WHAT HAPPENS AT A DISABILITY HEARING?

Over a million people will attend a Social Security disability hearing this year, hoping to get approved for payments.

What typically happens at these hearings?

BRIEF OVERVIEW:  A hearing is a legal proceeding before the Social Security Administration.  It is a fact finding event to determine if the claimant meets the rules established by the US government to receive disability payments.  It is presided over by an administrative law judge (ALJ) and typically lasts 45 to 60 minutes.

WHO ATTENDS?  In addition to the presiding judge, the following individuals usually attend a hearing:

• The claimant
• The claimant's attorney or representative
• A vocational witness (job expert) - called by Social Security
• A hearing clerk

The following things generally occur at a hearing:

• The ALJ explains the purpose of the hearing and how it will be conducted.  He/She introduces everyone present.  The claimant and vocational witness will be placed under oath.

• The claimant's representative will be given the opportunity to make an opening statement.  Usually this is when the attorney will state the claimant's "theory of the case," or "Why we believe the rules and regulations allow this case to be approved."

• The judge interviews the claimant, asks a lot of questions--called the "direct examination."  Your representative should inform you of the types of questions to expect.

• The claimant's attorney or representative will ask the claimant a lot of questions.  The purpose is to be sure the judge understands the claimant's impairments, past work history and why he/she is no longer able to work.

• Next, the judge will ask  the vocational witness (VE) a few hypothetical questions.  The ALJ will pose a hypothetical set of facts, then ask the VE what kind of work would be available for a person in those circumstances.  This is a critical part of the hearing and will have a definite effect on whether or not benefits are awarded.

• The claimant's representative will get to examine the vocational witness and ask any questions necessary.  This is also a vital part of the hearing that may indeed effect the outcome.

• The judge will rule on any objections, issue any final instructions (such as requesting more medical evidence or ordering a consultative doctor's examination, if needed).  The judge will then close the hearing, usually without announcing a decision.  The decision will come in the mail and may take a few months following the hearing to receive.

3 Decisions are Possible After the Hearing

A.  FULLY FAVORABLE:  The claim is approved for payment just as applied for.  This usually allows for the maximum back pay and the earliest possible eligibility for Medicare insurance benefits.  It's everything the claimant wants it to be.

B.  PARTIALLY FAVORABLE:  The claim is approved, the claimant is found disabled, but some part of the claim is not fully favorable to the claimant.  This usually means that the judge moved the alleged onset date that was claimed in the application, finding the disability to have begun at a later date than was alleged.  This will usually have two effects on the claim:  (1)  There will be less back pay than requested, and (2) the date for Medicare eligibility will be further in the future.

C.  UNFAVORABLE:  The judge has denied the claim altogether, found the claimant not to legally disabled under the application and denied payment of all benefits.

Both unfavorable and partially favorable decisions can be appealed by the claimant, who should seek legal advice before deciding how to respond to a denial or partially favorable decision.