SSA Hearing Tips for SOAR Practitioners

1. SSAHearing Tips for SOAR PractitionersPlease stay on the line. The webinar will begin shortly.AUDIO:Toll Free Number: (855) 749-4750Access code:660 367 515Contact jdeschamps@prainc.com if you experience technical difficulties.This webinar is being recorded and will be available for download within 1 week of this presentation.

2. SSA Hearing Tips for SOAR Practitioners Presented BY: SAMHSA SOAR Technical Assistance Center Policy Research Associates, Inc. Under Contract TO: Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services

3. Welcome! Kristin Lupfer, LmSW, Project Director, SOAR Technical Assistance Center, Policy Research associates, Delmar, New York

4. Webinar Instructions • Muting • Recording availability • Downloading documents • Evaluation • Question instructions

5. Learning Objectives • Know the major activities performed by SSA’s hearing office called the Office of Disability Adjudication and Review (ODAR) • Know what is expected from the Authorized Representative when preparing for a hearing in a Social Security disability claim. • Know what is expected from the Authorized Representative when conducting a hearing in a Social Security disability claim.

6. Agenda The SSA Hearing: Preparing for ALJ Hearings • Sarah F. Anderson, JD, Senior Attorney with Greater Boston Legal Services in Boston, MA The SSA Hearings: Conducting ALJ Hearings • Jessica F. Krefman, JD, Attorney & SOAR Local Lead with Office of Recipients Rights/Livingston County Community Mental Health in Howell, MI SOAR Benefits Specialist/Non-Attorney Perspective • Beth Argent, Benefits Specialist & SOAR Local Lead with Mental Illness Recovery Center, Inc. in Columbia, SC Questions & Answers • Facilitated by SOAR TA Center Staff

7. Poll Question #1 How many ALJ hearings have you participated in? a. None b. 1-5 c. More than 5

8. Hearing Preparation Tips for SOAR Practitioners Sarah F. Anderson, Attorney Greater Boston Legal services Boston, Massachusetts

9. Office of Disability Adjudication & Review • ODAR holds hearings, issues decisions, review appeals • Nationwide corps of ALJs hear cases de novo • 10 regional offices, 168 hearing offices, 5 national hearing centers, 2 national case assistance centers • Over 1,300 ALJs issue over 700,000 decisions annually

10. ALJ Hearings: Overview • Individuals have the right to appeal denial and/or termination of SSI/SSDI claims • Must file appeal within 60 days of receipt of denial of reconsideration • Limited late filing for “good cause” • iAppeal is SSA’s online appeal system • Forms SSA-3441, SSA-827, HA-501-US must all be filed before deadline for appeal to be timely • Can also mail in appeal forms, ask SSA for help

11. Before Hearing Prep • ODAR hearing office sends acknowledgement of receipt of hearing request • Introduce yourself • ODAR asks for updated medical, vocational information • Scheduling a hearing: up to the ALJ • See if you can agree upon a date and time before Notice of Hearing is sent

12. Before Hearing Prep • VTC (video teleconferencing) hearing • Claimant must object to VTC within 30 days of notice that one may be scheduled • Limited good cause for missing deadline to object • Weigh the pros and cons in your case for VTC • Quicker hearing, but not in same place as ALJ • Could be telephonic hearing • e.g. prisoners

13. Before Hearing Prep • Takes about a year to get an in-person hearing • Varies from hearing office to hearing office • Check out statistics on your hearing office • Remember strategies to get quicker decision or hearing • On the Record (OTR) • Compassionate Allowance, TERI • Dire Need • You need to make the case to the ALJ why she should allow the claim without in person hearing

14. Before Hearing Prep • Pre-hearing conferences • Find out if your hearing office or ALJ uses these • May be used if there is no appointed representative • May be used even with rep to “narrow the issues” • If claimant does not show up, case may be dismissed at that point

15. Before Hearing Prep • Get a copy of the record that ODAR is using ASAP after filing for hearing • Most disability cases now have electronic records as opposed to paper records of the claim • Various parts of electronic record • Exhibit List, Case Documents: parts A,B,D,E,F • Multimedia (audio) • Get the CD from claimant or from ODAR • Encrypted • Need certain programs to read it on your computer

16. Before Hearing Prep • File your letters, updated records electronically • Need bar code from ODAR • Some registered representatives can upload files directly to claimant’s electronic record • Deadline for filing evidence before the hearing • Learn what it is your location • Region 1 (ME, NH, VT, CT, RI, MA) has more restrictive evidence rules known as “DSI” • Request interpreter for hearing if needed

17. Before Hearing Prep • Review the ODAR file to see what they have/what is missing for evidence • Personal, medical, vocational • Know what you have to prove to get benefits • SSI vs. SSDI • Five-step analysis of claim • Develop your theory of the case • A few sentences, “Susie Jones is disabled because…” • Figure out how you will get the evidence that you think is missing from the case needed to prove your theory • Live testimony vs written records

18. Pre-Hearing Prep • Remember, this is first time claimant meets face-to-face with decision maker • Initial, Reconsideration decisions made on records only • Prepare your claimant and other witnesses for hearing • Moot court, or practice sessions

