The Social Security Administration issued a final program uniformity rule that, among other things, will now require that the claimant inform Social Security or submit all relevant medical evidence to the Office of Disability Adjudication and Review at least five (5) business days prior to the administrative law hearing for Social Security Disability and Supplemental Security Income cases. The new rule also extends the notice that Social Security is required to give claimants for their hearing date from twenty (20) days to seventy five (75) days prior to the hearing. This rule became effective on January 16, 2017 and will be enforced starting May 1, 2017.
The rule was revised to create nationally uniform hearing and Appeals Council procedures and improve accuracy and efficiency in the administrative review process. Social Security anticipates that this new rule will positively impact their ability to manage workloads and lead to better public service. The requirement to notify or submit all evidence five (5) business days prior to the hearing has been in effect in the Boston region since 2006.
The rule on its face makes sense. You give claimants more advanced notice of their hearing and they should be able to have all the evidence identified or submitted to the Administrative Law Judge within the timeframe of the rule. This will allow the Administrative Law Judge the opportunity to make a decision faster and effectively help work through the backlog of people waiting for hearings. As it currently stands, most people have to wait roughly 15-20 months from the date they request a hearing before actually getting a hearing date. But will it be that easy to comply with the rule and will this rule help reduce the backlog and create more efficiency?
Unfortunately, many people who file for Social Security Disability and Supplemental Security Income in Tennessee and throughout the South are facing many external and internal stressful situations. Many claimants have to deal with their poor health and also substantial life changes. Many people lose their homes, cannot pay their bills, and struggle with access to healthcare as their Social Security Disability or Supplemental Security Income claim slowly navigates through the Social Security Disability process. This creates a situation where it is easy for people to forget about doctors they have seen or emergency room visits. Despite diligent efforts of the claimant and/or the claimant’s representative to update the medical file, evidence can be missed. If this evidence is not identified five (5) business days prior to the hearing, that evidence will not be considered when the disability determination is made unless the Administrative Law Judge finds good cause. So, what is good cause?
The rule defines good cause in an open-ended manner. The rule sets out some examples of what might be good cause, such as the claimant having a physical, mental, or linguistic limitation that prevented them from informing Social Security or submitting evidence earlier or if the claimant was seriously ill. However, it also gives the Administrative Law Judge great discretion to decide what is, or is not, good cause. This is likely a better approach then stringently defining what is good cause. Naturally there should be some gray area so claimants have a fair opportunity to present evidence if circumstances prevented them from adhering to the five (5) day business rule. The potential issue of course, is that Administrative Law Judges, just like us, are people. This means that while one Administrative Law Judge may determine facts give rise to good cause, another may not, which can lead to different outcomes for claimants.
For now, the biggest take-away for claimants is this: if you do have an attorney, make sure you tell them about every single last doctor or medical provider you have seen. Making lists of medical treatment can help. Despite the tough circumstances claimants suffer from, it is imperative they remain diligent or their case could suffer. If your application has been denied, call our Social Security Disability lawyers at 1-800-LAW-4004 for a free consultation.