When I worked with ALJ’s as a senior attorney adjudicator, I was able to discuss with ALJs on how s/he arrived at the decision to grant or deny a social security disability claim at the hearing level. I also had the advantage of reading the ALJ’s notes and instructions to the decision writer explaining how the decision was made and which evidence to address in the decision. Although ALJs vary on a variety of factors such as how they prepare for a hearing and how they decide a case, after working with ALJs, I understood what they looked for when making a decision. I learned which evidence was detrimental to a claim and which evidence to emphasize in the decision. It became second nature.
However, I began to question, do ALJs still want to see the same things in a brief as when I first started working with them?
Then, as luck would have it, I got the opportunity to hear from an ALJ what s/he is looking for in a prehearing brief! Although it was from one ALJ’s perspective, this ALJ was a great judge who is balanced in granting and denying claims. It was not an outlier ALJ.
Here’s what the typical ALJ looks for in a prehearing brief:
1) What’s the story? What happened? Is this an older individual who had worked in a manual labor job and the body just fell apart due to wear-and-tear?
2) How did you come up with the alleged onset date (AOD)? Injury? Surgery? Explain why the AOD makes sense based on the evidence.
3) Which evidence supports the AOD? Which evidence shows that the individual continued to have symptoms and functional limitations for at least 12 months after the AOD? Focus on the date.
4) Explain periods of improvement and what happened afterwards. Did the improvement continue or did pain worsen, was there a fall that exacerbated symptoms, or was relief temporary? Were more invasive procedures required after improvement? Keep telling the story for the ALJ.
5) Rather than describing a medical source opinion, include which evidence supports the opinion. Even better, include evidence that supports this opinion from the provider’s own treatment notes.
6) Explain why the individual cannot perform past relevant work (PRW) and other work. Do medicinal side effects interfere with semiskilled or skilled work? Does the individual need to lie down and which evidence supports this limitation?
This is your opportunity to collaborate with the ALJ, work with the ALJ, help the ALJ, guide the ALJ to a favorable decision supported by the medical evidence of record.
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