When you file a disability claim, it goes through an initial review to see if you qualify for disability. If you are denied, it then goes through reconsideration. Hopefully, you are one of the lucky ones who gets approved initially or at the reconsideration level. However, if you at not approved at either of these levels, you can request a hearing in front of an Administrative Law Judge, or ALJ.
Who is an Administrative Law Judge (ALJ)?
An Administrative Law Judge is an attorney who has at least 7 years of experience, though many of the ALJs have been practicing law for quite a bit longer. An ALJ is not bound by any prior determination on your case and is obligated to provide a neutral and independent view of your case. They will consider the basis of why your case was denied, look at your medical evidence, consider your testimony, and listen to your hearing arguments. They will also issue a decision in writing for your claim.
Why am I forced to present my case to an Administrative Law Judge?
If you are pending a hearing in front of a judge, it means that you have been denied at the initial and the reconsideration level (a few states, such as Louisiana, do not have a reconsideration level). At each of these levels, an agency has looked at your file and determined that you are not disabled. Usually, a doctor who has not examined you will look at your evidence and make a determination as to your work ability. The hearing in front of an ALJ is helpful to prove that the reviewers at the initial and reconsideration levels were incorrect in determining that you are not disabled.
What happens at an ALJ Hearing?
The ALJ will introduce themselves and the other people in the room, briefly discuss the issues, explain the ALJ’s role in the case, and, if you have an attorney, ask your attorney about the exhibits in your case. The exhibits are all electronic, and an attorney will be able to review those exhibits prior to your hearing. The ALJ will also ask if there are any records that have not been submitted due to delays in obtaining them. Do not be alarmed if there are some records missing. Medical providers can sometimes be non-responsive and most ALJs routinely hold the record open so that your medical information can be provided.
After the initial introduction, the ALJ will swear you in and permit you to provide testimony. Some ALJs ask many of the questions for themselves. Some allow your attorney to perform all or most of the questioning. After you testify, a Vocational Expert will testify. Another blog post will discuss vocational testimony. Briefly, the vocational expert testifies about jobs that are available in the national economy. After the vocational expert testifies, the ALJ will conclude the hearing.
Will I know the ALJ’s decision at the hearing?
More than likely, you will not know the ALJ’s decision on the date of the hearing. Sometimes the ALJ will tell you his or her decision at the hearing, but that is not common. More than likely, you will have to wait a few months for the ALJ to issue a decision in writing. That decision will be either a) fully favorable (you won all that you were asking for) b) unfavorable (unfortunately, you did not win your case), or c) partially favorable (the judge found you disabled but only for a partial period of time).
How to win your case in front of an ALJ
A skilled attorney can focus the testimony you provide on what the ALJ needs to hear. You need to testify to support your medical evidence, but also need to provide testimony to facts that may not be included in your medical records. It is important that you testify truthfully, and take care not to either overstate or understate your limitations. A quick way to hurt your case is to testify to something that is inconsistent with your other medical evidence. Also, if the ALJ does not believe you on the little things, they will have difficulty believing you on the big things as well.
A skilled attorney will make sure all the medical evidence has been provided to the judge. Sometimes, the initial and reconsideration level reviewers did not have all of your medical evidence. More likely, since they last reviewed your case, you have undergone additional medical treatment. Perhaps your condition has gotten worse. All of the records need to be sent to the ALJ for review.
The Law Office of Brad Thomas will attempt to get a medical source statement from your doctor that will hopefully support your disability claim. This evidence is very helpful to the ALJ as it will explain what your doctor thinks that you can or cannot do. Also, it is helpful to ask the vocational expert about the limitations your doctor has provided.
ALJs have a heavy caseload. Our office will, in most circumstances, submit a prehearing legal brief, which is a short summary of your case with an outline of the reason you are disabled. This helps the ALJ know the basis of your claim at the outset and assists him or her in approving your case. This also shows the ALJ that they are dealing with an attorney that has carefully reviewed your case.
What if the ALJ was biased against me?
The hearings are meant to be neutral and “non-adversarial.” Most ALJ’s take this responsibility very seriously and try to be as fair as they can be. If an ALJ appears to be focused solely on your credibility and ignoring the actual medical evidence or focusing on clearly irrelevant facts, the ALJ is violating SSA’s rules pursuant to Social Security Ruling 16-3p. These issues need to be brought up on appeal, as the Appeals Council can remand the case if they feel the ALJ has violated the non-adversarial nature of the proceedings.
If you feel that an ALJ has been biased against you, there are mechanisms to show unfairness, prejudice, partiality, bias, misconduct, or discrimination by an ALJ. However, the SSA is deferential to the ALJ, evaluating these allegations under an “abuse of discretion” standard. Before making these allegations, please be aware that the mere fact that an ALJ has denied your case does not equate into bias. Also, simply being wrong about the law and the facts is not the same as being biased. From experience, it is easier to prove the ALJ was completely wrong on appeal rather than to prove he or she was biased.
Please note that the vast majority of ALJ’s are polite and friendly during your hearing. They realize you have been waiting for some time for this hearing and fully allow you to present your case.
ALJ hearings can be stressful. A skilled attorney can talk you through the process, make sure you are prepared for the questions you are going to be asked, and verify that the SSA has the correct medical evidence.