If you have a pending Social Security Disability Insurance or Supplemental Security Income (SSI) claim, you need to pay attention to this rule change:
If your case is waiting for a hearing, you will receive a letter with this notice: “You must send us or let us know about all evidence at least 5 business days before your hearing.”
What does “5 business days” mean?
Usually that means one week before the hearing date, but if there are federal holidays in that week, it could be longer.
What happens if I don’t submit the evidence or let SSA know about the evidence?
The administrative judge will not consider the evidence when he or she decides whether or not you are disabled and eligible for benefits. Without the evidence, your claim could be denied, AND you may not be able to fix the problem by introducing the evidence at the next level, the Appeals Council.
Even if your claim is approved, if you fail to disclose all evidence that relates to whether or not you are blind or disabled, the decision could be reversed and your benefits could end.
I thought SSA took care of gathering up the evidence in my case!
At the first two decision levels (initial and reconsideration) the Disability Determination Service (DDS in Illinois) gathers medical evidence, but at the hearing level, you are responsible for EITHER gathering the medical evidence OR requesting assistance from the hearing office staff in a timely way.
When should I ask the hearing office staff to help me gather medical evidence?
The hearing office will send you three forms to complete and return—one for recent medical treatment, one for current medications, and one for work since disability onset. When you return those to the hearing office you should clearly request that the hearing office staff request the records.
As the hearing date approaches, you should continue to inform the hearing office staff of all treatment and testing even if they do not send you new forms.
Keep in mind that medical providers have 30 days to respond to a records request!
I submitted a copy of some of my records from one of my doctors who treats me for my most severe condition, is that enough?
No. Every claimant is required to submit all evidence that relates to whether or not they are blind or disabled. For example, let’s say you are suffering from back pain and you have had back surgery, but you spent the summer at your cabin on the lake, and you get hurt while riding a jet ski. Does that “relate to” your impairments? Absolutely! That medical evidence demonstrates what you are physically capable (or incapable) of doing.
If I am required to submit evidence relating to my disability AND that evidence has to be submitted 5 business days before the hearing AND I don’t meet that deadline, what if I have a good reason for not meeting the deadline?
The administrative law judge will accept evidence for good reason.
Each person with a Social Security Disability Insurance or Supplemental Security Income claim has a lot at stake when the claim goes to hearing. They have waited years for the hearing to be scheduled. Failure to follow agency rules can deprive a claimant of an award of benefits or cause lengthy delays in receiving benefits. Many claimants choose to retain a representative with experience when their claim is at the hearing level.
Joni Beth Bailey is a Southern Illinois Social Security Disability attorney.