What are you paying for when you get a disability lawyer?
This is a very interesting question, mainly because there are so many assumptions as to what one will get when Social Security Disability representation is obtained.
Here are some of those assumptions:
1. A disability lawyer will ensure that my Social Security Disability or ssi case is won.
2. A disability lawyer will be able to speed my case up.
3. A disability lawyer will do everything for me on my case.
Let's discuss these assumptions in order.
Related: Cost of getting a disability attorney
Assumption one - will a disability lawyer guarantee that your disability claim will be won? Answer: No. There is truthfully no way to guarantee that a case will be won and anyone who offers this guarantee is "off-base" at the very very least. Can you improve the chances of winning a Social Security Disability claim and, more specifically, can a disability lawyer improve your chances of winning benefits? The answer to both these questions is yes.
How can YOU improve your chances of eventually winning benefits? Several ways---
A. Always appeal in a timely fashion when you have been denied (because if you don't, you'll have to start all over again with a brand new application).
B. Go to a medical exam if social security decides to send you to one (failure to do so can result in being denied on the basis of "failure to cooperate").
c. Stay on the lookout for correspondence regarding your claim (you can't appeal if you don't know you were denied and you can't go to a disability medical exam if you don't know one was scheduled).
D. Keep up with your medical treatment (granted, this is very difficult if you no longer have medical insurance).
E. Report your medical treatment to your attorney (or non attorney rep) if you have one, so your representative will know who to request records from. Also report this the individual who is processing your claim if the claim has not proceeded to the hearing level (this would be the disability examiner who is assigned to your case).
F. Stay compliant with your medications (again, difficult to do if you don't have insurance, but a disability judge may use it against you if you have not been "compliant" with your prescription medicine regimen---your inability to obtain these meds is not the primary factor in their eyes).
Now, how can an attorney improve your chances of winning? Well, an attorney may take quite a bit of anxiety away by doing status checks for you and by filing your appeal paperwork for you. But, the maximum benefit you will obtain from a disability attorney will be at a disability hearing. At a hearing, a disability attorney will present your case and argue, in the context of social security rules and regulations just why it is that you should be approved for benefits.
Can you do this yourself? You can try, but very very very very very few disability claimants will even know what the listing book is, what residual functional capacity is, what the grid is, what the significance of specific medical evidence is, and what the importance of a treating physician's detailed and directed opinion is. So, in other words, 99% of all disability claimants will not be able to provide representation for themselves that is equal to what they would obtain from an experienced lawyer or non attorney representative. That' my opinion, of course, but I believe it to be valid.
Assumption two - will a disability lawyer will be able to speed your case up. Possibly. If your claim is pending at the hearing level (meaning that you or your representative have already requested an ALJ--administrative law judge--hearing and you are now waiting for a hearing to be scheduled), AND your financial circumstances or medical situation is dire (i.e. you are in danger of losing your domicile, having your utilities shut off, or not being able to obtain needed medications), then your representative may be able to get your hearing request expedited on the basis of dire need.
Can a disability lawyer speed up your case if it is pending at the initial claim or first appeal level? It probably doesn't happen that often but it's possible and here's why: when a claimant's case is sitting on disability examiner's desk (or in the filing cabinet) it's mainly sitting there because the examiner is waiting on medical records to be received. If a claimant or a claimant's rep can assist to obtain those records and get them to the examiner who's assigned to the case, it can potentially shave weeks off the total processing time.
Assumption three - a disability lawyer will do everything for me on my case. Well, let's put it this way. A disability attorney or non attorney representative will typically do nearly everything. Meaning? The rep will complete your appeal paperwork, work to gather your most recent records, attempt to get statements from your treating physicians, submit copies of these records to the examiner or (most likely) the judge handling your case, and will prepare your case for presentation at a hearing. Many reps will also send reminder notices for any consultative exams that may have been scheduled and for hearings that have been scheduled.
Will a lawyer or non attorney representative actually complete your disability application for you? Well, this is not unheard of. Some reps will allow their office staff to assist claimants in the completion of disability applications and questionaires (such as for work history and activities of daily living).
However, to be quite frank, this shoud actually be done by the claimant and for a simple reason. Only the claimant will know his or her work history and daily activities, and only the claimant will be able to provide a list of medical treatment sources (needed for the application). Though, in most cases, a claimant who is experiencing difficulty with SSA forms will be able to receive assistance in completing these forms from the office of their representative.
When should you find help for a disability claim? Well, you can actually find representation at any point in the process. You should definitely get representation if you have requested a hearing. And if your claim has been denied at the basic application (initial claim) level and your next step is to request your first appeal (called a review or reconsideration), you may wish to consider finding representation as well.
Reason: most first appeals are likewise denied---meaning that if your claim is denied at the application level you will probably find yourself on the road to a disability hearing in front of an administrative law judge.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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