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.

Those who suffer from physical or mental conditions that make it difficult or impossible to work will often be concerned about their ability to support themselves financially. Fortunately, Social Security disability benefits are available in many cases. However, the process of applying for Social Security disability can be complicated, and disability claims are often denied for a variety of reasons. While it is possible to appeal the decision to deny disability benefits, it is important to understand the procedures followed when doing so and the types of evidence that may be considered in an appeal.

Appeals Court Upholds Decision to Deny Benefits and Refuses to Reweigh Evidence

If a disability claim is denied, an applicant will usually need to file a request for reconsideration, and if benefits are once again denied, they may request a hearing before an Administrative Law Judge (ALJ). Both sides will present evidence at this hearing, and the ALJ will follow specific procedures to determine whether the applicant is disabled and whether they should be able to find work that fits within their physical or mental limitations. If an ALJ rules that a person is not disabled, the applicant can appeal this decision. However, an appeal must be based on the claim that the ALJ committed errors, and an applicant cannot introduce new evidence or ask the appeals court to reconsider or reinterpret previous evidence.

If you suffer from injuries or illnesses that make it difficult or impossible for you to continue working and earning an income, you may be able to receive Social Security disability benefits. However, the process of applying for disability benefits can be complicated, and applications are often denied. When appealing a disability denial, it is important to understand the factors that will be reviewed to determine whether you are disabled and eligible to receive benefits.

Analysis of Whether a Person Is Disabled

When reviewing a plaintiff’s appeal of the denial of Social Security disability benefits, an Administrative Law Judge (ALJ) is required to perform a five-step analysis in which the following questions are considered, in order:

• Is the plaintiff currently unemployed?
• Do the plaintiff’s medical issues constitute a severe impairment?
• Is the plaintiff’s impairment one of the specific impairments listed in Social Security regulations, or is it equal to one of these impairments?
• Is the plaintiff unable to perform work in their former job?
• Is the plaintiff unable to perform work in another occupation?

An answer of “yes” to either step three or step five will result in a finding that the plaintiff is disabled. If the plaintiff can meet the requirements of step four and show that they are unable to perform work they have done in the past, the Commissioner of Social Security has the burden of proof to show that the plaintiff should be able to find work based on the available jobs in the national economy that meet their physical limitations.