SSR is encouraging OTR submissions
Recently, the Social Security Administration (SSA) encouraged Social Security Disability representatives to submit an On-The-Record request (OTR) to Administrative Law Judges (ALJs). What are OTRs exactly? An On-The-Record request is a brief asking the ALJ to make a decision based on the medical records.
Normally, OTRs are helpful in guiding an ALJ through the theory of disability. Now, OTRs will both help ALJs and assist in handling many hearings that have been postponed or are all being held over the phone due to Coronavirus.
The SSA’s encouragement to submit OTRs means there is an increased chance of receiving a favorable decision for a claimant. To avoid an increasing backlog, OTRs assist ALJs to efficiently process hearings—or even avoid a hearing altogether. In this way, many SSD cases can be decided “on-the-record” and do not require a hearing.
When to submit an OTR
By using an OTR, you can show that your case doesn’t need a hearing, either. Keep in mind, though, not every case will be successful. Here are a few tips for knowing which cases will benefit with an OTR and how to draft the one.
Case involves a listing-level impairment
A case that involves a listing-level impairment (or multiple) will be ideal for an OTR.
Be sure to include listing-level criteria in the OTR; particularly, if there is an unusual or complicated impairment, remind the ALJ about the appropriate listing-level criteria by including it in the request.
Next, explain the required symptoms, clinical findings, and medical techniques and measurements. For example, if the case involves back pain and there is evidence of back flexion painful at 30º, show the ALJ this is a positive straight leg raise test, which is listing-level criteria for 1.04A. If the case involves anemia, show abnormal hemoglobin and hematocrit levels.
Some listings require specific time limits to meet or medically equal the listing-level impairment, so be sure to show exact dates of diagnosis, listing-level clinical signs, and/or supporting evidence demonstrated by objective medical imaging and techniques.
Cases involving claimants aged 50+
If you have a case involving an individual aged 50 years or older, it is likely a good case to submit an OTR. It is even better if the claimant has light or medium past relevant work.
The Grid-Rules can ‘direct’ a finding of disability for some individuals. For example, if an individual is 50 years or older, not likely able to perform his/her light or medium past relevant work, and there are likely no skills transferable to sedentary work, submit an OTR.
If the individual is limited to sedentary work due to the effect of the impairments, singly or in combination, the Grid-Rule will absolutely direct a finding of disability.
Cases that can rely on the Framework of Grid-Rules
Many cases do not involve listing-level impairments or individuals over the age of 50. If you’re able, show the impairments involved result in exertional and nonexertional limitations; then an ALJ can find someone disabled based on the “framework” of the Grid-Rules—which will cover most cases.
A framework argument allows the ALJ to still find an individual disabled, even when the Grid-Rules indicate “not disabled.” This requires a well-structured argument and a succinct review of the facts. Remember, the OTR should be a maximum of five pages.
Submitting an OTR for your case can be highly beneficial. You can order an On-The-Record request from Terri M. David (RUSH option available!) or schedule a call for consultation on how to write a strong and concise OTR. It may be the difference between a claimant receiving benefits or getting denied!