Cleveland, Ohio, Social Security Disability Appeals Attorney
THE SOCIAL SECURITY APPEALS PROCESS
After you apply for Social Security Disability benefits, your case is sent to a claims adjudicator at the Bureau of Disability Determination (BDD) in Columbus, a State agency charged with making the disability determination for Social Security. That person, usually working with a doctor, makes the initial decision in your case, usually within 3-6 months of the date the application was filed. The formal decision is issued by Social Security. Unfortunately, for Ohioans, about 3 out of 4 of these decisions will be denials. If you are not one of the lucky 1 in 4 who wins at the first level, what can you do?
First of all, appeal the denial promptly! The initial appeal (called a Request for Reconsideration) must be filed within 60 days of your receipt of the denial. Social Security will presume that you received the decision within 5 days of the date it was mailed.
Many attorneys, including Janet McCamley Co., L.P.A., will accept cases at the Reconsideration level and will electronically file your appeal for you.
After Social Security receives your Request for Reconsideration, your claim goes back to the Bureau of Disability Determination in Columbus for further review. At this level, only about 1 out of 10 claims is allowed.
If a claim is denied at the Reconsideration level, the claimant can request a hearing before an Administrative Law Judge (ALJ). ALJs are hired by the Social Security Administration, and have lifetime appointments. At present, there are approximately 12,000 claims awaiting hearing in the Cleveland hearing office (formally known as the Office of Disability Adjudication and Review, or ODAR), and there are only 15 ALJs to preside over hearings. The waiting time for a hearing is generally 2-3 years, though there is an ongoing effort to reduce the backlog in the Cleveland hearing office. Many claims are transferred to hearing offices across the United States. Once transferred out of the Cleveland office, the hearings are held by videoconferencing technology, with the claimant and his or her representative (and sometimes medical or vocational experts) appearing in person at the Cleveland hearing office, and the ALJ (and sometimes a medical expert or vocational expert) appearing from his or her hearing office location. These videoconference hearings have been a great benefit to the claimants, as they are able to have their claims heard more quickly.
The administrative hearing is de novo, meaning that the ALJ is not bound by any of the decisions made at the first two decision levels. There is no consistency in the manner in which judges conduct their hearings. Most judges allow about an hour, though some hearings take 10 minutes or less, and some take several hours. Some judges do most of the questioning of the claimant, and permit the representative (usually a licensed attorney) to ask follow-up questions. Some judges ask the claimant's representative to do the questioning of the claimant.
Often, the judge will have a medical and/or a vocational expert testify as a consultant at the hearing. The medical expert will assist the judge in determining whether the medical impairments of the claimant meet or equal any condition described in the Listing of Impairments, and in determining functional limitations resulting from the impairments. The vocational expert will provide a description of jobs the claimant has performed in the past, and will be asked hypothetical questions by the judge that take into account what the judge believes to be the residual functional mental and/or physical capacity of the claimant. He or she will then ask the expert whether there are any jobs existing in substantial numbers in the national economy that such a hypothetical person can perform. If the judge accurately describes the claimant's actual, documented limitations, and the vocational expert provides jobs the claimant can perform with those limitations, then benefits will generally be denied.
Damaging vocational expert testimony can sometimes be countered by effective cross-examination by the claimant's representative, particularly where there is likelihood that the claimant would not have the ability to sustain employment. Also, key limitations may have been omitted from the ALJ's hypothetical questions. An effective representative may pose his or her own hypothetical questions to include those limitations, and will hopefully elicit favorable vocational testimony.
A skilled advocate can make a big difference at your administrative hearing. Contact us today to discuss your upcoming hearing.
Though the majority of claims are won at the ALJ hearing (approximately 60%), if an unfavorable decision is rendered, there are other appeals that can be taken. The first appeal is to the Appeals Council of the Social Security Administration. That agency reverses a small percentage of claims, and may remand the claim for further hearing with particular guidelines. An unfavorable Appeals Council decision can be appealed to the United States District Court. A small percentage of cases areappealed to Federal Court, where the standard of review is whether there is substantial evidence to support the decision of the ALJ. The District Court may reverse or remand the claim, or may deny the appeal. Very few claims are appealed to the United States Court of Appeals. Claims may even potentially be appealed to the United States Supreme Court, though that Court seldom accepts jurisdiction in Social Security claims.
