What Happens if a Social Security Disability or SSI Claim gets Denied on a Reconsideration Appeal?

If the case was denied at the reconsideration appeal level, the disability lawyer will submit the second appeal that is available to claimants, a request for hearing before an administrative law judge. This appeal will, as was the case with the reconsideration, be sent to the social security office that has jurisdiction over the case.

However, instead of being forwarded by the social security office to DDS, it will be sent to ODAR. ODAR stands for office of disability adjudication and review, although it is commonly referred to as simply "the hearing office."

At the hearing office, the case will generally be put on hold for a long number of months due to large backlogs at this level of the disability system. The backlogs for hearing requests vary across the nation, but it is not unusual for a hearing request to take a year or longer before a hearing date is granted.

During that time, the claimant should notify their disability attorney of any changes in their situation (such as diagnosed conditions, new medical treatment, new doctors or procedures, etc). The attorney should further be kept up-to-date regarding changes in contact information should the claimant move or change their phone number.

While the case is waiting to be scheduled for a hearing, the claimant can periodically request a status update on their case. This will involve having the disability attorney contact the hearing office and speaking to a clerk.

Generally, however, the only practical value of this will be to verify that the case was, in fact, transferred from the social security office (where the hearing request was sent by the attorney) to the hearing office. Other than that, the hearing office will usually be unable to say much on a status call. However, if the case has been assigned to a specific judge, the hearing office will be able to verify that.

As the case gets closer to being scheduled, however, the hearing office may send out a copy of what is known as the exhibit list. This is a listing of everything that is in the claimant's disability file (including copies of prior decisions, all the gathered medical evidence, the claimant's original application for disability, and pertinent case materials) which may be referred to at the hearing. For the sake of convenience and clarity, each item is marked as a numbered exhibit.

Generally, when the exhibit list has been made, this signifies that the case is much closer to being scheduled, and this usually happens within 90 days of the receipt of the list.

The receipt of the exhibit list by the attorney will also be taken as an opportunity for the attorney to start sending out requests for updated medical records to the claimant's medical treatment sources. The trick, of course, to requesting updated (i.e. recent) medical records is that, by the time that the hearing takes place these records, in order be considered currrent, should not be older than 60 days.

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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