How To Avoid Hearing Delays

Most Social Security Disability (“SSD”) claims are denied initially, and the denial rates are even higher in New York. After the state agency renders its decision, the claim gets transferred to the Social Security Administration (“SSA”) for adjudication at the hearing level. The most frequent complaint at this next level is the amount of time it takes before a hearing is scheduled. Two years is not unusual.

It may be possible to avoid a hearing by requesting an “on the record (“OTR”) decision. An OTR summarizes the medical and vocational evidence and explains why the objective evidence in the file suffices to establish disability under the SSA rules and regulations. Some hearing offices are allowing Senior Attorney Adjudicators to decide OTRs, which helps expedite the process even more. I just had an OTR approved that illustrates some of the key tactics for getting an OTR approved.

The claimant’s primary medical condition was Guillain-Barre syndrome. Since Attorney Adjudicators are not doctors, I explained what Guillain-Barre syndrome is and how it affects a person’s ability to work, along with an article providing statistics regarding the percentage of patients who become disabled from it. According to an article republished on the National Institutes of Health. Reports detailing the claimant’s functional capacity were submitted not only from the claimant’s neurologist, but also rheumatologist and internist. While only one physician is technically required, the chances of having an OTR approved increases with multiple corroborating sources.

Because I established a rapport with the staff attorney, he contacted me and asked if there were any recent diagnostic or laboratory tests. Even though I did not feel they were needed, I immediately complied to ensure that the staff attorney would feel comfortable contacting me in the future.

Finally, I emphasized the import of the vocational evidence, which is frequently as important as the medical evidence. The claimant 58 years old and her past work was non-sedentary. Under the SSA regulations, those facts meant that in order to find the claimant had transferable skills to sedentary there had to be very little, if any, adjustment. Therefore, under another SSA rule, known as a grid rule, the claimant would have to be found disabled even if capable of performing sedentary work.

The medical and vocational evidence reviewed by the state agency before the SSA took over may have been sufficient for the claimant to win at a hearing. However, to secure benefits through an OTR, a stronger case needs to be presented.