Who Makes the Decision at the Social Security Disability, SSI Hearing Level?

How to prove you are disabled
and win disability benefits

If your SSI or Social Security disability claim has progressed to the disability hearing level, an administrative law judge will make the decision on your case and decide if it is to be approved or denied. The ALJ uses essentially the same process to decide a claim as a disability examiner when you first apply for disability benefits.

What is that process? The following page discusses what happens on a disability case when a case is being worked on initially by a disability examiner: The Social Security Disability Approval Process. However, at the hearing level, the process is still essentially the same. The ALJ will review the medical evidence looking for signs of limitations that might prevent a person from engaging in normal daily activities.

When the claimant is a child (such as for SSI child benefits), being unable to engage in normal daily activities would typically mean having difficulty engaging in age-appropriate activities. For children who are school-age, this will typically mean having to examine evidence as to the child's ability to perform school work. For this reason, child disability cases will often involve reviewing IQ testing, achievement testing, grades, IEPs, and questionaires from the child's teachers, all in the attempt to determine whether or not the child is being impaired from engaging in what is thought to be normal and expected for the child's age.

When the claimant is an adult, the emphasis will still be on evaluating whether or not the individual can engage in normal daily activities. However, here the emphasis will be on determining whether or not the individual is capable of A) performing work activity and B) working and earning at least a certain minimum threshold of income each month.

Item B is important because the social security administration has taken the position that even individuals with disabilities may still be able to work, even if they cannot work to the extent of being able to earn a livable wage. It is for this reason that disability benefit applicants and recipients are not necessarily penalized for working, though their benefits may be reduced or stopped altogether if they demonstrate the ability to work in excess of a certain limit (that limit is known as the substantial gainful activity, or SGA, level).

How does the administrative law judge (or a disability examiner if the case is being worked on at the lower levels of the system) evaluate whether or not a person can work? This decision process involves reviewing the claimant's past work and comparing that to the physical and mental capabilities they currently possess. If the evidence suggests that the individual cannot return to a former job (potentially any job they have done in the last 15 years) or perform some type of other work they have never done but for which their education, physical and mental condition, and work training might qualify them for, then it is likely that they will be approved for disability benefits.

Additional information:

What does social security mean by past work?

What does social security mean by other work?

What is the process for approving a Social Security disability claim ?

How are Social Security Disability cases decided? - the Process

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SSD and SSI are Federal Programs

The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states:

Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming

Recent approval and denial statistics for various states can be viewed here:

Social Security Disability, SSI Approval and Denial Statistics by state

Special Section: Disability Lawyers and unnecessary claim denials