Social Security Disability Hearings - What is the ALJ
If your case has progressed to the hearings level of the Social Security Disability process, then an administrative law judge, or ALJ, will be the individual to determine if you are considered disabled under the disability rules and guidelines of the Social Security Administration.
What is an administrative law judge? An ALJ is comparable to a trial judge; consequently they can take oaths, hear testimony, and make decisions regarding an individual's entitlement to disability, whether from the Social Security Disability or SSI disability program.
The administrative law judge does this through reviewing your disability case file, questioning you about your disability (in other words, your mental or physical impairments), and examining the evidence you (if you are unrepresented) or your disability representative presents during the hearing.
Note: it is not at all uncommon for individuals who have been to a Social Security Disability hearing to complain that they were not treated well by the judge or that the ALJ was not fair to them. It is true that disability juges are often rude, sometimes even hostile to claimants who appear at their hearings. Many would argue they are not governed by the rigid set of rules used by disability examiners who make decisions on claims at the first two levels. Some judges will simply declare that they are not required to acknowledge the Social Security Administration's POMS, or Program operations manual system which are "Instructions used by employees and agents of SSA to carry out the law, regulations, and rulings".
Approval chances are better at the disability hearing level
However, the fact remains that disability judges make far more approvals on cases than occurs at the lower levels of the system (disability application and reconsideration appeal).
This is due to a number of reasons. First, by the time an ALJ hears a case, the claimant may have undergone additional medical treatment that strengthens their claim, or their physical or mental condition may have worsened. Or, as is often the case, their attorney or non-attorney representative may have obtained and submitted critical evidence (particularly a favorable medical source statement from the claimant's treating physician) that persuaded the judge to conclude the claimant's case met the necessary criteria for approval.
The importance of attending a disability hearing
There are cases in which a judge will have reviewed the case file and essentially made up his or her mind by the time the hearing commences. But although a disability judge's decision can be based on the evidence in your disability file alone, it is still advisable, and sometimes crucial, for you to attend your hearing.
Why is it advisable to attend your hearing? Because while some cases will be approved on the basis of meeting or equaling the approval criteria of a listing in the SSA blue book, and other cases will be approved on the basis of the grid rules that favor older claimants, particularly those of advanced age, or closely approaching retirement age, many cases will require the disability attorney or representative to put forth a compelling theory of the case, i.e. a rationale as to why the judge should approve the case. And, certainly, when the judge has chosen to have a medical expert and/or a vocational expert appear at the hearing to provide testimony, it would be unwise for a claimant to decline appearing, miss their hearing date, or appear without the benefit of representation.
However, another important reason that should not be disregarded is this: Each administrative law judge has the power to give the benefit of the doubt to the disabled individual and the hearing is the only time a decision-making individual from the Social Security administration will ever see you in person, which makes it more difficult to perceive you as just an anonymous pile of medical records.
Perhaps the independence of ALJs accounts for why more than fifty percent of all previously denied Social Security Disability and SSI claims are later approved at the disability hearing level.
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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