Founding Attorney
If you have to stop working due to a prolonged or permanent disability caused by an injury or medical condition, you may decide to file for benefits from Social Security Disability Insurance (SSDI).
Unfortunately, the Social Security Administration denies the majority of initial applications for various reasons. The good news is that applicants can challenge a claim denial through the SSA’s administrative appeals process, the second step of which involves a hearing before an administrative law judge.
The Administrative Law Judge’s Decision Process
An administrative law judge who presides over a hearing for an appeal of an SSDI claim does not issue their decision at the hearing. Instead, the ALJ will review the medical record, other evidence, and the testimony and legal arguments presented at the hearing to decide whether to approve or deny an SSDI claim. At a hearing, the ALJ usually gets to hear testimony from medical and vocational experts about the nature of the claimant’s disability and how it affects their ability to work. As a result, it can take several weeks to several months for the ALJ to issue a final written decision after a hearing.
Possible Outcomes After the Hearing
An administrative hearing in an SSDI claim can result in one of several possible outcomes:
- Fully Favorable Decision – The ALJ approves the claimant for SSDI benefits from the alleged onset date.
- Partially Favorable Decision – The ALJ approves the claimant for SSDI benefits, but finds a different onset date than alleged by the claimant (which can affect back pay) or different limitations (which may affect the claimant’s ability to work if their condition improves).
- Unfavorable Decision – The ALJ upholds the denial of the claimant’s SSDI application.
What Happens When the ALJ Rules in Your Favor?
When an ALJ issues a favorable decision, the Social Security Administration will process the award and begin paying the claimant benefits, including any back pay owed to the claimant based on the onset date found by the ALJ. The claimant will then start receiving monthly payments after they have completed the required five-month waiting period following the onset of disability.
What Happens If the ALJ Upholds the Denial of Your Claim?
When an ALJ upholds the denial of an SSDI claim after an administrative hearing, a claimant may pursue further appellate steps to challenge the denial of their claim. After an administrative hearing, the next and final step in the administrative appeals process involves filing a request for review with the Social Security Administration’s Appeals Council. The Appeals Council may either deny review (thereby upholding the ALJ’s decision) or grant review and either decide the case itself or return (remand) the case back to the ALJ for further consideration of issues identified by the Appeals Council. Should the Appeals Council also deny the claimant’s SSDI application, the claimant may seek judicial review of their claim by filing a civil action in a federal district court.
Managing Expectations and Next Steps
Best practices for claimants to follow while awaiting a decision from the ALJ after an SSDI hearing include:
- Check the Social Security Administration’s online portal regularly to see whether the ALJ has issued a decision on your claim.
- Make sure the SSA has the correct addresses for you to receive the ALJ’s written decision (which triggers the deadline for filing a request for review with the Appeals Council).
- Continue gathering medical records and other evidence in case you need to appeal your SSDI claim further.
Should you have to request review by the Appeals Council, you have 60 days from the receipt of the ALJ’s decision to file your appeal (the SSA presumes you receive the decision five days after the date on the decision).
Contact an SSD Attorney Today
If you’re thinking of requesting an administrative hearing before an ALJ to challenge the denial of your SSDI claim, it can be helpful to know what to expect from the appeal process. Contact Grech Law Firm today for a free, no-obligation consultation with an SSD lawyer to learn more about what to expect in an administrative hearing on your SSDI claim, what happens afterwards, and what steps to take after the hearing.