Skip to main content

WHAT IS A "THEORY OF AWARD"?

If you listen to lawyers talk about Social Security disability you will hear the term "theory of award."  Judges often ask attorneys at the hearing, "What is your theory of award?"

A theory of award means:  What set of facts meets Social Security's rules to allow a payment of benefits?

It isn't sufficient to say, "The claimant can't work," or "the claimant is disabled."  The lawyer has to carefully examine Social Security's rules and explain which rule allows a payment or an award.

Here are some examples of a theory of award: 

 1.  The claimant's medical condition meets or equals Listing 12.05.

2.   Grid rule 202.06 will direct a finding of "disabled" based on the claimant's age, education, past work history and residual functional capacity.

3.  Based on the severe functional impairments, the claimant cannot perform past relevant work under 20 CFR §404.1520. 

4.  The claimant would be unable to perform any significant gainful activity which is available in the national economy using Medical-Vocational Guideline 201.04 as a guideline.  

5.  Pursuant to SSR 85-15, the claimant is unable to sustain any other employment available in significant numbers in the US economy.

Think of the Social Security disability process as a long, winding path. The path takes many turns and twists. The end of the path is the conclusion about how the regulations dictate a particular ruling.  Your lawyer always looks for a favorable decision at the end of your path--one which allows you to collect all the benefits you are entitled to get.

Only by explaining the legal reasoning can a lawyer expect to obtain a favorable ruling which pays his/her client.  That reasoning is the "legal theory of the case."  

Comments

Popular posts from this blog

MOST IMPORTANT FACTORS IN A SOCIAL SECURITY DISABILITY CASE

What are the top 3 most important factors in a Social Security disability case? 1.  Medical Evidence. 2.  Medical Evidence 3.  Medical Evidence 4-10     Medical Evidence Federal regulations set the eligibility requirements for Social Security disability (SSDI) benefits.  A claimant must meet these strict legal requirements More than anything else, the claimant's medical evidence will determine the outcome of the claim or appeal.  Without strong objective medical evidence Social Security cannot legally pay you a benefit. Objective Medical Evidence means the result of medical examinations, laboratory tests or imaging studies (X-rays, PT scans, MRI or CT scans). This type of evidence can only be obtained by going to your doctor. There's an old adage that says truthfully:  "The path to Social Security disability benefits runs straight through your doctor's office."  Being approved for an SSDI benefit requires objective medical proof. ...

SOCIAL SECRITY DISABILITY: THE DECISION WRITING PROCESS

  By Charles W. Forsythe - The Forsythe Firm in Huntsville An Administrative Law Judge (ALJ) has made a decision on your Social Security disability appeal hearing. The decision must now be sent to to a process called "Decision Writing" - where an attorney or paralegal will draft the formal binding decision, explaining the judge's legal rationale for the decision and explaining the mandatory 5-Step decision making process. The decision writing process translates a judge's ruling into a formal, legally binding document. It is a vital but time-consuming phase that ensures all medical evidence and vocational factors align with the law. A typical written decision will be 10 to 20 pages, thus very detailed.  It takes time to write one. There are many decisions ahead of yours and usually they are written in the order received. The step-by-step process breaks down as follows: The Judge’s Ruling & Instructions:  Following your hearing, the Administrative Law Judge (ALJ) r...

UNDERSTANDING THE 5-STEP SOCIAL SECURITY DISABILITY PROCESS

Receiving Social Security disability payments depend on one thing:  Proving that you are not able to work. The one and only thing that SSDI pays for is the physical and/or mental inability to work for a period of at least 12 months.  Who decides if you are able to work?  The Social Security Administration (SSA) will decide.--according to their own strict rules and regulations. In reaching that important decision, are you disabled or not, Social Security must use a 5-step examination process.  It's important to understand these 5 sequential steps. STEP 1:  The work Test .  Is the claimant now engaged in Substantial Gainful Activity (SGA)?  If yes, the claim is denied at Step 1.  They look no further.  You cannot be eligible for SSDI benefits if you are working at SGA, regardles of your medical condition.  (In 2026 you are working at SGA if you earn at least $1,690 per month from work or self-employment). STEP 2.  The Medical Requirem...