You have had your hearing. You get your decision in the mail. You open it up and right under your name and address you hopefully see: “NOTICE OF DECISION—FULLY FAVORABLE.”
You may also see: “NOTICE OF DECISION—PARTIALLY FAVORABLE,” or “NOTICE OF DECISION—UNFAVORABLE,” “NOTICE OF DECISION—DISMISSED.”
What does this actually mean? Are you going to get your social security disability benefits or not?
The letter is long and confusing. You want a short answer.
Well, the short answer is this:
Your claim was granted and the Administrative Law Judge (ALJ) accepted your onset date. This is the decision you want. This means you get everything you asked for in your application. Of course, the Appeals Council can review the decision, but the chances of that are small. You should receive a letter from the payment processing center a few weeks after your decision and the letter will tell you how much your back benefits are as well as your monthly benefit. You will probably receive your first monthly check prior to receiving your back benefits.
Usually, a partially favorable decision means that the ALJ agreed that you were disabled, but changed the onset date to a later time. This is good and bad. You should get benefits, but your back benefits will be less because the onset date was changed. Also, with a partially favorable decision, you need to see if the onset date was changed to a date after your date last insured because if so, you may only be entitled to SSI benefits and not SSDI. You may need to appeal certain aspects of a partially favorable decision.
No one wants to see this, but it does happen. This decision means that the ALJ did not find you disabled, and you will not be getting benefits. You can appeal this decision. The first level of appeal is to the Appeals Council and then you appeal to Federal Court if your claim is still denied. Many cases that were initially ruled as unfavorable by an ALJ have been overturned either by the Appeals Council, a Federal Court, or by another ALJ. Whether or not you will be successful on an appeal of an unfavorable decision depends on the facts of your case, the ALJ’s rationale for the decision, the regulations and the law.
A dismissal may sometimes be issued by an ALJ as well. In this decision, your case is dismissed without a decision. This can happen when you don’t go to the hearing, when you filed your appeal too late without good reason, or when your case has already been decided and you have no new evidence. A dismissal can be appealed to the Appeals Council or Federal Court.
Of course, there is much more that could be written on the effect and result with each type of decision. But, the above is meant as a short overview of the most common decisions given by ALJs in social security disability claims.