Filing the Application for Disability
Social Security Disability SSI Back pay
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Disability Lawyers can prevent unnecessary denials of claims
Representation can be invaluable for winning a Social Security Disability or SSI disability claim. At the hearing level, a disability attorney or non-attorney representative (many non-attorneys are former Social Security Administration staffers or former disability examiners) can easily increase the odds of winning a disability hearing by as much as 50%.
But the advantages of representation are not simply confined to the hearing level. Working as a disability examiner, I routinely observed mistakes by unrepresented claimants that A) sometimes doubled or triped the amount of processing time for the claim and B) would probably not have occurred if a representative had been involved at some point in the case.
Here is a short list of mistakes commonly made by claimants who are not represented by a disability lawyer or disability representative:
1. Getting a statement from a personal physician (known in Social Security terminology as a treating physician), but not one that is actually helpful in terms of the information needed by a disability examiner or administrative law judge.
This typically happens when the doctor's statement is simply that: a statement. What Social Security actually needs is a description of the ways in which the applicant is physically or mentally limited--for example, only being able to lift a certain amount of weight, or only being able to sit or stand for a certain length of time, or having difficulty with attention, concentration, or memory.
To ensure that a physician provides information that allows an approval to be made, a disability attorney or representative will usually request that the doctor complete and return a medical source statement (often, this is a check-off form). This type of form will guide the physician toward providing relevant, detailed information as opposed to a useless statement such as "patient cannot work".
2). Failing to include detailed information about one's work history and medical treatment history - Each applicant who applies is asked to give their work history and places of medical treatment. This information is crucial in two ways. First, a small percentage of approved claims will be awarded on the basis of the medical evidence alone if they have a condition that meets a listing in the SSA list of impairments. Listing approvals are 100 percent dependent on medical record documentation, so the more records that are available to an examiner or judge, the better.
However, most approved claims will not be awarded based on a listing, but, instead, will be awarded on the basis of a medical vocational allowance. This is an approval that occurs when the determination is made that the applicant cannot A) return to their past work and B) cannot switch to a new type of work.
A medical vocational allowance relies on both medical records and work history information and can be very difficult to achieve if the disability examiner or judge does not have access to all the relevant medical records, or is lacking important details about the jobs performed by the claimant before they became disabled. Yet, most claimants when they are filing a claim, will give only bare and minimal details that make it hard to approve SSD or SSI benefits.
However, when a disability lawyer or disability representative handles a claim, attention is usually paid to such issues not only to win the disability claim, but to achieve the fullest amount of payable benefits for a claimant whose financial condition may have come to the breaking point after going without income for so long.
3) Filing a new disability application instead of filing a disability appeal - This type of mistake can lead to many months of wasted time, chiefly because a new claim that is filed immediately after a prior claim has been denied will almost certainly be denied again for the same reasons.
This mistake can also cause a claimant to lose eligibility for months or years of Social Security back pay due to the legal concept of Res Judicata. Clearly, starting over from the very beginning with a new claim is seldom the best approach. But it happens with a large percentage of claims. When representation is involved, this does not happen because the representative files the appropriate appeal with SSA in a timely manner.
These are really just a few mistakes that may be avoided when representation is obtained early on in a claim, as opposed to simply obtaining a disability attorney or disability representative immediately before a hearing is set to take place (by which time, 1-2 years of time have already passed.
Return to: SSDRC, or the Questions, Answers, Tips, and Advice page
The following pages provide information on disability representation within individual states. Claimants who are seeking representation will, after choosing a representative, need to sign a fee agreement that allows the disability lawyer to receive payment for their services. Currently, the maximum fee that may be received by a disability attorney is 25% of whatever back pay the claimant is eligible to receive up to a current maximum of $6000.
Claimants will also need to sign a form SSA-1696. This is the appointment of representative form that notifies the Social Security Administration that the claimant is represented. Once this notification is made, the claimant's attorney will receive copies of all correspondence, notices, appointments, and decisions.
Tips for choosing a disability attorney or disability representative:
1. Find someone who has experience dealing with the Social Security Disability and SSI disability system. This may be an experienced disability attorney, or an experienced disability representative who has previous work experience as a Social Security Administration field office CR (claims representative).
Or, like the author of this site, the individual may be a former DDS (disability determination services) disability examiner with years of experience making decisions on claims, who now choose to represent claimants who have been unfairly denied.
What you do not want is an attorney who only sporadically handles disability claims and spends the rest of his time in traffic court, drafting wills, and pursuing personal injury claims. Social Security law is intricate, complex, and detailed and SSD and SSI claims should not be handled by amateurs who have no real understanding of Social Security rulings, the code of federal regulations, the dictionary of occupational titles.
A non-attorney disability representative who has past work experience in the Social Security system often makes an ideal representative. A disability attorney who has applied himself to learn the intricacies of the the SSD and SSI system can do just as well. But under no circumstances should you choose someone who "dabbles".
2. Read your fee agreement before signing it. When you are represented by a disability lawyer or non-attorney disability representative, you are charged a fee if your case is won, not if it is lost.
However, win or lose, you may have to reimburse the disability attorney for incidental expenses that are incurred on your case. Some of these are quite reasonable, such as the cost of obtaining medical records (doctors do not provide medical records for free). However, some fees, such as the cost of a phone call, are ridiculous. Read your fee agreement before signing it.
3. It is very difficult to screen potential disability lawyers. For one thing, many are so busy that you can find it fairly difficult to get them on the phone. Traveling to hearings several times a week can easily account for this and this is why you may find yourself speaking to a parlegal versus the disability attorney himself. Don't let this bother you. However, if you really need to speak with the attorney or representative before signing the fee agreement and SSA-1696, and this option is not made available---look elsewhere for a lawyer. If you can't get the lawyer to speak with you at the very beginning, you probably won't have much more luck later on.