Your Hearing Could Impact How Much Back Pay You Are Entitled To
Author Attorney Lloyd Bemis:
An upcoming Social Security Disability Insurance hearing can be a nerve-wracking event. Months of waiting, mountains of paperwork, and a byzantine system of denials and appeals all lead to a short meeting where it will be decided whether or not the applicant is eligible for benefits.
The hearing is important for several reasons.
In a sense, it is the last step in determination process. While the decision can be appealed, appeals beyond this point do not determine whether or not the applicant is disabled, but instead focus on whether the Administrative Law Judge handled the case properly. Additionally, it is very unlikely that a case that has been denied at the hearing level will be appealed successfully. Less than 25% of applicants who appeal beyond the hearing stage are awarded benefits.
If the applicant loses the hearing, they may reapply for benefits, but it will affect their date of disability.
The date of disability is defined as the day the applicant became unable to work. This is important because the date of disability, also called the disability onset date, determines the how much back pay the applicant receives. The applicant is entitled to benefits beginning 5 months after their date of disability.
If you have been denied disability for you may still qualify for benefits. Contact an experienced Texas Social Security disability lawyer at 512-454-4000
When an Administrative Law Judge (ALJ) decides in a hearing that the applicant is not disabled, they cannot claim disability prior to the date of the hearing.
According to the Social Security’s internal guide, the Program Operations Manual System, DI 20101.025(D1), “The onset date on the subsequent claim cannot be set earlier than the day after the date of the ALJ decision in the prior claim, except for cases in which the prior ALJ decision is a continuing disability review (CDR) cessation.” The CDR cessation exception refers to applicants who were already receiving benefits and then were judged no longer eligible.
After a lost hearing, the applicant has two options if they want to continue.
They can appeal to the Appeals Council or start over with another initial application. The onset date rule does not affect those attempting to appeal because the focus is on the ALJ’s decision rather than the applicant’s disability. Any new evidence introduced must be regarding events before the hearing was conducted. However, in many cases, taking a claim to the Appeals Council is not advisable. The Appeals Council is a group of roughly 70 judges who have over 155,000 cases per year to process. On average it takes 374 days for them to review a case. Only about a quarter of cases are eventually approved. Before appealing to the Appeals Council, the applicant must carefully consider whether he/she can show that the ALJ’s decision was incorrect and should be reversed.
Reapplying is usually the best option after losing a hearing.
However, once the Administrative Law Judge’s decision has been made on a previous application, the applicant will have to choose a date of disability after the date of the hearing. Time prior to the hearing is considered “Period Adjudicated”, meaning that a final determination has already been made that the applicant was not disabled during that time.
Social Security Disability Insurance applicants usually have extremely limited means of support before receiving benefits. Back pay helps many applicants pay off debt accumulated while waiting for their benefits. Losing a hearing could ruin an applicant’s opportunity to claim back pay. If you are facing a Social Security Disability Insurance hearing, you will want a professional with you who knows what to expect. The attorneys at Bemis, Roach and Reed have experience helping applicants with their disability appeals. Contact us today for a free consultation. Call 512-454-4000 and get help NOW.
Author: Attorney Lloyd Bemis has been practicing law for over 35 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Through his extensive litigation Mr. Bemis obtained dual board certifications from the Texas Board of Legal Specialization. Lloyd is admitted to practice in the United States District Court – all Texas Districts and has argued before the U.S. Court of Appeals, Fifth Circuit. Mr. Bemis is a member of the Travis County Bar Association. He has been active in the American Association for Justice and is a past Director of the Capital Area Trial Lawyers Association. Mr. Bemis and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.
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