SSA

The day you’ve been waiting two years for is finally here. It’s time for your Social Security hearing before an Administrative Law Judge (ALJ). You are happy the day has finally arrived, but also nervous because you don’t know what to expect. At Greeman Toomey we ask that our clients arrive at our office 90 minutes prior to their hearing’s scheduled time. Our office is conveniently located in the same building as the Office of Disability Adjudication and Review (ODAR), the location of hearings for Twin Cities’ metro area residents. When you show-up to our office you can be confident that your hearing attorney has reviewed your file and is prepared. The first step is to discuss what will happen at the hearing with a Greeman Toomey attorney. During this time the attorney will go over any questions he or she has about your medical conditions and treatment, as well as answer any questions you may have a bout the process. After the preparation is complete it will be time to go to ODAR for the hearing. You will then wait in the ODAR lobby until your case is called before the assigned ALJ. Once this happens you will proceed to the hearing with your attorney. At the hearing there many be a few other people in the room with you besides your attorney and the ALJ. Almost every hearing includes the presence of a vocational expert. This independent expert will testify about what types of jobs you may or may not be able to perform. The ALJ might also appoint an independent medical expert to testify about your disabilities and how they might affect your ability to work and a court reporter is assigned to document the hearing. After testimony from the experts your attorney does a thorough job of proving the facts of your case to the ALJ. The entire process takes about 45 minutes and is a lot more informal than a typical hearing you might see in a different type of courtroom. Typically you will not know the decision the judge is going to make the day of the hearing and have to wait until the presiding judge writes the official decision, which can take up to 90 days to receive.

In a previous post on this blog entitled “The Initial Level” we discussed the first of the four main levels of an application for Social Security disability benefits and/or Supplemental Security Income. This entry discusses the second level which is commonly referred to as the “Reconsideration Level.” If an individual’s application was denied at the initial level, then the process will continue to the reconsideration level. The reconsideration level is very similar to the initial level in that the Social Security Administration (SSA) will conduct a complete review of your claim and the medical evidence which has been collected from your health care providers. However, at this level the evidence will be reviewed by individuals who did not take part in the decision made at the initial level. The SSA will again review all of the evidence that was considered at the initial stage, as well as any new material that has been submitted. Although a new evaluation is being conducted at the reconsideration level, unfortunately, the denial rate at this level is very high. For example in 2009 only 8.2% of medical decisions made at the reconsideration level resulted in approval. (See Outcomes of Applications for Disability Benefits here) If it is determined that an individual is not disabled at the reconsideration level, the individual may request a hearing in front of an Administrative Law Judge, which is the third stage an application for disability benefits can progress to. The Hearing Level will be addressed in a future post.

An RFC is important at several stages of the 5 step sequential evaluation process, but let’s start with a definition. RFC stands for residual functional capacity, and is an individual’s maximum remaining ability to perform sustained work on a regular and continuing basis. In other words, what can the person do 8 hours a day, for 5 days a week? An RFC is assessed based on all the medical records in a case and is supposed to represent the most a claimant can do, both physically and mentally. A person’s RFC considers both exertional and non-exertional limitations. Exertional limitations have to do with physical strength and fall into one of seven categories: sitting, standing, walking, lifting, carrying, pushing, and pulling. Non-exertional limitations include any work-related limitation that is not covered by one of the exertional categories. Non-exertional limitations include: mental abilities, vision, hearing, speech, climbing, balancing, stooping, kneeling, crouching, crawling, reaching, handling, fingering, feeling, and environmental restrictions. If any exertional limitations are involved in a disability claim, then the RFC assessment must include an exertional classification of sedentary, light, medium, heavy, or very heavy work. As a person moves down the list of exertional classifications (for example, from heavy to medium) fewer jobs are available that fall within the person’s RFC. As a result, the lower the exertional classification, the better the claimant’s chances of being found disabled. Non-exertional limitations can also decrease the number of jobs that fall within a claimant’s RFC. For example, limitations in fingering and handling could exclude assembly jobs, while limitations in interacting with the public could exclude customer service jobs. In future blog posts we will look at RFCs in several different scenarios and examine how they might affect the outcome of case.