What can you do to improve your chances of winning and maximizing your benefits?
- First, you should apply for benefits as soon as it becomes apparent that you (or your child) have an impairment (or a combination of impairments) that is expected to render you or your child disabled for 12 months or longer, or result in death. In an SSI claim, benefits are paid only from the time of the application. In an SSDI claim, benefits are paid only for one year prior to the application, regardless of the date the disability began. Delay can be very costly.
- Promptly appeal an adverse decision and do not give up. Remember, only one in every four claims filed in Ohio is allowed at the initial claim level. Of the claims that are appealed, approximately 10% are allowed at the Reconsideration level, and 60% or higher are granted at the Hearing level. Many deserving claimants become discouraged early on.
Seek legal representation. Claimants who have legal representation have a higher success rate than unrepresented claimants, and claimants represented by Janet McCamley Co., L.P.A. have approximately a 90% chance of ultimately prevailing. In the event of a favorable decision, legal representatives are usually compensated at a rate of 25% of the claimant's past due benefits, up to a current maximum of $5,300.00. This is the amount authorized by Social Security for direct payment of fees to the representative. Fees could be more if appeals are taken subsequent to the administrative hearing, though the claimant should never have to pay a fee in excess of 25% of his or her past due benefits. This is a small price to pay for what may be a lifetime of benefits. It should be stressed that there is no fee unless you win! Contact Janet McCamley Co., L.P.A. with any questions you have about the fee structure.
- Promptly respond to all requests from Social Security or the Bureau of Disability Determination. There are often questionnaires, such as Symptoms Reports, sent by these agencies to claimants and others who know about their problems. These reports need to be promptly completed and returned. Also, these agencies are aware of all new and material treatment so that a decision will be made based on a complete record.
- Talk to your doctors, and let them know that you are pursuing a disability claim. Ask them to promptly respond to agency requests for records and other information. Don't be discouraged if the doctor says he or she will not help or says he or she thinks you can work. Doctors usually do not know the law. Sometimes, because of your age, education, and lack of transferable job skills, you will not need to prove that you cannot do all types of work. Also, if your doctor limits you to part time work, Social Security may find you disabled. Although it is certainly better to have your doctor "in your court," it is not always necessary.
- Keep your doctor appointments and try to be compliant with treatment recommendations, and especially with taking prescribed medications. A claimant who receives regular treatment and is medically compliant greatly increases his or her chances of winning his or her claim. Medical evidence is critical!
- If you are addicted to drugs or alcohol, get treatment for your addiction. Drug and alcohol addiction will preclude the payment of benefits if the judge or adjudicator finds that the addiction is a material factor in your disability. The law has changed, and these addictions cannot serve as a basis for disability anymore.
If you have any questions or would like to discuss your claim, do not hesitate to call Janet McCamley Co., L.P.A. Your call is confidential. As your Social Security Attorney, I will help you explore your rights and options in the appeals process. As your representative,
- I will provide you with straightforward information and realistic expectations for your case.
- I will work with you to collect necessary evidence for your case, including doctor's statements and necessary medical reports.
- I will promptly file your appeals to ensure the timely processing of your claim.
- I will appear at all hearings on your behalf and help prepare you for the hearing process for optimal results. From your initial consultation through the final resolution of your claim, I will remain a staunch advocate and trusted counselor on whom you can depend. For more information about the appeals process, please contact my office.
Contact me today for a free consultation with an experienced Cleveland, Ohio, Social Security Disability and SSI appeals lawyer. I offer flexible appointment schedules, including weekends and evenings. Call now to protect your rights.
Janet McCamley Co., LPA
Beachwood Office
PDC Building
3659 South Green Road, Suite 306
Beachwood, OH 44122
Phone: 216-292-7355
Fax: 216-292-9123
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