Your fight for disability benefits has been the most frustrating of all experiences. Your initial SSDI application was denied, and so was your request for Reconsideration. You have endured undue emotional and financial hardships.
Finally, the time has come for your ALJ Hearing. You may have been waiting for months or even years to reach this point. Now that the hearing is near, what can you expect? Who will be in the room? What will the judge ask you? How should you respond? What does it take to win?
These are all questions we will help you answer.
A hearing before an Administrative Law Judge is perhaps the most crucial stage in your claim for disability benefits. More than half of ALJ’s decisions nationwide are in favor of the claimant. Ninety percent of those claimants have representation.
Understanding what goes on in a hearing, and preparing ahead of time for your case, go a long way towards enhancing the whole hearing process and easing your mind. When you can anticipate the kinds of questions the ALJ will ask, and know what’s expected of you, you will be much more comfortable and effective.
To help you visualize the proceedings, we present our video of a fictional ALJ hearing. As you watch the process unfold, you will get a sense of the typical setting, atmosphere, and type of discussions that may take place during a hearing.
These are your best odds of winning at any step in the entire Social Security appeals system. How can you make the most of this opportunity? By understanding the process, and having a good Social Security attorney helping you.
Let’s start with the question:
What is an Administrative Law Judge (ALJ)?
Administrative law judges are independent federal judges who conduct legal hearings and issue decisions as to whether you are disabled under SSA’s disability rules and guidelines.
ALJs serve as both the judge and trier of fact. They control the hearing so that they can make an informed, new decision about your case. Their decisions are based on their review of your administrative record and the testimony and evidence presented at the hearing. An ALJ’s decision is not to be influenced by the fact that your case was denied at the time of your initial application and on reconsideration.
Administrative Law Judges each have their own styles and are given flexibility as to how they question and interact with you and with your lawyer. Some judges will ask you the majority of the questions and then allow your attorney to fill in the gaps.
Other judges prefer that your attorney conduct the questioning for your testimony, and then they follow up with their questions. Just be prepared and expect the ALJ to interject with questions at any time during the hearing, to clear up any points he or she still has questions about.
The ALJ You Get Can Make a Difference!
No two judges are alike, and some judges have higher approval rates than others. The ALJ sets the tone and pace of the hearing. Depending on the judge assigned to your case, the hearing may feel confrontational and tense or it can be relatively relaxed and easygoing.
Simply put, the administrative law judge you have for your hearing can impact your case significantly. Unfortunately, you don’t get to pick your ALJ.
Texas ALJ Approval / Denial Rates & Office of Hearing Operations (OHO) Statistics
We have compiled SSA’s most recent data revealing the approval and denial rates of all Texas ALJs. These numbers show how wildly the rates can vary from judge to judge.
These stats also tell you about locations, contact information, wait times for a hearing, and processing times until a case is completed, for all regional and local Texas OHOs (formerly called ODAR*).
Our Social Security disability attorneys are familiar with all local administrative law judges and will know what to expect based on the judge assigned to your case.
* SSA hearing offices used to be called ODAR which stood for Office of Disability Adjudication and Review. As of 2017, ODAR has been renamed to OHO: Office of Hearings Operations. OHO offices are the hearing offices where your case will be heard before an Administrative Law Judge (ALJ).
What Happens at the ALJ Hearing?
The purpose of the hearing is for the ALJ to make an accurate decision whether you are totally disabled and the extent of your disability. The judge will already be familiar with your disability case.
At the hearing, an administrative law judge asks questions in order to reach a determination in the case. Questions may be directed to you, as well as to witnesses. Questions focus on:
- The nature of your medical condition
- The severity of the condition
- Your ability to do your prior work
- Your ability to do other work
It is a hearing in the true sense of the word. This is your chance to present your arguments and case directly to the person who will decide whether you will receive disability payments. You can tell the judge, face to face, about your condition and how your impairments affect you.
You can present new medical evidence at the hearing that was not available at the time of your initial denial. The ALJ will consider this plus any evidence of disability that occurred in the months leading up to your hearing.
In your best case scenario, you will have an experienced Social Security Disability lawyer representing you. There will be no charge up front. A good attorney will be well-informed about your case and can help you before, during and after the hearing.
You may have witnesses to testify on your behalf at the hearing. Genuine, candid lay testimony from your own witnesses can be a decisive factor in your appeal for disability benefits.
The ALJ is going to listen to you and to your attorney. He or she will also interview and question you and your witnesses.
The judge may also call in and question vocational and medical experts to offer opinion evidence. You or your attorney may question these expert witnesses as well.
Your hearing is a serious legal proceeding, but you are not on trial. There is no SSA lawyer who will “cross examine” you or otherwise challenge your record or what you say. The ALJ may ask you to explain discrepancies or variances during the testimony phase of the hearing.
Once the record is complete, the ALJ considers all testimony and evidence in the record. The judge probably will not issue a decision that day. In most cases, the judge will make a decision after the hearing, and you will receive your notice of award letter in the mail.
Note: in some cases, the ALJ may leave the record open after the hearing if he or she believes additional evidence is needed to make a decision.
Where Will My Social Security Hearing Be Held?
SSA will notify you of the date, time and location of the hearing. Approved locations are regional or local OHO hearing offices or satellite locations. Most hearings are held within 75 miles of your home, but sometimes they are further away. Disability hearings may also be conducted via video teleconference (VTC), and in some cases may be via telephone.
Rather than a stiff courtroom affair, the ALJ hearing is by design an informal, non-adversarial event. Usually, they are conducted in a conference room or office type of setting.
ALJ hearings generally last from about 30 minutes to an hour. SSA will notify you of the date, time and location of the hearing.
Who Attends the ALJ Hearing?
Present at your ALJ hearing will be:
- The Administrative Law Judge. The ALJ presides over the hearing and is the fact-finder and the decision-maker of your case.
- A court reporter. This person assists the judge and accurately records all proceedings.
- You (the claimant). While your attendance at the hearing is not required, it is strongly encouraged! Unless you are physically or mentally unable to be present, the judge expects to see you there. Think of it this way: if SSA could determine your disabled status on your administrative record alone, it should have already happened. Presenting your case to your judge is an opportunity you don’t want to miss.
Additional people at your hearing may include:
- Your disability attorney or representative;
- Expert witnesses hired by the SSA. This may be a Vocational Expert (VE) and/or a Medical Expert (ME), who are called on by the ALJ for impartial clarification and testimony on matters beyond the ALJ’s expertise;
- Your own witnesses: you will be able to bring in witnesses, such as a family member or care giver, who can attest to your physical condition and how it impacts you. Your lawyer can help you determine who you can call as a witness in your case.
Why Is a Vocational Expert (VE) at My ALJ Hearing?
Most ALJs rely on VEs to provide expert opinion evidence to help them determine whether you can do your previous work or other work. The VE does not question you; he or she only responds to the AJL’s or your attorney’s questions.
Hearings generally conclude with the testimony of the vocational expert. Questions posed by the ALJ to the VE address issues that could be decisive in your case. The judge will raise hypothetical situations to the VE about:
- what sort of jobs you’re capable of, based on your impairments;
- the types of jobs that you could potentially do based on your age, education, and experience;
- how many of those jobs exist in the national and local economies;
- analysis based on transferable skills: (do you have skills from prior jobs that make you able to do “other work”).
Your lawyer can question the VE about the types of jobs you can perform. In our experience, vocational expert testimony can often be argued and proven different than what the VE believes.
Likewise, a judge’s decision can be overturned or sent back for rehearing should that judge fail to consider every impairment that our client suffers from.
As your attorneys, we will see to it that the right questions are asked. We make sure that every symptom, impairment, and combination of impairments you experience, as well as your actual occupational skills and limitations, are properly considered by the VE and the judge.
Why Is a Medical Expert (ME) at My ALJ Hearing?
In cases involving complex or unclear medical evidence, an ALJ may seek the advice of an independent medical expert to get a better understanding of the medical evidence in a case.
MEs are physicians, psychologists, and other medical professionals in the specialty appropriate to your diagnosed impairment. They are not there to examine you. Their purpose is to provide factual and impartial expert opinion evidence for the ALJ to consider when making a decision about your ability to work.
MEs may answer questions that could be decisive in your case, such as whether your impairment meets or medically equals a specific listing. Or they may be asked to give their opinion about what you can still do despite your impairments, and if you have limitations that make you unemployable.
The ME is expected to cite specific evidence from your record to support his or her testimony.
