What Happens at an Administrative Hearing?
A hearing before a Social Security Administrative Law Judge (ALJ) begins after your Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) claim has been denied AND your appeal, or reconsideration, has also failed. You then have the right to have your claim decided by an ALJ.
So, what does that process look like?
You or your legal representative may file a request in writing within 60 days of receiving notice your reconsideration claim has been denied. Failing to get your request submitted within that time frame could result in the ALJ dismissing your appeal. According to the Social Security Administrations guidelines, you must provide a good reason for going beyond the 60 day time limit. If your appeal is filed late you must explain why in writing and request the Social Security office extends the time limit. This is decided on a case-by-case basis, and is not guaranteed to be successful.
After your hearing is requested, the Social Security Administration (SSA) office transfers your case file to the ALJs office, and an appearance can be scheduled. Appearances can be either in person or by a video conference link. Often, a video conference appearance can be scheduled quicker, due to ALJ travel schedules and case backlogs. There are 161 hearing offices across the country, and according to the SSA, 40 percent of hearings are held remotely through a video link, lessening the likelihood youll have to travel far for your hearing. Whichever method is used, you should be given a 20 day advance notice outlining the time, date and location of your hearing.
Hearings are usually held within 75 miles of your hometown, but they can be farther away if the ALJ wants to consolidate hearings into a central regional location. If travel is a hardship, contact the SSA to make alternative arrangements.
It is crucial to have everything regarding your claim submitted prior to your hearing. Make sure all paperwork, government forms, doctors bills, medical histories and other information is on file.
The SSA offers the following advice for helping the hearing process go more smoothly and quicker: If you choose to have a lawyer represent you, obtain one as soon as possible. This will allow your counsel adequate time to review your claim and prepare your case. If you cut it too close, your hearing may have to be postponed. This is a problem because most hearings are scheduled two or three months in advance. Also, dont cancel a hearing unless absolutely necessary. This can push you to the back of the line and add months to the process.
If you dont want to appear in person at the hearing, you must notify the SSA in writing. Then, you have to ask the ALJ to make a decision based on the contents of your file. The ALJ may decide, however, that you need to be present, especially to explain certain aspects of your disability claim. In that case, you will be required to appear. If you dont appear and cant provide an acceptable excuse for your absence, the ALJ could very well dismiss your claim.
At the hearing, the ALJ will explain the issues regarding your case and may question you or any witnesses you bring to testify on your behalf. The ALJ may also ask doctors or vocational experts to testify about your medical condition and ability to work. All questioning is done under oath, and you and your lawyer may question the other witnesses.
At the end of the hearing the ALJ will most likely move to close your Administrative Hearing Record, in order to prepare their decision. Normally, you wont receive that decision at the hearing, but as many as 90 days afterwards. Sometimes an ALJ will make what is called a bench decision, although this is rare. In these cases, the ALJ determines your claim is strong enough for them to issue an oral decision. Usually, within seven to 10 days youll receive a summary of your hearing explaining you received a fully-favorable decision and you are eligible for benefits.
There are four possible decisions that can be handed down by the ALJ:
- Fully-Favorable Decision
- Partially-Favorable Decision
- Unfavorable Decision
A Fully-Favorable Decision is issued when the ALJ has approved you for the entire period of disability you have requested. This is based on your last working day, and you will receive continuing monthly benefits.
A Partially -Favorable Decision comes when the ALJ agrees you are entitled to disability benefits, but does not grant them for the entire period you requested. This decision can stem from the ALJs opinion that you were disabled at a later date than you claimed, or you had past disability but were able to work. The ALJ must write in their decision why they ruled in this manner.
An Unfavorable Decision comes when the ALJ determines you are not eligible for disability benefits for any of the time you requested. In their written decision, the ALJ will provide full details of why you failed to meet SSI or SSDI requirements. The ALJ is also required to explain why your doctors medical opinion were not acceptable.
Finally, a hearing may result in Dismissal. Under this decision the ALJ determines that medical proof of your disability is not necessary. The ruling is you are not entitled to disability payments. Dismissals are usually the result of failure to attend your scheduled hearing, a too late filing for a hearing request (more than 60 days), or if you volunteer to withdraw your hearing request.
The national average is 30 to 90 days from the closing of the administrative record for the ALJs decision to be received, although there is no time limit for the ALJ. Bench decisions and dismissals are the fastest, and average about a week to process. Fully-favorable decisions average between 30 to 45 days, while partially-favorable decisions can take much longer due to the bureaucracy involved, according to national averages and Social Security disability advocates.
For more information on this topic, visit this link on the SSAs website: