Qualifying for disability in Texas at a hearing

Continued from: Eligibility and qualifying for disability in Texas

According to recent statistics published by SSA, of all applications for Social Security Disability that were decided at the hearing level, 76 percent resulted in an allowance. Statistics show that applications for both SSD and SSI had an allowance rate of 55 percent. These statistics were for all classes of applicants including disabled workers, disabled adult children, and widowers and widows.

In Texas, the hearing approval rate varies from 40% (the Houston Bissonnet hearing office) to 42% (the San Antonio hearing office), to 47% (the Houston North hearing office), to 50% (the Dallas downtown hearing office), and to 52% (the Dallas North hearing office).

As one can see, the odds of winning at a disability hearing in Texas are a bit lower than in the nation at large, and lower than in many other states. For this reason, of course, it becomes even more important for a person filing for disability in Texas to be fully prepared by the time they get to a disability hearing.

Common questions about filing for disability in Texas
Texas disability hearings

The process of reaching a decision at a disability hearing is arguably the same as with the intial claim or reconsideration appeal. That's because the same system of rules and eligibility requirements is in place. Once again, the decision-maker, this time a judge, must determine if a claimant meets a listing.

Note: See If the person filing for disability meets the listing, can the judge still deny benefits?

If they do not, the judge will determine if the claimant is incapable of returning to their past work. If so, are they incapable of doing some type of other work? If that is true, the judge may approve the case.

However, there are differences between the hearing and the first two levels, the application and reconsideration appeal.

1. While an examiner does not meet the claimant, the judge will see the claimant and their representative (who may be an attorney or non-attorney representative) at the hearing (unless the claimant is scheduled for a video hearing which the claimant has the right to decline).

2. Social Security will not gather any medical evidence for the case. So, this means that the last evidence in the case file will be from the reconsideration appeal, meaning it will be many months old. Since Social Security cannot approve a case without recent medical evidence, it will be incumbent on the claimant or their representative to obtain records from recent medical visits and submit them to the judge.

3. While disability examiners routinely ignore the statements provided by a claimant's own doctor at the application and reconsideration levels, judges give them credence if they are in line with the claimant's other medical evidence. Thus, a doctor's statement in the form of a medical source statement can help qualify a case.

4. At the first two levels, examiners make their decisions in a vacuum. But at the hearing, the judge will ask the claimant questions. The disability attorney or representative may also ask questions. If the judge has elected to have a medical expert or vocational expert present at the hearing, the attorney may ask questions of that individual.

The goal at the hearing, whether the claimant is represented or not, is to show that, based on the available evidence, the claimant no longer possesses the ability to work and earn a substantial and gainful income, either at their past work, or at some type of other work. Doing this will require showing that the medical evidence demonstrates that enough functional limitations exist as a result of the claimant's condition, or conditions, so as to make work activity not possible.

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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