After an individual files an application with the Social Security district office, either in person or electronically, the “file” is transferred to the Disability Determinations Section of the Missouri Department of Elementary and Secondary Education. The Disability Determination Service, or DDS, obtains medical evidence about which the claimant and/or his or her representative informs the Social Security Administration have provided treatment to the claimant. In addition, DDS requests the completion of multiple forms prior to a determination. Often times, DDS will arrange for the claimant to be examined by doctor(s) who are supposed to have expertise in the area of medical practice associated with the claimant’s alleged medical impairments. After a recommended determination is made by DDS, the Social Security Administration will advise the claimant in writing as to the decision on entitlement. If the claimant is not satisfied with the determination, they have the right to appeal. In Missouri the claimant must first file the intermediary step of Request for Reconsideration. If an adverse decision is made by Social Security on the Request for Reconsideration, a Request for Hearing before an Administrative Law Judge is filed with the Social Security Administration. The file is then sent to the Office of Hearing Operations (OHO). It is at this stage that the claimant is entitled to a de novo hearing before an Administrative Law Judge. The selection of the Administrative Law Judge is supposed to be a random one and done on a rotational basis.
How long it takes: Varies depending on the case, but usually 6-8 months.
A hearing is eventually scheduled by the Office of Hearings Operation staff with the claimant or his representative if the attorney has entered his appearance. Attorneys who have been previously representing the claimant prior to the scheduling of the hearing are normally contacted by the hearing office staff to avoid potential conflict with the attorney/representative’s schedule. If a claimant is unrepresented, the claimant is advised by the OHO staff that they do have a right to an attorney and can obtain a postponement for the purpose of obtaining representation. There is no opposing counsel at the hearing before the Administrative Law Judge and the proceedings are for the purpose of providing the claimant an opportunity to explain how his or her medical impairments impact upon his or her ability to function in the work place. The hearings are not supposed to be adversarial and it is a duty of the Administrative Law Judge to see that the claimant has a full and fair hearing and to develop the record to the fullest extent possible so that the proper decision can be made.
At the hearing, most Administrative Law Judges will have a vocational expert present to testify. Other Administrative Law Judges often call medical experts to testify. Their role is to be an impartial witness and offer expert opinions as to issues raised in the evidence contained in the file.
It is the role of the Administrative Law Judge to not only conduct the hearing and question the claimant and expert witnesses called, but also to ultimately decide the issue of whether the claimant’s medical conditions are so severe that they satisfy the requirements of the law. The claimant’s representative is also allowed to question all witnesses.
How long it takes: https://www.ssa.gov/appeals/DataSets/01_NetStat_Report.html this website will tell up-to-date wait time for a hearing before an ALJ.
If a claimant received an unfavorable decision and wishes to appeal, the next step in the administrative process is filling a Request for Review of Hearing Decision by the Appeals Council. From an advocate’s perspective, the attorney must determine if he or she feels sufficient errors are contained in the decision of the ALJ that he can convince the Appeals Council members to reverse or remand the decision of the Administrative Law Judge
How long it takes: It can take from 6-12 months to receive a decision from the Appeals Council.
A review of the final determination by the Appeals Council is through an appeal to the United States District Court. This is done by filing a Complaint in the district where the claimant resides. Following the filing of the Complaint, the United States Attorney will act on behalf of the Commissioner of Social Security and will file a copy of the administrative record with the Court at the time of the filing of the Answer to the Complaint. (60 days) Once the Answer has been filed, the plaintiff will file a Brief in Support of Claim. (30-90 days) Following the filing of a responsive motion by the United States attorney (30-60 days), the United States District Judge and/or Untied States Magistrate may require the parties to appear for oral argument, or may simply decide the appeal based upon the motions and memorandums previously filed. The decision of the United States District Court can, of course, be taken to the 8th Circuit Court of Appeals; but such appeals by claimants have become rare in the 8th Circuit and we do not currently file these appeals.