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New rules complicate SSDI hearings

| Apr 11, 2019 | Social Security Disability

The Social Security Disability eligibility process may be complicated, but new federal regulations issued over the last two years have also added complexity to seeking SSDI benefits. The Social Security Administration imposed requirements that evidence must be submitted within at least five days before a hearing or the administrative law judge must be notified of that evidence within that time. ALJs may refuse to consider evidence that was not submitted before this deadline. Some ALJs may not consider any late evidence unless there was good cause for missing this deadline, but there are no rules defining good cause.

Important evidence may be disregarded. This rule has also presented problems for claimants with disabilities involving mental limitations, which may prevent them from timely providing information about their medical providers. Additionally, claimants frequently have additional medical records because of their ongoing care.

Claimants must submit or notify the ALJ of all evidence concerning the disability claim that is known to them. Attorneys must now provide residual functional capacity evaluations that they prepared and sent to the claimant’s providers to complete. Before this change, claimants were required to submit material evidence concerning their claim.

The new rules also eliminated the substantial deference that was afforded to a treating doctor’s opinion on a claimant’s imitations. Their opinions received controlling weight if they were consistent with most of the medical evidence. These opinions no longer receive this deference or evidentiary weight and may be disregarded by ALJs.

Attorney must also disclose any other referrals to a doctor who provided an opinion on the claimant’s abilities and limitations. These include referrals for workers’ compensation, a personal injury lawsuit or other unrelated matters. This may lead to unjustified skepticism on the provider’s treatment or opinions.

Hearing scheduling now fluctuates. These are scheduled at any time from 12 to 24 months after the hearing request was submitted. This may hamper case preparation.

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