5.8 Administrative Law Judge Hearing

ADMINISTRATIVE LAW JUDGE HEARING

Group Law Judge Hearing

After you appeal your reconsideration denial and request a hearing with an administrative law judge, your file is sent from DDS to the Office of Hearings Operations (OHO). Social Security with review your case again, and then schedule it for a hearing before an administrative law judge (ALJ). You will generally be given at least 90 days (about 3 months) notice of when this hearing will be held.

At your hearing, you’ll be able to appear before the ALJ and be given the opportunity to review the file Social Security has put together and submit any new evidence that may be missing. You will also be able to present arguments as to why you are unable to work and should be awarded disability.

On average, it takes 6 to 9 months (longer in some states) from the time you file your appeal until a hearing before an ALJ is held, but it is at this level that you have the highest chance of success. While you have the right to represent yourself without the assistance of a disability attorney, those who are represented have a statistically significantly higher chance of being approved. On average, ALJs award benefits to about 46 percent of disability applicants who attend hearings.

After your hearing, it will take approximately 2 to 4 months to receive the decision from the ALJ. If approved, you case will then be transferred to either the Social Security Payment Center, or a Social Security Field Office, where payments will be set up.

If you are denied, you can seek review of the ALJ’s decision. As with other appeals, you’ll have 60 days to make this request.

Why the state you live in matters.

The national approval rate for disability applications that are appealed to the hearing level (meaning the application was denied at the initial stage and in most states at the reconsideration level and now is scheduled to be heard in front of an ALJ) is at 46%. This is less than a 50/50 chance of winning – not great odds. However, depending on your state, this national average can go significantly up or down. For instance, if you live in Delaware, Kansas, Nevada, Rhode Island, Texas or Wisconsin, your chances of winning go down to between 30-40%. If you live in Alaska, your chances plummet to 17%. On the bright side, if you live in New Jersey, New Mexico or Tennessee, your chances of winning at the hearing level increase to 55-56%. If you live in Hawaii, Puerto Rico or Utah, your chances sky-rocket from the national average of 46% to over 60%. That is significant. Approval rates also tend to vary greatly within states at the various hearing sites and among the different judges.

Why is there such a difference in approval rates between the various states, hearing sites and judges? Again, there is no easy answer. The variance from state to state, hearing site to hearing site and from judge to judge can be affected by state law, local rules, politics, social ideology, prejudice and training. These of course are things you, as an applicant, have little to no control over. However, there are several things that also have an enormous influence on approval rates that you can help to control. These include consistent treatment with a doctor (not from a Registered Nurse, Physician’s Assistant, etc.), objective proof of your physical impairment(s) (i.e. X-ray, MRI, CT scan, EMG, Pulmonary Function Test, etc.), objective proof of your mental impairment(s) (i.e. mental status examination, IQ tests, Patient Pain Profile, etc.), making sure you are compliant with your prescribed treatment (i.e. medications, diabetic testing and diet, exercise, stop smoking, stop drinking alcohol, etc.) and obtaining medical source statement regarding your ability to perform work-related functions (i.e. how much you can lift, how long can you walk, stand or sit, whether unscheduled breaks or absences from work would be necessary, etc.). If a claimant is denied at the Hearing level, the next appeal is to the Social Security Disability Appeals Council, and finally to the Federal District Court. Your disability advocate will have more information about each level of the process.

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