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After you request an Administrative Law Judge (ALJ) hearing, the Social Security Administration (SSA) looks at your disability claim before the hearing to make sure the record is ready for the judge and to see if anything needs to be addressed. In some cases, that includes a prehearing review of the disability claim.
Disability Determination Services (DDS) is the state agency that typically makes disability determinations for the SSA, but another office may make the decision in some cases. Sometimes, an ALJ sends the claim back to the office that made the earlier decision.
This formal process is called a prehearing review. The purpose of a prehearing review in a disability case is to decide if the earlier decision should be changed and if the hearing still needs to happen.
This article explains why a claim may be referred for prehearing case review and possible outcomes.
A claim may be referred for a prehearing review when something in the claim file suggests that the earlier decision could possibly be changed.
A claim may be referred for a prehearing review when:
The referral gives DDS or the SSA office that made the earlier decision a chance to change the decision before the ALJ hears the claim.
Whichever office made the prior determination reviews the evidence and decides if there is a reason to change it. The SSA calls this the “preponderance of the evidence” standard.
The ALJ still has authority over the request for hearing during the prehearing review.
A prehearing review means the SSA found a reason to look at the prior determination again. The review doesn’t mean an approval is likely, although it could result in a fully favorable or partially favorable change.
A prehearing review can end in one of three ways:
A fully favorable revised decision means the SSA changes its earlier denial and approves your disability claim.
The SSA will send you a written notice explaining the revised decision. Because the SSA has approved your claim, the ALJ hearing is no longer needed, and your request for hearing will be dismissed.
If you disagree with the revised decision for any reason, SSA rules allow you to ask for the hearing request to be reinstated. You have 60 days after receiving the dismissal notice to make that request in writing.
A partially favorable revised decision means the SSA changes part of its earlier decision in your favor but does not fully approve everything in your claim. For example, the SSA may find that you are disabled but that your disability began on a different date than you originally claimed.
The SSA will send you a notice explaining what changed and what part of the decision is still unfavorable. If the SSA approves your claim but sets a later established onset date, your ALJ hearing continues so the judge can decide if you were disabled during the earlier period.
If you are satisfied with the partially favorable result and don’t want the judge to decide the remaining issue, you can agree in writing to dismiss the hearing request.
If the SSA decides not to change the earlier decision, your claim goes to a disability hearing for the judge to decide.
You can still hire a disability representative at this point. Advocate’s disability specialists can help you prepare for the hearing and represent you in court. We may want to postpone your hearing if we need more time to review your claim and prepare.
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Get EvaluationA prehearing review doesn’t postpone your hearing.
If the review is not finished by the hearing date, your claim goes forward to the hearing unless a favorable revised decision is already being processed or all parties agree in writing to postpone the hearing.
Several SSA procedures may apply at the hearing level of a disability claim, but they serve different purposes. Similar names can make them confusing.
Reconsideration is the first stage of the Social Security disability appeals process. A prehearing review happens at the hearing level after your claim is denied at reconsideration and you file for an ALJ hearing.
An on-the-record decision is made without a hearing. After you request an ALJ hearing, you or your representative can ask the judge to approve your claim based on the record without holding a hearing.
The judge may request a prehearing review before deciding the case when new medical evidence or another issue calls for another look.
A prehearing conference is a meeting the ALJ may hold with you and your representative if you have one before the hearing to clarify issues in your claim. It’s only used when the judge decides it would help prepare for the hearing or decision.
Check your SSDI eligibility in a few minutes.
No cost to start.
Talk with our team about your situation. We'll walk you through what comes next.
Get EvaluationSee what documents you need. We'll help you get everything in place.
Get EvaluationNot sure what that SSA letter means? We can review it with you.
Get EvaluationGet support from a team that handles the paperwork and follows through.
Get EvaluationNo. It means the SSA is reviewing whether the earlier decision should be revised. The review itself is not an approval.
Yes. If the earlier decision changes, you will get a notice explaining the revised decision. If nothing changes, you will get a notice that your hearing request will proceed.
Advocate’s disability specialists can help you understand what is happening with your claim and help you prepare for a disability hearing before an ALJ. We can also communicate with the SSA for you and represent you in court.
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