An ALJ may have the ME testify before, during, or after a hearing. The ME often testifies by phone or may be asked to testify in person or by video teleconferencing. Sometimes MEs provide opinions in writing by answering written questions from the ALJ called interrogatories.
What Will My Attorney Do?
Your attorney’s job is to protect your rights before, during and after the hearing, so you present the best case possible to the judge.
Even at this stage, there are many options available to you to strengthen your claim. Your disability attorney will help you understand what went wrong and develop your claim with relevant information to fill in any gaps and reinforce weak areas of your case.
We prepare for the ALJ hearing by working with your doctors. We assemble all necessary documents and exhibits, and present new information and evidence on your behalf in a format the judge expects.
Our attorneys make sure you are personally advised and ready for the questions to be asked of you. During the hearing, your attorney will be at your side to present you as an honorable and credible person.
We know that judges and expert witnesses are not infallible. Mistakes can easily be made if all evidence is not properly looked at by the judge or VE, or important facts are ignored.
We will challenge the validity of any unfavorable opinions that may be given by SSA’s medical or vocational experts, and intercede with appropriate arguments when an ALJ fails to develop the facts or makes legal errors.
SSA’s own statistics show that ALJs are far more likely to award disability benefits to claimants represented by an experienced disability attorney. Our own conversations with ALJs make it clear they prefer claimants who are represented by experienced disability attorneys.
It makes the ALJ’s life easier, as SSDI attorneys do most of the work that the ALJ would otherwise have to do. And when our attorneys do this work, you can bet it is done 100 percent for the win.
What Questions Might They Ask Me at the ALJ Hearing?
The Administrative Law Judge (ALJ) will ask you a series of questions to evaluate the claim. These questions usually cover four topics:
1: Your Personal Information and Background:
This includes your full name, Social Security number, mailing address, age, DOB, height, and weight.
2: Your Work Status and History:
Be prepared to discuss your work history over the past 15 years. This will be information the ALJ needs to know to understand how your disability affects your ability to work, such as:
- Why did you leave a previous job, and how long were you there? What was your rate of pay while there, and would you be able to do that job now?
- Have you tried to work since the onset of disability? How did those work attempts turn out?
- At the time you became disabled, what job did you have? What were those dates of employment? What were your exact job duties?
- How long did it take to learn to do this job?
- Describe machines, tools, and equipment used
- Describe any technical knowledge or skill used in this job.
3: Your Medical Condition & Limitations:
The ALJ is trying to discern any limitations you have that affect your ability to perform work tasks as well as to carry out activities of daily living.
The judge will ask about your medical condition itself, the date of diagnosis, and how your symptoms affect your ability to work and manage other aspects of your life.
No one is expecting you to answer like a doctor. Take a breath, and answer honestly with what you know, how you feel, what you experience, and what you believe to be correct.
The ALJ will likely ask targeted questions about your symptoms. For example, if you have pain, the judge may ask:
- Can you tell me about the pain you are experiencing?
- Where is the pain located?
- Can you describe what your pain feels like?
- What brings the pain on? Does it come and go? How long does it last?
- Can you rate your pain on a scale of 1 to 10?
- Are other symptoms associated with this pain, such as swelling, weakness, cramping, or heat?
The ALJ might further ask you
- How have your symptoms affected your life?
- How often do you see your doctor?
- What treatments have you undergone? Have any treatments helped?
- What medication do you take now? How much does it help and for how long? Are there any side-effects?
4: Your Residual Functional Capacity (RFC):
RFC refers to the most you can still do in a work setting, in spite of your physical and psychological limitations caused by your impairments.
Depending on your condition, the judge may ask questions such as:
- Can you sit at a desk? On a backless stool? In an office chair with arms?
- Do you need help getting up from sitting?
- How long can you sit, walk, lie down, stand or move around?
- Can you stand without leaning against something?
- Can you safely climb, stoop, or bend?
- Can you walk around the neighborhood?
- How much weight you can lift, carry or otherwise move, and how often.
- Are you able to push objects, or pull them, or reach for things?
- Can you use your hands to grasp and to hold and turn objects?
- Do you need assistive devices? (such as gripping devices, a cane or walker, motorized chair, specialized equipment)
- How often do you need to take breaks?
- Can you understand and remember instructions?
