Part 4-The Hearing Decision
Following the hearing in your Social Security Disability (SSD) and/or Supplemental Security Income (SSI) case the Administrative Law Judge (ALJ) is required to issue a written decision. Assuming all evidence is before the ALJ at the hearing, and there are not medical records outstanding, most ALJs will issue their written decision within 60-90 days of your hearing. In general, in order to be eligible for disability benefits, a person must have a condition, or combination of conditions that have either kept you from working for a period of 12 months or are likely to keep you from working for a period of 12 months. There is no “partial disability” or a percentage of disability through the Social Security Administration. Either you are disabled or you are not. There are essentially three different types of decisions the ALJ may issue.
1. Fully Favorable Decision -this is good news. If you see “Fully Favorable” written on the first page of the decision it means the ALJ has found you to be disabled. Most written decisions are between 5 and 10 pages long and the ALJ discusses the evidence and why he/she felt the evidence and law supported the claim. After the issuance of a Favorable Decision the Social Security Administration will move forward to calculate the amount of benefits you should receive for SSD and/or SSI benefits.
2. Partially Favorable Decision-these decisions do not occur often but typically mean that the ALJ has found the individual disabled for a specific period of time. For instance, say Mr. Jones is in a bad car accident and is out of work beginning January 1, 2015. He slowly improves throughout 2015 and early 2016 and returns to his prior job without restrictions on February 1, 2016. If the ALJ felt that Mr. Jones was disabled under the Social Security guidelines from January 1, 2015 to February 1, 2016 the ALJ would issue a partially favorable decision. Mr. Jones would be eligible for benefits for the period of January 1, 2015 to February 1, 2016 but not eligible for continuing monthly benefits.
3. Unfavorable Decision-unfortunately this means the ALJ does not believe you are disabled and has denied your claim. While this is certainly not the decision anyone hopes for it may not be the end of the road. If the ALJ issues an Unfavorable Decision you have 60 days to file an appeal with the Appeals Council. Sometimes it is wise to file an appeal with the Appeals Council while other times it may not be the best course. The Appeals Council will review a claim under limited circumstances and there needs to be a solid legal basis to warrant review. The mere fact that you disagree with the ALJ’s decision is not enough to have the Appeals Council review a claim. I would recommend consulting an experienced Social Security attorney to discuss the advantages and disadvantages of pursuing a specific claim to the Appeals Council.
As stated above the hearing decision is not always the last step in the Social Security Claim process. If an individual receives an Unfavorable Decision they can appeal that claim to the Appeals Council and if that appeal is denied then they can file suit in Federal District Court. The majority of cases are concluded at the hearing level and I have tried to step you through the process from the beginning at the initial application through the hearing and subsequent decision.
Randy Walton; February 29, 2016
If you have questions regarding a Social Security Disability or Supplemental Security Income case please call me. Get a local experienced attorney to help. Cases are handled on a contingency fee basis so there is no fee unless benefits are recovered. Call today to schedule an appointment in one of our convenient Mobile and Baldwin County offices. 1-251-455-5819. www.WaltonDisability.com
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