The Disability Hearing Before an Administrative Law Judge: What to Expect

What happens before a Social Security disability hearing

Before any hearing, you file a written request, SSA sends a notice of hearing at least 75 days ahead, and you finish building the medical record. For a Social Security Disability Insurance (SSDI) claim, 20 CFR 404.933 makes the hearing request due within 60 days after you receive the reconsideration notice. The request should give the reasons you disagree and describe any additional evidence you plan to submit, with the date you expect to submit it. Supplemental Security Income (SSI) claims follow a parallel set of rules in Part 416.

The notice of hearing sets your schedule. Under 20 CFR 404.938, SSA mails it at least 75 days before the hearing date. It lists the specific issues the judge will decide, how you and any witnesses will appear, the location for an in-person or agency video hearing, how to ask for a different time or place, and the deadline for written evidence. The notice also asks you to return a form confirming that you received it.

Read the issues listed in the notice closely. Like the line items on a repair estimate, they tell you exactly what work is on the table, and everything you prepare should answer one of them.

A separate notice explains the ways you can attend, with its own 30-day window to object or agree in writing. We cover those choices in our guide to video, phone and in-person hearings. Our disability hearings page covers the hearing stage as a whole.

Back to contents

Who is in the room at a disability hearing?

An administrative law judge runs the hearing, and you, your representative and any witnesses you bring take part. SSA's hearing process page says the judge may also call a medical or vocational expert to testify. Under 20 CFR 404.944, the hearing is open to the parties and to other people the judge considers necessary and proper.

The room may not be a single room. SSA's rules generally direct the witnesses it calls, including medical and vocational experts, to appear by audio, agency video or online video, so an expert may join by phone or screen even when you appear in person. Our guide to vocational expert testimony covers what the job expert does and how that testimony is tested.

SSA describes the hearing as informal, and it makes an audio recording. There is no jury. What happens is closer to a structured interview than a trial: the judge explains the issues, asks questions, and decides the order in which evidence comes in and each issue is discussed.

The people present each have a defined role. The judge decides the claim. The experts answer questions within their field. Your representative may question witnesses and helps present your evidence. You describe your own condition and history in your own words.

Back to contents

How does the five-day evidence rule work for disability hearings?

Written evidence must be submitted to SSA, or SSA must be told about it, no later than 5 business days before the hearing date. That is the rule in 20 CFR 404.935, and the matching SSI rule sits in 20 CFR 416.1435. If you miss it, the judge may decline to consider or obtain the evidence.

The count runs in business days, not calendar days, and it is measured back from the scheduled hearing date. The notice of hearing repeats the deadline so it is in front of you from the start.

The rule has three exceptions. As long as no decision has been issued, the judge will accept late evidence when:

• An action by SSA misled you.
• A physical, mental, educational or linguistic limitation kept you from submitting it earlier.
• An unusual, unexpected or unavoidable circumstance beyond your control prevented it. The regulation's examples include serious illness, a death or serious illness in your immediate family, records destroyed by fire or another accident, and evidence you actively and diligently sought that did not arrive, or arrived less than 5 business days before the hearing.

The last example is the one to plan around. Provider offices answer records requests on their own schedule, so the request date becomes the proof. Send records requests early and keep a copy of every one, because a dated request is what shows diligence if a provider answers late.

Back to contents

How your testimony works at a disability hearing

You testify under oath or affirmation, and the judge leads the questioning. SSA's hearing page says the judge explains the issues and may question you and any witnesses, and that you and your representative may question witnesses too.

Prepare to describe your daily routine, your past work, your treatment, and what you can and cannot do, in specifics. A sentence like “I can stand at the sink for about ten minutes before I have to sit” tells the judge more than “I have bad days.”

Answer the question asked, honestly, even when the honest answer is unflattering. The judge has the records, and the records already speak to things like missed appointments or substance use. An answer that conflicts with the file costs more than the fact it tried to hide.

Feeling nervous is normal and nothing to hide from the judge.

The hearing can pause. Under 20 CFR 404.944, the judge may recess and resume on a later date if key evidence is missing, or if something outside SSA's control, such as poor audio or video, prevents the hearing from proceeding. The judge may also reopen the hearing at any time before the decision notice is mailed to receive new and material evidence.

Back to contents

The kinds of decisions a disability hearing judge can issue

After the hearing, the judge issues a written decision that states the findings of fact and the reasons, based on the preponderance of the evidence in the hearing record. Under 20 CFR 404.953, a copy is mailed to every party at the last known address.

Decisions take a few forms:

• Fully favorable. The judge approves the claim. In case categories SSA identifies in advance, a judge may enter a fully favorable decision orally at the hearing, often called a bench decision, and later issue a written decision that incorporates it. SSA's hearings manual limits bench decisions to fully favorable outcomes and excludes some claim types, such as claims for a closed period of disability.
• Partially favorable. SSA's hearings manual records fully favorable and partially favorable decisions separately, along with the established onset date the judge finds. A partially favorable decision approves part of the claim, such as approval from a later onset date than the one you alleged.
• Unfavorable. The judge denies the claim. SSA says Appeals Council review generally begins after a claim is denied at the hearing level.
• Recommended decision. In some cases the judge sends the case to the Appeals Council with a recommended decision and mails copies to the parties.

The deadline pattern repeats at the next level. SSA says you generally have 60 days after receiving the hearing decision to request Appeals Council review. Our guide to the Appeals Council and federal court covers what that review involves.

Back to contents