Social Security Disability or SSI claimants and representatives often are faced with Unfavorable Decisions from ALJs or non-reverals or reviews by the Appeals Council. Here are ten reasons that sometimes prevent a favorable outcome.
1. Failure to formulate a complete and detailed theory of the case, covering ALL FIVE steps of the sequential evaluation.
2. Failure to ask for the DOT codes for all jobs mentioned at the hearing, including past relevant work (PRW).
3. Failure to prove the specific functional limitations precluding past relevant work, and to verify which work is PRW by verifying recency, SGA-level earnings, and duration satisfying the SVP (specific vocational preparation) requirement.
4. Failure to get claimant testimony identifying functions necessary for past-relevant and other work the claimant can no longer do, and why.
5. Failure to get treating physician opinion(s) showing that the claimant cannot do functions required for past relevant and other work, and why.
6. Failure to find evidence that could give rise to negative inferences, and show why they do not disprove disability. This includes statements like "Needs work excuse" or "May be engaged in drug-seeking" in medical records, post-alleged onset date earnings, etc.
7. Failure to present hypothetical questions showing that each disabling limitation precludes work. If the claimant describes three symptoms which individually preclude work, each should be presented separately to the VE so that all must be rejected to deny.
8. Failure to get consultative examinations when required. The burden of proving disability is on the claimant not the ALJ.
9. Failure to get school records. There is no evidence with as high a cost/benefit ratio.
10. Failure to establish limitations on admitted activities, allowing the ALJ to compile an unchallenged laundry list of activities the claimant has done. When claimants say they read novels, find out how long it takes and whether they remember what they read. If they go fishing, find out how long and how often. Prepare for this by comparing the difference between their current life and their pre-impairment life.
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