Skip to main content

WHAT YOU DON'T KNOW CAN HURT YOU AT A DISABILITY HEARING

It's a fact that most Social Security Disability claims must go before an Administrative Law Judge (ALJ) for a hearing to be approved and paid.  This is not the exception; its the rule.

If you are considering representing yourself before the ALJ, you need to consider the many technical and legal dangers of doing so.  Most claimants don't know what they will be up against at a disability hearing.

1.  Defending your Alleged Onset Date (AOD).  This is the date you claim your disability began.  It's also the "pay back to date" on your claim.  The onset date will determine how much, if any, back pay you can receive.  This date is often questioned or disputed.  You must know how to defend it.

2.  You must understand your Date Last Insured (DLI) and how it will impact your claim.

3.  You need to understand what "acceptable medical sources" are and the difference between objective medical evidence and subjective evidence.

4.  You must understand the "grid rules," which will decide around 80 percent of disability claims.  These are complicated for the lay person.

5.  You should understand the Blue Book Listings found in 20 CFR, Appendix I, § 404, Subpart P. At Step 3 of the sequential determination process, it will be determined whether you meet or equal a Listing.

6.  You are going to hear terms from the vocational witness (VW) that are unfamiliar to you:

    SVP - Specific Vocational Preparation

    PRW - Past Relevant Work

    Exertion Levels

    Per the DOT* and "as actually performed"

    * The Dictionary of Occupational Titles (DOT) was last updated in the 1980s and contains thousands of outdated job titles that the vocational witness may use in prescribing work you are "still able to perform."

Often, the vocational witness will present evidence of jobs that you can still perform and these can result in a denial if not responded to effectively.  The claimant is probably not trained to cross-examine the vocational witness.  This is a vital role for your representative!

7.  Whether any drug or alcohol abuse is material to the claim.  If you know the rules, not all substance abuse can be used to deny a disability claim.  Some abuse is "material" to the claim, some is not material.

8.  You should know Social Security's definitions of such terms as:  substantial gainful activity (SGA), Past Relevant Work (PRW), regular and continual, and what they mean by frequently, occasionally, and rarely.  

9.  You must know how to frame medical evidence into "Residual Functional Capacity" or RFC.  This will be used to determine what type of work you are still able to do.  This also will be used to determine whether your meet the rules for disability or not.

10.  You should be able to address any questions or concerns the judge may have effectively.  Remember, if you represent yourself there is nobody to turn to for help or advice.  

A question I often ask:  "Would you represent someone else in their disability appeal?"  Most people will answer, "No, of course not."  Then, why on earth would you represent yourself?

_____________

Charles W. Forsythe is a founding partner of The Forsythe Firm in Huntsville, AL.  He has represented thousands of claimants in Social Security claims, appeals and hearings and recovered millions of dollars in
benefits for claimants.  He is available for a free consultation.

PHONE (256) 799-0297   

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...