Most claimants end up appearing before an Administrative Law Judge (ALJ) after being denied by lower level state agency adjudicators.
This is the most important step in the administrative review process because it is the only time a claimant gets to go face to face with the decision maker. Everything before this stage, and after it, is done by phone, mail and written arguments.
Preparation for a hearing actually begins at the very first meeting between client and representative. Experienced representatives know that most cases, even strong ones, are going to involve an ALJ so from that first meeting the goal is to make the case as strong as possible at the hearing.
As we have often written, the core evidence in any application for disability benefits is the clinical chart of each of the treating specialists. Diagnosis is almost never in dispute. The reason the file made it to the hearing level is because Social Security did not believe that the evidence supported that the symptoms were severe enough to make the claimant totally disabled.
Hearing preparation begins with the first meeting when we explain to our clients what symptoms are related to their condition and will be most persuasive to the ALJ. Then we counsel our clients on how to explain the limitations caused by those symptoms to their doctors and therapists so that the clinical charts are complete. Ultimately, we must rely on claimants continuing to stay in medical treatment, because without the record of treatment the case weakens!
Recent Rules changes mandate that we submit all evidence, whether favorable or not. After downloading and reviewing the ALJ’s exhibit file, we prepare and submit a pre-hearing memorandum summarizing our view of the issues, the evidence and providing the ALJ with our legal theories supporting a favorable decision.
Only at this time are we really ready to prepare the client. We teach clients that they are not to go in looking for a fight. We want the Judge to understand and empathize with them. This is their opportunity to make the computer disc with their file become a real live person. This is their chance to make the Judge understand what life is like trying to deal with these symptoms.
Over-stating is bad – no ALJ believes someone has “pain all over” or that their pain is a 12 on a 10 point scale. Similarly, many clients are embarrassed to say that they cannot shower or clean their home or properly care for their children, but those limitations and frustrations are real and need to be heard by the Judge. It is just as important, though, that they were heard by the doctors and therapists and all limitations are in their medical charts.
Often the ALJ brings in vocational and medical experts to help decide the case. We are prepared to cross-examine those experts if the testimony is adverse.