A Social Security disability hearing is a formal procedure which takes place in front of a US administrative law judge (ALJ). Witnesses are sworn and provide testimony under oath (including the claimant). At stake is whether you will get all, part, or none of the disability benefits you have applied for. If you get to the hearing stage, you have already been denied at least part of your benefits once, perhaps twice.
Most claimants have little understanding of what happens at a disability hearing, the nature of the evidence required and how many things can potentially go wrong. I have space here for only a very brief Introduction to Social Security Hearings - the Basics.
In a hearing that will last from 30 to 60 minutes, you will be asked dozens of questions about your life, your past work, how you spend your days, your hobbies and interests, and why you can no longer work. The judge is required to walk through a Five Step Sequential process, which I will mention here in a brief manner.
Step 1: Are you now engaged in "substantial gainful activity" or SGA? The judge wants to find out of you are doing things that amount to the demands of a full time job, whether or not you're getting paid to do those things. Limitations of physical activity are very important here.
Step 2: Do you have at least one serious medically determinable impairment? This impairment must be reasonably capable of producing the symptoms, signs and limitations that prevent you from performing persistent and regular work-like activities.
Step 3: (A) Do you meet one of the Social Security listings for disability? If you do and have adequate medical documentation, your hearing could stop here with a finding that you are disabled. Most claimants, however, do not meet a listing. (B) The second part of Step 3 involves establishing a "Residual Function Capacity," which is merely a list of activities that you can no longer perform due to your impairment(s), and a list of functions that you can still perform in spite of your impairment(s). The judge will use this to decide which exertional level you are capable of: sedentary work, light work, medium work, heavy work, or very heavy work.
Step 4: The judge will ask a vocational witness ("vocational expert") to help determine whether you can return to any of the "past relevant work" you have performed. If you are able to return to some type of the work you performed within the last 15 years, you will be found NOT DISABLED. If you cannot perform any of your past work you move on to the final step.
Step 5: Can you perform any other work available in the economy, given your education, work experience, age and RFC. (The same RFC must be used in both steps 4 and 5). If there is no "other work" that you can perform, you will be found disabled. Note that "other work" does not have to be of the same type or classification that you did in the past. If you were once a brain surgeon and cannot return to that type of work, you are not disabled if you can still teach, sell surgical instruments, be a pharmacy sales rep, or work in a department store.
By knowing the specific steps the judge is required to take, I hope it helps claimants to know the evidence that will be necessary to prevail in a Social Security disability hearing. The evidence must show functional limitations that are severe enough to prevent persistent work related activity - 8 hours per day, 5 days per week, 52 weeks per year. Limitations can be physical (exertional or postural), or mental/emotional, or a combination of these.
In my opinion, claimants who are facing an upcoming Social Security disability hearing have two choices. They can invest a great deal of time studying Social Security law, procedures and evidence, OR they can hire a representative who understands these things. Any other choice, such as representing themselves, in my opinion, carries huge risks. Remember that an experienced Social Security representative cannot charge you a fee unless you win you case--and then only if you have collected retroactive (past due) benefits. A fee must be approved by the judge who heard your disability case.
For anyone who may believe that a hearing is a mere formality, a rubber stamp process where benefits are awarded to anyone with a good story - consider that awards (wins) in disability hearings have dropped below the 50 percent level as of 2011. Consider also that most of those who won were represented by well prepared, knowledgeable and motivated representatives who had spent months preparing their cases. This may cause you to think twice before going into a Social Security disability hearing unrepresented.
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