When you file a disability claim with the Social Security Administration (SSA) for yourself or someone else, consider yourself in a new relationship with the SSA. This relationship is focused on developing and completing the record in order to gain a favorable decision. (Not so romantic, right?) As it is in all relationships, each side has a responsibility to do their part. It’s important to understand your responsibilities, as well as the SSA’s responsibilities, when it comes to developing the record. Let’s take a look at the regulated guidelines that will guide you through the process.
20 C.F.R. § 404.1512 and 416.912
Once you have filed, your responsibility in developing the record is to provide the following:
Evidence, such as medical sources
Vocational Factors, such as age, education, training, and work experience
Activities of daily living
Any work activity after the relevant date in your case (AOD, DLI, etc.)
Most income is reported by the IRS on a quarterly basis, so be sure to provide the evidence throughout the adjudicative process.
The SSA is responsible for developing the record at least 12 months prior to the application filing date, date last insured, alleged onset date, ending date of the seven-year period for widow’s benefits, or age 22.
The SSA will also develop work history and order a consultative examination (if necessary) to fully develop and adjudicate the claim. Ordering a consultative examiner is important if there is not enough evidence to fully evaluate the severity of an impairment.
*If a consultative examination is ordered, make sure you/claimant attend the examination.
Social Security Ruling 17-4p
SSR 17-4p clarifies it is primarily your responsibility to develop the record.
At the hearing level, you must submit or inform the Office of Hearings Operation/ALJ about written evidence at least 5 business days before the date of the scheduled hearing. When you inform prior to the hearing, the written information must be specific. For example, include the source, dates of treatment, and why the information is relevant to the issue of disability.
Note that an ALJ can file a grievance if there is a pattern of not acting in “good faith” to obtain and timely submit evidence.
The SSA will make an initial request and a follow up within 20 days. They will also request evidence if they are properly informed.
Finally, the Appeals Council will consider “new and material” evidence that relates to the period on or before the ALJ decision is issued, and it is likely to change the decision.
HALLEX emphasizes the ALJ’S responsibility to “fully and fairly” develop the record and document all attempts to obtain evidence. The ALJ must document all attempts to obtain evidence to prove he or she made every reasonable effort to obtain the evidence.
Documenting the record is essential to show that the ALJ informed you of the need for specific evidence to decide an issue, as well as gave you an adequate opportunity to obtain and submit the requested evidence. When the evidence is received, the ALJ must decide whether to admit it into the record as an exhibit.
*Do not expect an ALJ to enforce or provide a subpoena to obtain evidence
Receiving an Unfavorable Decision
If you’ve received an unfavorable decision and you believe the ALJ did not uphold their duty to develop the record or the AC should have considered new evidence, you may be able to file an appeal. You can purchase the Appeals Brief here or schedule a 1-hour consultation to explore your options.