Most disability cases will wind up before a judge, just as a matter of routine. It's not an exception, it's the rule. In our practice, only about 1 case in 15 gets approved without a hearing, and I think that is about average with everyone these days.
So, what will a judge look at, and what will it take to convince the judge that you qualify for a benefit (payment)?
1. What Will the Judge Look At?
A judge will look first at the technical issues of the case, to be that it fits the legal requirements of a Social Security disability claim.
- Does the claimant have insured status and when does it expire?
- Does the claimant have a severe condition that has lasted at least 12 consecutive months, is expected to last at least 12 straight months OR is expected to end in death?
- Is the alleged onset date (AOD) within the insured period for SSDI?
2. Does the Claimant Meet Social Security's Definition of "Disabled"?
There are many different definitions of "disability." Social Security has their own definition and it is written into the law ("the rules and regulations"). To get a benefit, you must prove that you are disabled according to the regulations of the Social Security Act and any later rulings and changes to the law.
A judge will look at
- your level of education
- age at the time of alleged onset
- past relevant work going back 15 years, and
- your 'Residual Functional Capacity' or RFC.
Your RFC, based on your medical record, will establish how severe your work restrictions are and what exertional level you are limited to.
So, it's not a matter of a judge listening to your story and making a subjective decision (believe you or not believe you). It's a matter of, "Did you provide the judge with enough hard medical evidence to restrict you to the requirements that Social Security has set for your age and RFC? Another question is: "Did you provide enough vocational evidence that the judge has a good understanding of the requirements of all your past relevant work?"
The judge will apply all of the facts he or she found at your hearing, along with all documents you submitted, and determine whether or not you have met all of the rules and regulations.