Appeals Spotlight: Success Story

A Successful Appeal Using SOAR!

Perseverance and Preparation Make Third Time the Charm  

Submitted by Candice Masesie, SOAR Benefits Specialist at Fulton Friendship House in Gloversville, New York 

The county department of social services referred Amanda* to me. She was experiencing homelessness and had been diagnosed with several serious mental illnesses in addition to having intellectual and learning disabilities. Amanda’s SSI/SSDI application was denied at the initial and reconsideration levels, so in November of 2022, I served as her representative at her ALJ appeal hearing. The following month, the SSA supervisor called to congratulate me on Amanda’s approval. She was awarded over $16,000 in back pay and can now afford and maintain housing after experiencing homelessness since 2018. 

My words of wisdom for new SOAR practitioners are that persistence and dedication are essential in areas where SOAR is not widely recognized. SOAR works! 

Q&A with Candice Masesie 

1. Did you have any prior experience representing claimants at the ALJ level?  

I did have prior experience representing claimants at the ALJ level. I represented my 16-year-old daughter at the ALJ level in 2014, and I represented a SOAR claimant at the ALJ level over the phone in September 2022. Though both were denied, I learned from those experiences. 

When I filed an appeal on Amanda’s behalf to request a hearing before an ALJ, I opted for an in-person hearing rather than an MS Teams video hearing or phone hearing because I felt this format would be in Amanda’s best interest, given my prior experience and Amanda’s situation. I chose an in-person hearing because I felt the judge needed to see my client firsthand. Mental illness is often unrecognizable unless you spend time with the person living with the illness. Amanda could not look people in the eye and often fixed her eyes on the floor when talking with strangers. She also has limited insight and will say, “I don’t know what that means.” Both of these behaviors were demonstrated throughout her hearing, so the judge could directly witness some of the symptoms Amanda was living with.   

2. How did you prepare yourself for the hearing?

Knowing I had time to prepare for the hearing, I did my research (a lot of research)! These are some resources that helped me get ready: 

• Submitting SSI/SSDI Appeals Using the SOAR Model [PDF]  

• Effective SOAR Representation for Social Security Appeals [PDF]  

• Using the SOAR Model with Social Security Administration (SSA) Appeals

• Physical Residual Functional Capacity Questionnaire [PDF] 

• Mental Impairment Questionnaire (RFC & Listings) [PDF] 

• Tips and Best Practices for Appointed Representatives [PDF] 

• SSA Online Video Hearings - Introduction Process [YouTube] 

• Code of Federal Regulations § 404.1740 

• Program Operations Manual System: DI 25025.035 - Tables No. 1, 2, 3, and Rule 204.00 - 06/26/2020 

• Vocational Expert Handbook [PDF] 

• Code of Federal Regulations, Part 404, Subpart P, Appendix 2 

• Medical Expert Handbook [PDF] 

• Listing of Impairments – Adult Listings (Part A) 

3. How did you keep the applicant engaged in the process, knowing there is often a 1-year wait for a hearing?  

I kept Amanda engaged by explaining that the possible 1-year wait would give us time to develop her case. (She was not in treatment at the time of denial; therefore, we now had time to get her into therapy and obtain and submit those records 5 days before her hearing. I also got her set up with two case managers from separate organizations that provided collateral letters and progress notes to support her claim.) I visited her regularly (at least once a week) and transported her to all relevant appointments for her SSA claim. 

4. How did the ALJ use your Medical Summary Report (MSR) in their written decision?  

The ALJ did not directly cite my MSR in his written decision. He did, however, use the written language, communication, and information flow within my MSR to put together his fully favorable decision.  

5. What advice would you give to a SOAR provider interested in continuing representation at the hearing level?  

• Study the impairment listings! If you know the claimant meets the listing requirements, you know the appeal process is worth the effort. 

• Dedication and determination will empower you.  

• We all get nervous, don’t let that discourage you. People need our help.

• SOAR works!  

Have a story of your own? 

Submit your SOAR success!  

*Sharing Our Successes stories are edited for brevity and clarity. All beneficiary names have been changed to protect anonymity.