19. Pre-Hearing Prep • Write a memo to the ALJ about your case • Tell the ALJ in detail why your client is disabled • Cite to specific records from the Exhibit List • Tell the ALJ your theory of the case • Pay attention to deadlines for submitting evidence • Don‘t miss them • Learn about your ALJ

20. New Evidence Rule • SSA published regulations effective 4/20/2015 clarifying their rules on evidence submission in disability cases • Claimant and representative must inform or submit all evidence relevant to claim for disability • Includes unfavorable medical opinion letters or other unfavorable evidence

21. New Evidence Rule • Two exceptions to rule • Attorney-client privilege • Attorney work product • Both apply to non-attorney authorized representatives • Representative may be sanctioned for failure to comply with rule • See Handout

22. Authorized Representative • Must submit signed 1696 form • SSA has rules of conduct for representatives • Who can be a representative • Authority of representative • Prohibited conduct • Sanctions for prohibited conduct

23. Contact Information • Sarah F. Anderson • Senior Attorney • Elder, Health & Disability Unit • Greater Boston Legal Services • 197 Friend St. • Boston, MA 02114 • Phone: (617) 603-1581 • Email: sanderson@gbls.org

24. Poll Question #2 What is the first thing to think about when beginning to prepare for a hearing? a. Should I wear a blue or black suit to the hearing? b. What is my working theory of the case? c. How do I cross examine a Vocational Expert?

25. Conducting ALJ Hearings Jessica F. Krefman, attorney and SOAR Local Lead Office of recipient rights Livingston county community mental health Howell, Michigan

26. Reminder • KNOW ABOUT YOUR ALJ!! • Whether he/she allows witnesses, or prefers written statements/affidavits (let them know if you plan to bring witnesses) • Whether he/she allows evidence to be submitted on the day of the hearing • How he/she conducts a hearing • His/her statistics (website)- www.disabilityjudges.com

27. The Day of The Hearing • Dress professionally • Business suit, blazer, ties for males • Determine if client should dress up vs. everyday dress • Arrive early • At least one hour • Secure conference room, or if one is unavailable, ensure that you respect all issues of confidentiality • Remind client of main points of his/her testimony • Remind client what to expect • If your client cannot make it, call the ODAR office • Your ALJ may require you to show up in order to show good cause to adjourn and reschedule.

28. The Day of the Hearing Review the file closely! • Ensure all submissions are included • Mark copies of exhibits submitted after you received ODAR file • Alert judge if there are any objections to ODAR file

29. The Hearing • Non-adversarial • Small and informal • Not guided by federal rules of evidence • BUT compliance with court room decorum is still required of the representative • Closed to public • Audio recorders/mics

30. The Hearing • People present: • ALJ • Hearing reporter • Hearing assistant (if needed) • Interpreter (if needed) • Claimant • Representative • Expert Witnesses • Medical Expert (if requested by judge) • Vocational Expert (if requested by judge)

31. The Hearing • Interaction with Judge • Address judge as “Your Honor” • Keep a respectful tone • Do your best to ensure the record reflects your best argument • Where necessary, assist your client if he or she is unable to appropriately respond to the judge. • For ex, The client has had several hospitalizations and she is unable to remember the name of the hospital where she was last hospitalized, You may politely interrupt the judge as follows: “Judge, if I may, Exhibit 15E reveals that claimant was hospitalized at St. Mary’s Hospital from June 19, 2012- July 4, 2012”; • Generally if the client is not responding well you may assist as long as you are able to point to a specific exhibit in response to the judge’s inquiry. This is not testifying on behalf of the client.

32. The Hearing • Claimant and representative will sit in front of the ALJ with mics in front of them. • The judge will: • Introduce all present parties • Ask the representative to make an appearance • Ex: “Jessica Krefman, on behalf of [CLIENT’S NAME]” • Ask the claimant to take an oath and swear to the truthfulness of his/her testimony • Introduce the case and the claimant • Ex: “this hearing concerns the claimant’s application of June 4, 2014 for Supplemental Security Income.” • Address all exhibits in the record, and ask for any additional exhibits. • The exhibits are then made part of the administrative record.

33. The Hearing • ALJ may take testimony from the claimant • Depending on the Judge • Representative may make a brief opening statement that sets forth the bases for finding the claimant disabled(ex: briefly discuss work history, date of onset, and when the claimant stopped working). • This may not be necessary if the ALJ has already presented the case. • Or, if pre-hearing memo was submitted prior to the hearing, the representative may refer to it. • You will be given a chance to: • question your client • question witnesses • cross examine expert witnesses

34. Claimant’s Testimony • Some judges will allow the representative to start the initial examination of the claimant. • Claimant should be prepared to effectively respond to all inquires at the hearing. • Representative should develop a series of questions pertinent to the client’s case! • Ex: If client has a mental impairment, questions should be geared towards mental impairment.

