SSI Appeal

If you are someone who is currently disputing with the Social Security Administration (SSA) regarding any withheld or inaccurate decisions regarding your supplemental security income (SSI), and have already filed for reconsideration, you may want to learn about the next stage of the appeals process. Most cases which are not resolved directly by the SSA will be reviewed by an ALJ.

What is an ALJ?

An ALJ stands for Administrative Law Judge. These judges are impartial legal officers who are appointed by governing agencies – in this case, the SSA – and meant to offer neutral decisions in administrative law cases – which SSI appeals fall under. They’ll conduct hearings where the claimants (in this case, you) alongside their legal counsel can present their case with any additional documents or facts. You can request this hearing in writing, or by filling out an online form or fax from the SSA.

While ALJs are appointed by the SSA, they are still bound by impartiality to act independently and ensure a fair process for all claimants who testify. Like what the Supreme Court Judges are to the other main branches of government, ALJs are checks and balances between you and the SSA. However, ALJs will possess a good deal of knowledge and expertise in the appeals process that may ultimately favor the SSA, but having a reputable and knowledgeable SSI lawyer by your side can help even the playing field by a big margin.

Administrative Hearings

So here’s what you’ll need to know about the hearing.

Most hearings are held in offices. The SSA has numerous offices in operation across the country where you may be requested to come. The SSA, the ALJ, and your lawyer can come together when choosing a date, time, and location for a hearing. They are prepared with the adequate video equipment to conduct a video hearing if need be, along with the appropriate accommodations for people with disabilities, including interpreters or mobility equipment and ramps.

In order to prepare for the hearing, there’s a few things to consider.

It’s first and foremost important to review your case. As the one who filed the claim in the first place, no one knows your argument better than you, but you’ll need to make sure you’re familiar with all of the details and angles of your case, including your medical records, test results, or any necessary evidence. Anything that may prepare you for an ALJ’s questions. 

What might an ALJ ask? They’ll primarily ask what your disabilities are and how much pain you endure. An ALJ may ask you to describe a typical daily routine, how you manage menial household chores and responsibilities, whether or not you drive or use public transport, and if you engage or are able to engage in recreational/social activities. They’ll assess to what degree your impairments affect your life and if the SSA should be supporting you further. They’ll also ask about your work history, all jobs you’ve worked or are currently working, your living situation, and marital status, as it affects your SSA eligibility.

Consulting with your doctors beforehand may be beneficial to structuring your argument. The SSA may be trying to dispute that your disabilities are not so severe that they impact your life, or that even if you’ve received SSI in the past, your disabilities have improved functionally enough to no longer require supplemental assistance. You’ll have to provide adequate evidence beyond just what you know of yourself.

You’ll likely also speak with your SSI lawyer to try and strategize an argument. You may rehearse key points and answers to any questions that might pop up. You’ll go over all the possible questions an ALJ might ask, and your rehearsal can help you to provide clear and concise answers. It’ll also help to quell any nervousness or public speaking anxieties one might suffer from. 

There may also be witnesses like family, friends, or co-workers/work references who can testify about your health condition, what your day-to-day life might look like, and confirm any of the arguments that make you eligible for supplemental income.

Your ALJ will direct you and give you careful instructions for how the hearing may proceed, but if you ever find yourself confused or in need of guidance, do not hesitate to ask questions at any point. It is encouraged and even expected in most cases. 

It’s also good to keep in mind that an ALJ is meant to be an impartial judge, who should not use bias or any other judgement when making or breaking a case. You’ll simply present the facts and your story as they are, and the judge will declare their decision. 

ALJ hearings are a key opportunity to present your case before a neutral party. With good preparation, clear communication, and the right evidence and witness, it’s in good faith to say you’ll have a successful outcome. And with the expertise and legal guidance of an SSI lawyer, your rights are in good hands.

What if an ALJ Denies My Appeal?

While it is most common for SSI appeals to be settled at this stage, there are certain times when an ALJ is simply not convinced and favors the SSA side of things. If you believe in your case and your lawyer advises it, then the next step to take your case is to an appeals council. This is a step above an ALJ and a step below federal court, but an appeals council will take an honest and fair assessment of your situation and determine whether or not to grant, deny, or send back your case to an ALJ. 

It is particularly helpful to prepare any new evidence or information to an appeals council when taking this step, and this is typically the case, or else a lawyer may advise against it. But if you’ve built a strong enough argument, eventually the legal arm bends toward justice.

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