What Is Included In An ALJ's Determination Letter For A Disability Claim Appeal?

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What Is Included In An ALJ's Determination Letter For A Disability Claim Appeal?

21 October 2015
 Categories: Law, Blog

If you request an appeal of a denied Social Security disability benefits claim and lose the appeal, a hearing with an administrative law judge, or ALJ, is scheduled if you want to continue the appeals process. The judge will review the evidence and make a decision. You will receive a determination notice that provides a look into what factors the judge considered. To help you understand the judge's decision, here is an explanation of three areas which should be included in the notice.

Medication Side Effects

The ALJ is required to consider not only the medications that you take, but also the side effects that are caused by them. In some instances, the medications can sometimes affect a person's ability to work. If this is true in your case, it is important that the judge factor this into his or her decision. If he or she failed to mention the side effects in the judgment, you can argue in your appeal that the side effects were not considered and you are entitled to a re-consideration of your claim.

Medical Record

The responsibilities of the ALJ extends beyond reviewing the information that he or she is presented. If the judge finds that the evidence you have submitted, such as your medical records, is not substantial enough to properly review your claim, he or she must take steps to find evidence that is. He or she can choose to contact you and request additional information, contact your medical care providers, and even request additional medical records. The judge can even ask that you undergo a consultative examination. If the judge in your case failed to take any steps to fully understand your disability, the decision can be viewed as grounds for a new hearing.

Judge's Explanation

When the ALJ determines that the denial of your appeal should stand, he or she is required to detail exactly why in the notification letter sent to you. For instance, if the judge did not feel as if your medical condition prevented you from working, he or she needs to state why. The ALJ could state that he or she felt work was not too difficult because you were able to do strenuous yard work without problem. The judge could argue that you made inconsistent statements about the extent of your injuries. Whatever the reason, the explanation needs to be very specific.

Consult with an experienced attorney who can help you assess the ALJ's decision and determine if there were any errors made by him or her that you can use to your advantage.  Contact a firm like   Ball & Ferrari.