What are Medical Experts at Social Security Disability hearings?

If you get denied for Social Security Disability or SSI at the disability application level, and then get denied once more on a request for reconsideration appeal, you will be in the position of being allowed to request the second appeal that is available to claimants. That appeal is the administrative law judge hearing.

The disability hearing is very different from the earlier steps of the system. First of all, the claimant will actually have a face-to-face meeting with the decision-maker who is a federally appointed judge.

Secondly, the claimant will have the right to appear at the hearing with a chosen representative (usally an attorney who specializes in disability claims).

Thirdly, the entire burden for gathering the most recent medical records and presenting them at the hearing...will fall entirely upon the claimant and their lawyer, assuming they have one.

This is because after a claim has been denied at the reconsideration level, the social security administration ceases all case development, meaning they no longer gather any records that may be used in the decision process.

The fourth difference between the hearing level and the prior levels of the system is that the decision-maker at this level, in this case a judge, will have the option of calling experts to the hearing.

Why are experts called to disability hearings? Arguably to assist the judge in his or her decision-making. Though, in all honesty, very often experts are called by judges to hearings to support a decision which the judge already has in mind so that:

A) The decision can gain the appearance of being more sound and

B) The case can stand less of a chance of being remanded and returned to the judge for a second hearing (remands are ordered by the appeals council when the AC finds some level of deficiency or inadequacy with the outcome of the hearing or the process by which the decision was reached).

What types of experts are called to hearings? Judge may call medical experts, physicians who are M.D.s. They may also call VEs, or vocational experts. It is not uncommon for a judge to call both a medical expert and a VE to appear at a hearing.

In either case, however, the expert will typically respond to questioning and address hypothetical situations conjured by the judge and the claimant's disability attorney--all of which may have a direct effect on the outcome of a case.

Which is exactly why no claimant would wisely decide to appear at a disability hearing alone and without representation. Representation may provide "iffy" benefits at the lower levels of the system, but at hearings, representatives should be be considered a given by anyone wishing to win their claim.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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