I-2-8-25.Writing the Decision

Last Update: 5/1/17 (Transmittal I-2-201)

A. In General

For the purpose and general description of a hearing level decision, see Hearings, Appeals and Litigation Law (HALLEX) manual I-2-8-1. If an administrative law judge (ALJ) is issuing a recommended decision, see the instructions in HALLEX I-2-8-15.

When writing or reviewing a draft decision, an ALJ will keep in mind that the primary audience for a decision is the claimant. Therefore, an ALJ will use plain language that an individual unfamiliar with Social Security terminology can understand, regardless of whether the claimant is represented. After a decision is drafted, the ALJ will proofread the decision carefully to verify that all dates, Social Security numbers, citations, and other information are accurate. If an ALJ determines that a record includes evidence that is potentially detrimental to a claimant's health, the ALJ will take care when writing the decision not to unnecessarily upset or harm the claimant with the discussion of this evidence. If disclosure of a particular condition may be detrimental to a claimant's health, see HALLEX I-2-8-35.

When writing or reviewing a draft decision, an ALJ will not use:

  • Emotionally charged words, disapproving or derogatory terms, or personal judgments or opinions;

  • Medical texts or publications as the authority for resolving an issue;

  • Non-prescribed standardized language in the rationale; or

  • The decision as a forum for criticizing the agency, agency policy or procedure, other government agencies, the courts, the representative, or the claimant.

B. Content and Format

Templates that incorporate and conform with the decision writing requirements outlined below can be found in the Hearings and Appeals Case Processing System and the Document Generation System.

1. Parties to the Hearing

Each decision must clearly identify the parties to the hearing by name and Social Security number. If applicable, the decision must also identify the wage earner by name and Social Security number. Each decision will indicate the type of claim being decided by its full title and not by case control system abbreviations (e.g., “Period of Disability, Disability Insurance Benefits, and Supplemental Security Income” rather than “SSDC”).

2. Jurisdiction and Procedural History

The decision will explain why the case is before the ALJ for a hearing and provide other relevant background information such as:

  • The procedural history of the case;

  • Specific information as to whether the claimant was represented at the hearing, whether an interpreter was used, and whether any other individuals appeared at the hearing (e.g., expert witnesses);

  • A statement regarding any other unique procedural circumstances (e.g., the claimant waived the right to a hearing and the decision is being issued “on the record”); and

  • A statement identifying any evidence that the ALJ declined to obtain or consider and the reasons he or she declined to obtain or consider the evidence. See HALLEX I-2-6-59.

3. Issues and Applicable Law

Each decision will include a statement of the issue(s) to be resolved and appropriate reference to the applicable statutes, regulations, and rulings.

4. Findings of Fact and Conclusions of Law

The decision must be set forth carefully. The rationale must reflect the sequential evaluation process and reconcile any significant inconsistencies. Reasonable inferences may be drawn, but presumptions, speculations, and suppositions should not be substituted for evidence.

The decision will provide the rationale for the ALJ's findings of fact and conclusions of law by including the following, as applicable:

  • An assessment of a disability case using the sequential evaluation process;

  • An explanation of the finding(s) on each issue that leads to the ultimate conclusion, including citing and discussing supporting evidence;

  • For claim(s) filed prior to March 27, 2017, a discussion of the weight assigned to various pieces of evidence, including medical source opinions and evidence the ALJ relied on in resolving conflicts in the overall body of evidence;

  • For claim(s) filed on or after March 27, 2017, a discussion about the persuasiveness of medical opinions and prior administrative medical findings, as required by 20 CFR 404.1520c and 416.920c;

  • A discussion of any evidence that raises issues of fraud or similar fault (see generally HALLEX I-1-3 and I-2-10);

  • A discussion of the claimant's subjective complaints, pain, and other symptom evaluation;

  • When a case involves drug addiction and alcoholism (DAA) and the claimant is found disabled, a complete supporting rationale regarding whether DAA is a contributing factor material to a finding of disability (see 20 CFR 404.1535 and 416.935, as well as Social Security Ruling 13-2p, Titles II and XVI: Evaluating Cases Involving Drug Addiction and Alcoholism (DAA)).

  • Any relevant language or analysis required based on the facts of the case, including any finding requested by the Appeals Council or a court; and

  • If a disability case is decided at step 5 of the sequential evaluation process, a statement acknowledging that the burden of showing the claimant can perform other work shifts to the Commissioner.

NOTE:

For more information on the need for written acknowledgement of the limited shifting of the burden at step 5, see Appeals Council Interpretation II-5-3-3.

5. Decision

A decision must include a brief but clear statement regarding the ultimate conclusion in the case.