The goal of each SSDI hearing is for the Administrative Law Judge (ALJ) to award a Fully Favorable Decision at the closing of the evidence. (While it does not happen too often, Claimants are sometimes found to be disabled after submitting an initial application for SSDI benefits.) Whether disability benefits are awarded via the initial application or a hearing, a key element in every case is the consistency of the medical records with the Claimant’s stated impairments and/or conditions. In other words, the medical records submitted to the SSA (or in the case of a hearing, the ALJ) need to solidify and ultimately prove that the claimed impairments or conditions indeed existed at the time work stopped and continue to the present time.
In determining if one is “disabled” as defined by the Social Security Laws and Statutes, the ALJ must evaluate the Claimant through a five step process. Although the five step process is statutory, the credibility of the Claimant is important and is considered in the evaluation of the SSD claim. Credibility is established through the consistency of the testimony of the Claimant and the submitted medical records.
It is becoming standard procedure for SSD hearings to be conducted via satellite and heard by judges from different regions of the country to expedite hearing dates. Sometimes what is lost on a video transmission is the ability of the ALJ to clearly view and observe the Claimant and the physical issues the Claimant is experiencing. This makes the consistency of the medical records and testimony even more important.
In my experience, each ALJ requires the following:
1) The existence of medical records documenting the condition or impairment which forms the basis of the Claimant’s case;
2) That the Claimant made reasonable efforts to obtain treatments for the claimed disabling condition or impairment;
3) The Claimant must be credible/believable. Credibility is established via consistency of the medical records and the testimony of the Claimant.
As previously stated, the ALJ must weigh all evidence against the SSD statutes and regulations. The SSD statutes and regulations (including the five step process) do not allow for variation.
Claimants should make every attempt to see her/his primary physician, specialist, etc., in order to establish through the medical records the Claimant is disabled from working. Ideally, most testimony at the Hearing will simply reinforce what the records already contain and what the ALJ has already read in the medical records obtained prior to the hearing.
Given the importance of the medical records, it is imperative that the ALJ have the opportunity to review all records that can establish the Claimant’s disabling condition/conditions. The Claimant needs to be diligent and proactive in securing and providing all medical records, prescription history, opinion letters, etc.