- Do you have difficulties concentrating?
- Can you stay on task and keep up the pace expected of you?
- Are you depressed, or anxious?
- Do you have trouble hearing or seeing on the job?
- How did you get to this hearing today?
- How often have you left your home during the past (month or year)?
- Do you have difficulties taking a bus, such as walking to the bus stop, sitting on the bus, or climbing the steps into the bus?
The judge relies on this type of questioning to understand your ability to perform normal job duties, and further determine your ability to hold any gainful employment.
How Should I Answer the ALJ’s Questions?
Be truthful and forthcoming at all times. No matter what the ALJ asks at your hearing, you want to answer all questions to the best of your ability. This means you must listen as attentively as you can, so your answer to the judge’s question is specific.
Keep your answer brief and on point (don’t ramble.) If you’re not sure what the judge is asking, ask them to repeat it. Never interrupt, and stay respectful and amiable.
Some claimants want to exaggerate their symptoms and limitations, thinking this will help their chances of winning benefits. This is never a good idea, because the ALJ may believe you are not being honest. The minute that happens, you lose credibility.
Other claimants tend to be stoic and brave and make out like they are more capable of doing activities than they really are. This approach never paints a true picture of your claim.
Just be calm, and be honest in your responses. A clear description of your disabling condition and the effect it has on your life is what you need to portray.
Your disability lawyer will prepare you for the judge’s questions, help you sort out your questions, and will be at your side to ensure your case is presented with every detail accounted for.
When Will I Know the ALJ Hearing Outcome?
Most judges don’t announce their decisions at the end of the hearing. Usually, in about 4 to 8 weeks, the judge will issue a written decision; you will get a Notice of Award (NOA) in the mail from the judge.
If the judge does issue an immediate decision at the hearing, you will also be sent a formal written NOA in the mail.
Notice of Award (NOA)
The NOA letter will state if you were approved or denied, and how the judge came to that decision.
If you are approved, the NOA will explain if your decision is partially favorable or fully favorable. The notice will state how much your benefits will be, and when you should expect payments to begin. Benefit payments typically begin a month after you receive the NOA.
What Does a “Partially Favorable” Decision Mean?
This generally means the judge finds you are disabled but on a different date than what you initially claimed on your application. This will reduce the amount of back-pay you receive.
A partially favorable decision may also be granted because you are awarded benefits for a closed period of time. If a judge finds your condition has medically improved enough that you are able to go back to work, you will receive disability for a set time period and then payments will stop.
If I Disagree with the ALJ’s Decision – What Can I Do?
If you were denied benefits or if you disagree with the SSA’s “partially favorable” decision, you still may have very good options before you.
You May Elect to Appeal the ALJ’s Decision
For the next level of appeal, you request that the Social Security Appeals Council hears your case. Details about how to appeal will be in your NOA. You need to request Appeals Council review in writing within 60 days of receiving the NOA.
The operative word here is “request” because you are not automatically entitled to a review by the Appeals Council. Why is that? At this level of review, the process is very different.
The Appeals Council does not agree or disagree with the decision that you can return to work; the Appeals Council can only review whether there was an error in law made by the ALJ.
Once the appeal is requested, the Appeals Council can review an appeal for a year before deciding to (1) reverse a denial, (2) remand the case back to the ALJ who denied the claim, or (3) decline to review the case.
You May Re-apply for Social Security Disability Benefits
You do have another option, and that is to start a new application for disability benefits, rather than appeal the ALJ’s decision.
The bottom line here is that you cannot have two SSDI cases open at one time.
If this is your situation, you need experienced legal guidance to help determine your best strategy to get you the benefits you deserve. We hope you will contact us as soon as possible to understand your options and preserve your right to appeal.
Remember, decisions issued at the ALJ hearing level often contain some error of fact or law that can be argued to the Appeals Council.
We can help you proceed carefully and judiciously, whether that involves preparing a new, initial disability application or helping you ask for a review by Social Security’s Appeals Council.
Never Give Up!
Do not lose hope — keep trying and keep fighting! After denial at the initial application or reconsideration levels, your chances of approval can still be very strong, especially with proper legal representation.
Call Marc Whitehead & Associates, 800-562-9830, for a free legal consultation in which we can explain how we can help you specifically. We never charge unless you win your case, and that amount is regulated by SSA.