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Social Security Attorneys and Disability Representatives - what you should know

If you have applied for either social security disability or SSI disability, or are simply considering applying, the thought may already have crossed your mind that you may need an attorney at some point. And, certainly, this is a valid concern. For claimants who may have to invest up to three years of their time in the disability evaluation system before being awarded benefits, it makes complete sense to try to maximize the chances of winning.

However, if you are seriously considering obtaining representation, here's what you should know about social security attorneys. And this applies equally as well to non attorney representatives (who are often former employees of the Social Security Administration--claims representatives--or disability determination services examiners).

1. Attorneys and non attorneys who represent social security disability and SSI claims work on something similar in concept to a contingency basis; meaning that they are not paid up front. Instead, they receive a fee only if they win your claim. At present, the fee is equal to one-quarter of whatever back pay a disability claimant receives (up to a designated maximum amount seen here). So, in other words, you won't need to worry about the expense of retaining a disability representative. In practical terms, anyone can afford to hire a disability lawyer or a non-attorney disability representative.

2. Attorneys and non attorneys who represent disability claims cannot guarantee that an individual's case may be won, though they can certainly improve the chances of winning benefits by utilizing knowledge of how the disability system works, and by the avoidance of certain pitfalls and mistakes (which an unrepresented claimant may unwittingly fall prey to). Also, it is probably just a simply reality of human nature that an administrative law judge may view a represented claimant a bit differently than one is not represented.

Competent disability representatives will understand the following:

A. The SSA definition of disability.

B. The five step sequential evaluation process of determining claims.

C. The meaning of past relevant work.

D. How medical vocational determinations are made.

E. The importance of a medical source statement.

F. Which types of medical evidence are appropriate, as well as at what point to obtain it.

G. The implications of other work, proper jobs identifications, a claimant's age, and their educational history.

H. How mental impairments are viewed and how they can impact a claim that involves both mental and physical impairments.

I. The analysis of consultative exam reports.

J. The analysis of RFC forms that have been completed by DDS examiners and medical and mental consultants.

K. Congressional inquiries, dire need situations, on the record decisions and other issues that intersect with hearings.

L. Viewing medical evidence in terms of how it relates to blue book listings.

3. Representatives do most of their work at the hearing level, meaning that you may not necessarily need representation prior to filing a request for hearing. However, having said that, many claimants will still benefit from the assistance of an attorney or non attorney at earlier stages in the process. Why is this? Well, it may not apply to every case, but in too many instances, an unrepresented claimant will fail to meet a deadline, or fail to respond properly to SSA correspondence. Why does this happen as often as it does? There may be a number of different reasons. Perhaps stress is a variable in some cases. However, a disability representative can fill this gap and, to some extent, make things easier for a claimant.

Additionally, there are numerous instances in which a claimant will face additional hurdles in completing filing and appeal requirements due to memory issues, affective disorder symptoms (depression, anxiety, bipolar), pain issues, and even the effects of cognitive disorders that can result from a host of physical and mental impairments. These individuals will often benefit from having qualified representation at an earlier level to ensure that their claim proceeds forward with fewer difficulties and, at the least, with no missed appeal deadlines or failures to respond to SSA and DDS requests for information.

4. The individual, firm, or agency that you select to handle your case will gather all the information needed to represent your claim, including your most recent medical records and statements from the doctors who have treated you. They will also gather your older records if necessary to substantiate the most favorable onset date for your claim (which may have a direct impact on the amount of backpay you can receive).

Disability claims are won with both older medical records and newer records. Older records can make or break a case if a person's DLI (the last date for which a person was covered for SSD) is in the past. They can also, as said, impact how much back pay a person can get. Newer records are absolutely vital for simply getting a disability award. But, those records must conform to what SSA considers acceptable and they must also prove that a case meets the SSA definition of disability as a result of functional limitations.

5. The social security administration, once it becomes aware of the fact that you have representation, will send copies to your representative of all correspondence that is sent to you. This may be considered a failsafe device as this is to ensure that both you and your attorney (or non attorney) stay on the same page and that certain requirements can be met (such as the timely filing of appeals). For example, if you, for whatever reason, do not receive a denial notice, but your attorney does receive his or her copy, then the appropriate appeal can be filed in a timely manner.

Does everyone need an attorney or non attorney to win a disability case? No, not at all. However, if your claim is denied at the initial claim level, the chances are good that you will have to appear, at some point, at a disability hearing before a judge. And at that level of the disability process, it makes perfect sense to be represented. Disability representation can result in as much as a fifty percent increase in the chances of winning benefits at the disability hearing level.

Return to:  Social Security Disability Resource Center, or read answers to Questions

Related pages:

How much does a Social Security disability attorney get paid?
How will an attorney help me win disability benefits?
Can a disability attorney speed up my disability case?
Disability Lawyers, Medical Records, and Social Security Hearings
Why do I need an attorney for Social Security disability?
Why does Social Security or DDS disregard my doctor's statement supporting my case?
When you file for disability do you have to see their doctors?
Social Security Disability Approval and Denial Rates
Social Security Attorneys and Disability Representatives
Disability lawyers - basic questions for Social Security help

Information on the following topics can be found here: Social Security Disability Questions and in these subsections:

Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI

These pages provide answers to basic questions about pursuing disability benefits

Disability qualifications - Who will qualify is based on functional limitations
What do you Need to Prove to Qualify for Disability Benefits?
How to file for disability and the information needed by Social Security
What conditions do they Award Disability Benefits for?
How does back pay for Social Security disability work?
What makes you eligible for Social Security Disability or SSI? Part I
To get a Social Security Disability or SSI Award do you have to have a Permanent Disability?
Social Security Disability Status - when should I call to check
Do Lawyers Improve The Chances of Winning Social Security Disability or SSI?
What is qualifying for disability based on?
How to qualify for disability - The Process of Qualifying for Benefits
Receiving a Social Security Disability Award Letter
How long does it take to get disability?
Filing and applying for disability in Texas