Claims that are denied at reconsideration are appealed to the Office of Disability Adjudication and Review, by filing a Request for Hearing.
When they reach the Office of Disability Adjudication and Review, claims for Social Security Disability are screened, to see if there are cases that can be allowed without hearing. That happens in a significant number of cases, and where a Fully Favorable Decision is possible, no hearing is necessary. In some of those cases, the claimant’s attorney has obtained crucial records or an opinion from a treating doctor, which clarifies the case so that benefits can be allowed without hearing. An attorney who is knowledgeable in Social Security Disability will review your case, to determine if you are a candidate for a Fully Favorable Decision, and to determine what additional evidence may help to get a favorable decision without waiting. Very often, despite the attorney’s best efforts, it is not possible to get a Fully Favorable Decision. It may depend on the Administrative Law Judge or office policy.
If a hearing is scheduled in Iowa, it is usually by videoconference. They work quite well, and have very few problems. Few other States have videoconference hearings, partly because Iowa set up a fiberoptic network over which videoconferences can be held. The videoconference has two major positive effects. First, since it drastically cuts the travel time for the Social Security Administration’s Administrative Law Judges, who have offices in West Des Moines, it allows them to have more hearings in less time. That helps to keep the backlog of cases down, and means faster hearings for claimants. Second, many claimants feel intimidated in the presence of the Administrative Law Judge, and are more comfortable with the video connection.
When the hearing is scheduled, a vocational expert is almost always called as a witness, and occasionally a medical advisor will be called. The vocational experts are almost always people with a good deal of traning and experience in evaluating and placing injured workers, and they have traning and experience in the hearing process. Claimants’ attorneys worked hard for years to have vocational experts included in hearings, and more often than not, they help claimants’ cases more than they hurt them.
The Administrative Law Judge will have read the medical evidence before the hearing, and if the claimant is represented by an experienced attorney, the ALJ will listen to the claimant’s testimony. Sometimes there will be further questioning by the ALJ, to clarify issues. Then the ALJ will ask questions of the vocational expert, including obtaining a written summary of the claimant’s past work over the last 15 years. Then the ALJ will ask the vocational expert what jobs would be available to the claimant under a particular set of restrictions. That question, usually referred to as a “hypothetical,” will be fairly detailed. After the vocational expert has answered, the ALJ may ask a second and perhaps additional hypotheticals. People often want to predict the outcome of the case based on the vocational expert’s answer to a second or third hypothetical, but that is usually not very accurate. Depending on the restrictions that the ALJ actually finds apply in the case, the ALJ may allow benefits, deny benefits, or decide that the person became more restricted at a certain point, and allow benefits only back to that point.
It usually takes four to eight weeks, sometimes longer, to receive a decision, and the claimant and attorney’s copies will be mailed at the same time. If the decision is favorable, there are often other programs which are available only to persons with favorable decisions, and the claimant should look into those. H. Edwin Detlie’s office sends out a brochure, developed over the years, entitled, “Favorable Decision Checklist,” to clients whose claim has been allowed.
If the decision is unfavorable or partially favorable, claimants have the option of filing a new claim, appealing to the Appeals Council in Virginia, or both. The claimant has 60 days from the receipt of the decision, which is assumed to be 5 days, to file a Request for Review of Hearing Decision/Order . Persons who have not had an attorney at the hearing level may find it hard to find a lawyer to represent them at the Appeals Council, since the attorney cannot find much of the information in the 60 day appeal period. He or she may or may not be able to look at the medical records, but it will not be possible to review the testimony of the claimant or of the vocational expert.
Many people who offer free advice will tell you that a claimant cannot file a new claim and appeal to the Appeals Council at the same time. They are wrong. That is a very common missconception, and free advice like that has caused a great deal of hardship. There are a lot of people who think that they know the system, who have very little information, often outdated, and they tend to do more harm than good. They usually do so out of good intentions, including telling people to lie to the Social Security Administration. Not only will that harm your claim, it also exposes you to charges of fraud and perjury. You could go to jail if you rely on advice like that.
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