A new rule that went into effect December 16, 2020, could make it harder for disabled individuals seeking to qualify for Social Security disability benefits. The rule changes the disability appeals process by allowing attorneys who work for the Social Security Administration to conduct hearings and make decisions on whether the claimant is eligible for benefits. Up until December, these hearings were always overseen by independent and impartial administrative law judges (ALJ).

Social Security Disability Benefits Process

It is important for anyone who is applying for Social Security disability to understand how complicated and drawn out this process often is and why it can be critical to have an experienced Chicago disability attorney advocating for you. There can be up to four steps in applying for benefits:

• Initial application: Many people file their initial request for disability benefits either online or over the phone. It is rare that an applicant’s initial application is approved at this stage. If a claim is denied, the applicant can request a reconsideration.
• Reconsideration: An applicant has 60 days from their date of denial to file a Request for Reconsideration. The Social Security Administration will again review the application. Sometimes, at this level, the agency will approve the applicant’s claim and they will begin receiving benefits. However, it is also very common for the agency to deny the claim again. If this occurs, the applicant can request a hearing.
• Hearing: An applicant again has 60 days from the day their Request for Reconsideration was denied to file a Request for a Hearing. The hearing usually takes place at the applicant’s local Social Security Administration Office in front of an ALJ. It is highly recommended that the applicant has a qualified disability attorney who is experienced in defending denied Social Security disability benefits. Once the attorney presents all the evidence on behalf of the applicant, the ALJ will decide if the claim should be approved. If the ALJ denies the claim, the applicant can appeal the decision to the Appeals Council.
• Appeals Council: These appeal hearings are decided by administrative appeal judges (AAJ). Unlike an ALJ, who is impartial and independent, an AAJ works directly for the Social Security Administration. The role of the AAJ is not to evaluate the applicant’s case, but only to determine if the ALJ made a technical error or did not consider any relevant medical information during the hearing.

New Policy

Under the new policy, those same AAJs will now be allowed to hear and decide hearings instead of or in addition to ALJs and this could have a detrimental impact on an applicant’s ability to obtain a fair and just hearing. In addition to requiring ALJs to be independent and impartial from the Social Security Administration, they also are required to have a minimum of seven years experience as a licensed and practicing attorney and have significant experience in trials and litigation.

When a person applies for Social Security disability benefits, there are many different factors that are considered to determine whether the person is considered to be disabled. A person must suffer from a physical or mental impairment that is “medically determinable,” and this condition must have lasted or be expected to last at least 12 months. An impairment must also affect a person’s ability to find gainful employment.

If a Social Security disability claim is denied, an applicant may appeal this decision, and an administrative hearing before an Administrative Law Judge (ALJ) may be held to review the case and determine whether the person is disabled. An ALJ will follow a multi-step process to evaluate the person’s claim, and one important step in this process is determining whether the claimant’s condition meets or equals any of the items included in the Listing of Impairments in the Social Security Code of Regulations.

Magistrate Reverses ALJ’s Decision Based on Improper Analysis of Listing of Impairments

One recent case in Illinois demonstrates the role that the Listing of Impairments may play in an administrative hearing. In Angela L. H. v. Commissioner of Social Security, a woman’s disability claim had been denied, and after appealing this decision, the ALJ who reviewed the case determined that she was not disabled, since her impairments permitted her to find work other than what she had previously performed.

There are a variety of conditions that can cause a person to become disabled, and some of them may be less obvious than others. While injuries or physical impairments can affect the type of work a person can perform, mental health concerns can also lead to disability. Unfortunately, those who suffer from mental illness may be denied Social Security Disability benefits, and they should understand their options for appealing these decisions.

Magistrate Overrules ALJ’s Decision Due to Incorrect Consideration of Mental Limitations

One recent Illinois case illustrates some of the reasons a person with a mental illness may be improperly denied disability benefits. In the case of Panayiota P. K. v. Commissioner of Social Security, the plaintiff was a 49-year-old woman who suffered from multiple mental impairments, including bipolar disorder, generalized anxiety disorder, and post-traumatic stress disorder (PTSD). She reported difficulty with concentration, understanding and following instructions, and getting along with authority figures. She also experienced anxiety attacks multiple times per week, anger issues, and a voice in her head that told her to strike people who upset her.

At the plaintiff’s evidentiary hearing, the Administrative Law Judge (ALJ) determined that the plaintiff had the residual functional capacity (RFC) to perform work involving simple, routine tasks. A vocational expert (VE) testified that the plaintiff could work in light jobs such as a cleaner or production worker, but they noted that being off-task for at least 10% of the time would result in termination, and the plaintiff would likely also be terminated if she had any verbal or physical confrontations while at work. The ALJ denied disability benefits and stated that the plaintiff should be able to find work within her limitations.