35. Claimant’s Witnesses • In some cases the theory of the case may be helped by testimony from other witnesses. • Ex: Family members, friends, case workers, former employers/coworkers, other relevant persons. • These witnesses MUST be specifically prepared prior to the hearing. ***If your ALJ does not allow witnesses at the hearing, you may want to provide signed affidavits from important, relevant witnesses

36. Expert Witnesses • Appear at the request of the ALJ • Medical Expert (ME) • Doctor or psychologist • Testimony is based on the record and testimony at hearing • Explains complicated medical issues to the judge • Level of severity of claimant’s impairment • Whether the claimant meets or equals the listing • Vocational Expert (VE) • Trained in vocational rehabilitation • ALJ usually asks a series of hypothetical questions based on: • Past Relevant Work,level of skills required to complete that job, and exertion levels

37. Cross Examining Expert Witnesses • Medical Expert • Ask follow up questions if the ME has not asked about certain strong evidence. • Ask to define terms such as “moderate” limitations. • If the ME’s testimony is favorable, do not ask follow up questions. • Vocational Expert • Have your own hypothetical questions prepared to follow up on those asked by the judge. • If the ALJ’s hypotheticals lead the VE to the conclusion that there are no jobs in the national economy for your client, do not ask further questions.

38. Closing Statement • After testimony is complete you will have an opportunity to highlight the important evidence that supports your case.  • Used only when unclear/unresolved legal issues arise at the hearing.

39. Post Hearing • Judges will occasionally state in the hearing whether they will award your case, but most will simply end the hearing without announcing a decision. You will have to await their written decision by mail to know if your case was awarded. • If you request more time to submit evidence: • Request that the ALJ keeps the record open, e.g.) “2 weeks” • Must follow STRICT deadlines • ALJ may order a Consultative Examination (CE) • Claimant must attend as scheduled

40. Next Steps • If the claim is denied: • If claimant choses to appeal, must due so within 60 days of ALJ’s denial. • The Appeals Council will review the administrative record and: • Dismiss the appeal • If dismissed, claimant has 60 days to file for judicial review with U.S. district court. • OR grant the appeal and take a different action • Reverse the findings • OR remand the matter for a new ALJ hearing.

41. Shadow, Observe, Train…. • Find local disability attorneys • Legal Aid/Legal Services • Pro-bono Attorneys • Disability Benefits Coalition • Attend mock hearings • YouTube hearing videos • National Organization of Social Security Claimants’ Representatives (NOSSCR) • Provides continuing education and training for persons who represent claimants for disability benefits • ASK YOUR LOCAL ODAR!!

42. Contact Information • Jessica F. Krefman • Attorney and SOAR Local Team Lead Office of Recipient Rights • Livingston County Community Mental Health • 2280 E. Grand River • Howell, MI 48843 • (517) 546-4126 / refmanj@ewashtenaw.org

43. Hearing Tips for SOAR Practitioners: SOAR Case Manager’s Experience Beth Argent, SOAR Case Manager and SOAR Local Lead Mental Illness Recovery Center, Inc. (MIRCI) Columbia, South Carolina

44. Non-Attorney Representative Advice • I’m a SOAR case manager, not a lawyer, but we need to following same rules and not provide client testimony. • The SOAR key components can help you advocate for a client, e.g.) 1696, gathering medical evidence, and submitting a signed Medical Summary Report! • As a non-attorney representative for a client experiencing homelessness and mental illness, you can advocate for this unique, often misunderstood population, and help tell their story through testimony and effective cross-examination skills!

45. Contact Information • Beth Argent • Benefits Specialist/Homeless Outreach and • SOAR Local Lead • Mental Illness Recovery Center, Inc. (MIRCI) • 2025 Main St. • Columbia, SC 29201 • (803) 786-1844 x 111  | Fax: 803.754.7783 | www.mirci.org

46. Resources • SSA Website • Information About Social Security's Hearings and Appeals Process - http://ssa.gov/appeals/ • Electronic Records Express (ERE)- http://www.socialsecurity.gov/ere/#a0=6 • Code of Federal Regulations (20 CFR) • Part 416 SSI- http://www.socialsecurity.gov/OP_Home/cfr20/416/416-0000.htm • Part 404 SSDI- http://www.ssa.gov/OP_Home/cfr20/404/404-0000.htm • Program Operating Manual (POMs)- https://secure.ssa.gov/apps10/ • Hearings, Appeals, and Litigation Law Manual (HALLEX)- http://ssa.gov/OP_Home/hallex/hallex.html • Books • Social Security Disability Practice (2014) by Thomas E. Bush • Social Security Disability Practice (2014) by Charles T. Hall • The Merck Manual (19th edition)

47. Questions and Answers • Facilitated By: • SAMHSA SOAR Technical Assistance Center • Policy Research Associates, Inc. • Please type your question into the Q&A panel located underneath the participant tab, or • To ask a question by phone, please raise your hand by clicking the hand icon in the participant pod. We will unmute you so you can ask your question.

48. For More Information on SOAR • http://soarworks.prainc.com • SAMHSA SOAR TA Center345 Delaware AvenueDelmar, New York 12054(518) 439 – 7415 • soar@prainc.com • www.facebook.com/soarworks @SOARWorks