If the Social Security Administration (SSA) denies your disability claim, you have the right to file an appeal for reconsideration. An appeal for reconsideration unfolds just like the initial claim in that a team of medical examiners from the SSA reviews your appeal to determine whether you qualify for disability benefits.
If the SSA denies your appeal for reconsideration, you take your denied claim in front of an Administrative Law Judge (ALJ) who oversees a live hearing.
What is an ALJ Hearing?
An ALJ hearing provides you with the opportunity to present your case in front of an administrative law judge. The goal is for you to present enough convincing evidence for the judge to reverse your denied disability claim.
ALJs work as independent federal judges that conduct hearings and issue decisions regarding denied disability claims. They control hearings to make informed decisions about pending appeals. ALJs review medical evidence and listen to the testimony presented by witnesses. At no time should an ALJ be unduly influenced by the fact that the SSA has denied your disability claim two times.
The ALJ who presides over your appeal hearing might ask most of the questions or defer to your attorney to ask a majority of the questions. Each judge brings a unique style to the courtroom, which means your lawyer must adapt to the ALJ who conducts your hearing.
What Happens at an ALJ Hearing?
Whether by phone, in person, or video conference, the ALJ introduces every participant in the hearing. You can expect the ALJ to ask you questions, as well as pose questions to any witnesses called by your lawyer. Every question asked is done so under oath. Any untruthful statements presented by any of the witnesses are grounds for a charge of perjury.
If the ALJ decides to defer to your Social Security disability attorney, the judge has the right to ask follow-up questions to clarify the statements made by witnesses under oath.
The primary intent of the questioning is to ensure the ALJ makes a decision based on the medical evidence presented, as well as the testimony provided by witnesses.
Here are some of the issues that might prompt questions from the ALJ:
- The extent of your disability
- The severity of your medical condition
- The results of diagnostic tests
- Your ability to continue working at your current job
- Your ability to move into another position
Unlike a vast majority of other courtroom procedures, an ALJ hearing is not a contentious legal battle between you and the ALJ. It is your best chance to present your case in front of an impartial judge.
You will not be cross-examined by the ALJ or an attorney representing the SSA. Working with a Social Security disability attorney can help you present the most persuasive case during an ALJ hearing.
The ALJ presiding over your appeal might request to leave the record open on your case if more evidence is required to issue a decision.
When Will I Get a Decision Letter from an ALJ
In some cases, an ALJ announces a favorable decision at the end of the hearing. However, most ALJ hearings end without the resolution of an appeal. You should hear from the ALJ between two and three months after the hearing ends.
It might take six months before you receive a decision letter from the ALJ. Typically, the longer it takes for an ALJ to send a decision letter, the more likely the decision will not be favorable to the claimant.
If the ALJ overseeing your appeal wants more evidence, then the decision letter will be delayed for several more months.
What Happens After an ALJ Makes a Decision?
Now that you know how long it takes to get results after an ALJ hearing, the next question to answer is what happens after an ALJ makes a decision.
If the ALJ denies your appeal, your information is sent to the SSA in case you take the next step in the appeals process You receive a notice of denial, as well as instructions on how to file another appeal.
If the ALJ approves your appeal, a representative from the SSA checks to determine whether you have worked above the substantial gainful activity (SGA) threshold since the day you file your disability claim. For 2021, the SGA is $1,310 a month. If you made more than $1,310, the SSA might deny your claim even though the ALJ approved it.
A notice of award explains the terms of your disability benefits, as well as whether the ALJ gave you a fully favorable ruling or a partially favorable ruling.
The difference between the two concerns the date your medical condition symptoms started to impair your work performance. If the ALJ believes the date you claim is not accurate, the ALJ might issue a partially favorable ruling.
Your file is sent to a payment processing center and within a month, you should start receiving your monthly disability checks. If the ALJ denied your appeal, you have the right to move on to the third step of the appeal process, which is filing a formal appeal with the Appeals Council.
Can an ALJ Decision Be Overturned?
The only way to overturn a decision made by an ALJ is to file an appeal with the Appeals Council. You can file an appeal to the Appeals Council by sending the SSA a letter or submitting Form HA-520.
One recent trend that is a bit alarming is that for some fully favorable decisions issued by an ALJ, the Appeals Council has requested to review the fully favorable decisions and overturned them. This is just one of the reasons why you should hire a Social Security disability attorney.
Get Help from a Disability Lawyer
In addition to fighting back against a negative decision made by the Appeals Council, a Social Security disability attorney can help you collect and organize the medical evidence you need to persuade the SSA to approve your initial claim.
A lawyer also ensures you file your claim before the deadline date. Legal counsel is especially important if you decide to file an appeal for an ALJ hearing.
