Administrative Law Judge Hearing – What Happens
By Pitt Dickey
This column will discuss what actually occurs at a Disability Hearing when a disabled worker appears before an Administrative Law Judge. These hearings only occur if the disabled worker has already been denied twice. The first two denials are called the initial decision and the reconsideration decision. To make this process easier to follow, I’ll use the hypothetical case of Deanna Jones. In this example, Ms. Jones suffers from herniated disks and has had surgery to try to repair her disk.
Ms. Jones applied for disability benefits and was denied at the initial level. She gave her notice of appeal within 60 days to request a reconsideration. Her reconsideration was denied as is frequently the case and now she is facing a hearing before a Judge. She is uncertain as to what to expect and nervous about how to approach this very important hearing.
The hearing before the Administrative Law Judge is the most important step in the whole Social Security Disability process. It is the only point that Ms. Jones will get to actually personally appear before the person who will make the decision as to whether she will be able to receive disability payments. The decisions at the other levels are made by people who review documents but don’t personally talk to and observe Ms. Jones.
The Judge is not bound by the earlier decisions made at the initial and reconsideration levels. In other words, he makes a new decision based upon the evidence presented to him at the hearing. He will have reviewed all the medical and vocational records in the prior decisions but his job is to make a new decision based upon his observation of Ms. Jones, listening to her testimony and review of the record.
Currently the Social Security Administration holds hearings in this area at the Office of Disability Adjudication and Review located at 150 Rowan Street, Fayetteville for Cumberland and surrounding counties
The hearing itself is not an adversary style hearing like criminal or civil trials. There is no prosecutor appearing on behalf of the SSA trying to prove a claimant is not disabled. The Administrative Law Judge’s role is to make a fair inquiry into the health problems of Ms. Jones. The Judges are uniformly polite and compassionate in conducting these hearings.
I tell my clients that these hearings will be the easiest judicial hearing they will ever attend. The hearings offer the client the opportunity to tell another human being how their health problems have effected their lives and ability to earn a living. No one knows any better how their health has effected their ability to work than the person involved.
The hearings themselves are reasonably informal in that the strict rules of evidence that apply in criminal or civil court do not apply. For example, hearsay is permissable in a disability hearing. Deanna could tell the Judge what her doctor had told her about her back problems and his opinion about her ability to return to work.
Most but not all of the Administrative Law Judges let the attorney handling the case do the majority of the questioning of the claimant. The Judge will ask questions during the hearing or at the end of the claimant’s presentation to cover areas that he has questions about. The Judge is interested in hearing evidence regarding the type of work Deanna performed. The Judge will want to know the physical requirements of her past jobs such as amount of weight lifted, how much sitting, standing and walking she performed in her prior jobs. Deanna’s vocational background is important because the Judge has to determine if she has skills from her past jobs that could be transferred to enable her to obtain other less demanding jobs.
The SSA has a fairly elaborate schedule within its “Grid” system of Medical-Vocational Guidelines which it uses to determine if a claimant should be determined to be disabled. One such factor it applies is to determine the transferability of skills from one type of work to another. For example a person who had been a manual laborer in construction would have very few transferable job skills as compared to a school teacher. The more transferable the job skills that Deanna possesses the more difficult it is for her to obtain disability benefits.
The Court is interested in her educational background regarding how far she went in school and any special training she may have received. Claimants with greater educational backgrounds have more ability to obtain other work outside their past jobs than those with limited educations.
The Court will also consider Deanna’s age. The SSA takes the position that younger persons are more likely than older persons to be able to locate jobs. The SSA has divided up the working population into the following categories:
Advanced age: 55 and over
Individuals approaching advanced age: 50 to 54
Younger individuals: 18 to 49
Finally the Court examines the health problems of the claimant. Deanna will have to describe how her back problems have effected her daily life, the symptoms that she has, the level of pain that she has to endure, when such pain occurs, limitations on movement, effect of her medications on easing pain and any side effects of the medication such as impaired concentration or memory problems.
The Judge does not usually announce his decision at the end of the hearing. Deanna will receive a written detailed decision in the mail from the Judge. Usually these decisions are received in about six to eight weeks from the hearing, however due to the Judge’s case load and the complexity of the decision this time frame can vary widely between cases.
Pitt Dickey has practiced law in Fayetteville since 1978. He has handled SSA disability claims for over sixteen years. He practices with the firm of Smith, Dickey, Smith, Hasty & Dempster, P.A. at 309 Person Street and can be reached at 484-8195.