Most applications are denied, regardless of merit. A client has to appeal, usually twice, through RECONSIDERATION and a HEARING. Some clients, about 15 percent of those I represent, have to appeal through the APPEALS COUNCIL and FEDERAL DISTRICT COURT REVIEW. Eventually, most of my clients win their benefits.

RECONSIDERATION is the first appeal. Generally, it amounts to little more than an affirmation of the original denial. This process can take two weeks to six months and is a "paper review" only.

The HEARING is the second appeal. At the hearing, the client testifies before a randomly assigned Administrative Law Judge (ALJ). If the client is represented by a lawyer, the lawyer will have developed the record and will assist the client through the hearing. Generally, it has been taking 24 to 30 months to get a hearing (more about speeding up the wait below). Most claims are won at the hearing. But still, some clients with very good claims lose at the hearing. Often, this has to do with the point of view of the ALJ. I appeal most of these cases.

APPEALS COUNCIL REVIEW is the third appeal. This review is conducted in Falls Church, Virginia. It does not require the client to testify again. Rather, it is a review of the existing record and of any new information the client and his/her attorney sends in. The client still has the opportunity to get more evidence showing why s/he cannot work. The Appeals Council typically takes two months to three years to act (no rhyme or reason for the varying waits). The Appeals Council usually affirms the ALJ. I appeal most of these cases.

FEDERAL DISTRICT COURT REVIEW is the fourth appeal. These cases are randomly assigned to a Federal District Court Judge or Magistrate, sitting either in Portland or Eugene. This appeals also does not require the client to testify again. It is also a review of the existing record, but with the benefit of a detailed, well-researched brief the lawyer prepares. In my experience, most of these cases are either sent back for another hearing by the ALJ or are sent back for payment of benefits. In cases sent back for a rehearing, I have observed most of the time the client wins.

SPEEDING UP THE WAIT. Most clients are stunned to hear the wait for a hearing is 24-30 months. By any standard, this is unacceptable. Most lawyer want to be able to say they can make an exception but saying so would be misleading, for there are few legitimate ways for a lawyer to get the hearings staff to place her cases against the thousands of equally deserving cases already in the long wait. That being said, I screen cases I accept to separate those I see as clearly "black and white" from those I see as "gray."

A "black and white" case usually involves a client who is over 50 with clear medical evidence showing that s/he cannot do past work or other work. Sometimes a "black and white" case involves a younger individual (under age 50) with a seriously advanced disease process. These cases seem so strong there is little question of disability. Therefore, they are good enough to be approved without a hearing. I do see many of these cases and when I do, I request a decision without a hearing, or an "on the record" decision. Such requests are reviewed by a hearing's office staff attorney. If the staff attorney agrees with my assessment, he will recommend an "on the record" decision to an ALJ and usually, the ALJ follows the recommendation. I have success with this strategy most of the time and the wait is reduced dramatically.

A "gray" case describes all other cases. Most cases are "gray" cases. They are "gray" because they come with both good points and bad points. Although there are more good points than bad, the bad points make the case "gray" enough to require a hearing. "Gray" cases are usually good cases, just not good enough to be decided without a hearing. These clients wait the long wait. Most clients wait the long wait.

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