Social Security disability or SSI claims generally follow the same universal procedures. First of all, it’s clear that most people in Pennsylvania and nationwide fail in their initial application for benefits. Moreover, there’s no correlation between the denial and the merits of the claim. The steps that follow the initial rejection are called an appeal. The appeal is concluded when an administrative law judge (ALJ) makes a decision on the disability claim, almost always after conducting a hearing or hearings.
Following the decision, the claimant may appeal the ALJ’s decision through an administrative appeal process. The claimant can present arguments why the ALJ’s decision was flawed. If still unsatisfied with the results, the claimant can later appeal or litigate the matter into a federal district court.
The chances of prevailing at the administrative hearing are increased substantially by having the guidance of a disability attorney. Going to the hearing without that help can be unwise. That is because the technical formulation of the issues and the evidence in the context of federal disability law is specialized, and requires the expertise of an experienced professional.
Prior to the hearing, the Social Security office attempts to obtain all of the pertinent medical records. A list of these records is usually sent to the claimant. The claimant should either provide copies of any missing records or sign a HIPPA-compliant consent form authorizing the Social Security Administration to obtain them.
It can help to have a treating physician write a report stating that the claimant is totally disabled. It should include wording that the patient is unable to engage in any gainful employment activities. With clear language from a medical doctor adopting the key terminology of the Social Security regulations, one’s chances can be enhanced.
The claimant should detail the inability to perform basic daily activities to the ALJ prior to and during the administrative hearing. In Pennsylvania and elsewhere, the claimant’s chances increase if she proceeds under the guidance of a disability attorney. Having someone who knows how to organize and present the evidence on the disability claim so that it satisfies the requirements of federal disability law is a substantial positive factor.
Source: Social Work Helper, Disability Claim Approved! Winning the Appeals Process for SSI, Lisa Coleman, Dec. 27, 2013