces the amount of back pay one is entitled to. Occasionally, however, a partially favorable decision can also be one in which the judge determines that you’re only entitled to a closed period of benefits moving forward rather than ongoing benefits for the foreseeable future. This ruling is meant to help people with temporarily debilitating disabilities that will eventually get better, allowing them to return to the work and the income that they’re used to.
If you don’t agree with these decisions, you still have options for appealing them. Read on for understanding your next steps.
Timing Your Appeal of the Disability Judge’s Decision
When you get your decision, it may not be the one you want. If you’re still denied benefits, you’ll likely have to re-start the appeals process or work with your attorney to appeal to a higher federal court level. The most important thing to remember about this process is that you have a time limit.
Final Approval, When You’re Going to Get Paid for Your Disabilty Appeal
Should your claim get approved by both the judge and a Social Security representative who determined that you aren’t partaking in gainful work, you will receive an award notice confirming that you’re entitled to benefits. This notice will contain all the relevant details to your case including how much money you’re entitled to and when you can start expecting that money to show up in your account.
The onset date is one of the most important factors of your final approval. Remember, payments don’t start based on the date of your approval. They start based on the onset of your disability. That means you’ll likely be getting a lot of back pay coming your way. After the judge reviews all the medical evidence, however, it is possible that your onset date will change in your final approval. That will, of course, alter the amount of back pay you receive in total.
Receiving Your Disability Payments After a Successful Appeal
Once you’ve received approval for your benefits, your file is transferred to a payment processing center. Usually, your payments will start coming in within a month, though there are some cases in which you’ll see mysterious payments in your account before you even get your approval. That’s not a likely scenario, of course, but it happens. Keep in mind that these trends are only the case if your onset date is more than five months before the date you were approved.
Some considerations could delay your payments. For example, if you’re approved for both disability (SSDI) and Supplemental Security Income (SSI), two offices will have to communicate and work together. They’ll need to make calculations to consider any limitations on payments that might restrict your overall benefits. That can delay your payments by several months.
What to Do While You’re Waiting for Your First Disability Check
While you’re waiting for your results to come in, it’s helpful to take any other steps you may need to help your situation. Make sure your future isn’t entirely dependent on getting disability benefits. Instead, submit claims for any other kind of benefits you may be entitled to, such as food stamps or Veterans Service Connected Disability Claims (which you can often collect concurrently with SSDI benefits). On this last point, it’s worth reading our blog about Veterans claims – often getting awarded SSDI benefits helps support lingering VA Disability claims as well. One federal agency seeing you as unemployable is compelling evidence for the another federal agency to see you in the same light. SSDI awards are powerful evidence of unemployability in VA TIDU claims.
Regardless, if you were successful, congratulations. If not, get help! Contact us below and we’ll put you in touch with an expert in disability claims and appeals.