The Initial Application
There are many stages that a claim for SSD/SSI benefits may go through and they often require multiple appeals. To start a claim, a person can apply for SSD/SSI benefits online, in person at a local Social Security office, or with the help of an attorney. The fee for an attorney is the same regardless of when in the process representation starts, so many applicants chose to have an attorney help them apply for benefits. This gives them the assistance of an attorney from the very beginning of the process.
Once an applicant applies for benefits, Social Security will make an initial determination as to whether a person qualifies for SSD/SSI benefits. Social Security will look at the applicant’s medical records, the work the person has done in the past, and other relevant documents, such as school and vocational rehabilitation records. Based on these records, they will determine what impairments the applicant has and whether those impairments prevent them from working a full-time job. Typically, Social Security will also have the applicant’s case reviewed by medical doctors to help with this determination. They may also send you to be examined by a doctor. If an applicant does not have an attorney, these doctors may not always have all the applicant’s medical records when making their determinations.
Social Security will also have the applicant’s work history evaluated by a person called a vocational expert, which is an expert on jobs. This person helps Social Security to determine what kind of jobs the applicant did in the past, whether they can do any of those past jobs with their current limitations, and whether there are any other jobs the applicant can do. If Social Security determines that an applicant can do their past work or can do other types of work that exist, they will deny the claim.
Appealing a SSD/SSI Denial
If the application is denied by Social Security, it can be appealed. Unfortunately, the approval rate for claims at this level is very low. Most people have to appeal. Social Security will then reconsider their decision. They will review any new evidence that is submitted when making their new decision. However, most people who are denied initially also receive a denial at this stage. If an applicant receives a second denial, it can again be appealed. However, a hearing before a Social Security Judge, called an Administrative Law Judge (“ALJ”), will then be required.
SSD/SSI Hearing Before an ALJ
Many Social Security Disability/Supplemental Security Income applicants end up having to go to a hearing before an ALJ to be approved for benefits. Although the thought of going in front of an ALJ often scares people, it is the stage where most people get approved for benefits. A good attorney will prepare you for this hearing and will attend the hearing with you. At the hearing, the ALJ will ask you a number of questions about your conditions, functional abilities, daily activities, and past work. The ALJ will determine your credibility based on the answers you give and what your medical records show.
There will also be a vocational expert present at the hearing. They will provide testimony about the jobs you’ve worked in the past, whether you can work those jobs now, and whether there are other jobs you could do. If you have an attorney, they will make arguments on your behalf to the ALJ, will make sure all your medical records are submitted to the ALJ prior to the hearing, and will question the vocational expert at the hearing.
A good Social Security Disability attorney will also submit a legal document called a Prehearing Brief to the ALJ prior to the hearing. This document summarizes the applicant’s work history and medical records and lays out the legal arguments as to why an applicant should be found disabled. This helps the ALJ know where an applicant is coming from before the hearing even starts, highlights important information for the ALJs who have to review dozens of cases every month, and makes the hearing go more smoothly.
If you’re well-prepared, a hearing can be something to look forward to rather than something to fear. An attorney can help you put your best foot forward, assisting you from the initial application to the hearing, if necessary.