Hiring a Qualified Disability Lawyer in West Virginia
Claimants with disability representation in West Virginia tend to have a higher percentage of benefit approvals, have a need to file fewer appeals, and receive more favorable "onset dates" (the onset date is the date the disability is proven to have begun) which can result in higher amounts of back pay benefits.
Social Security Representation may be provided by a disability lawyer or by a specialized non-attorney disability representative. Many non-attorney reps are former Social Security Administration Claims Specialists and Disability Examiners.
A well-qualified disability representative will have a knowledge of Social Security administrative law and procedures, especially concerning how claims are approved through the Social Security listings and the medical vocational grid rules. A qualified and competent disability representative or lawyer will also be skilled in the ability to obtain the most relevant case evidence, how to analyze it correctly, and how to incorporate it as part of a winning strategy for a claim.
To learn about fees for representation, see: "How do disability lawyers get paid?"
In all states, most Social Security (SSDI) and Supplemental Security Income (SSI) disability claims are initially denied. In West Virginia, the number of initial disability claims and reconsideration appeals denied (the request for reconsideration is the first appeal) actually surpasses the national average.
In a recent period, the West Virginia DDS (disability determination services, the state agency that makes claim decisions at the first two levels of the system) denied more than 75 percent of their initial disability claims. This was compared to a national average denial rate of about 68 percent.
A person who has been denied should always (assuming their condition has not improved) utilize the appeal process. Unfortunately, the odds of being approved at the reconsideration appeal level are even more dismal in West Virginia.
Reconsideration appeals are sent back to the same DDS for a review of the initial disability decision. Unless the initial disability examiner made an error or the disability applicant submits new and compelling medical evidence, there would be very little reason for the decision to change as the same strict rules and guidelines are used for the review and the initial disability claim decision.
The West Virginia DDS only approves 3.9 percent of their reconsiderations and that is one of the lowest reconsideration appeal approval rates in the nation.
If you have been denied at both your initial disability and reconsideration appeal, your next step in the disability process is to request a disability hearing with an administrative law judge. This is your best chance of being approved for disability benefits in West Virginia or any other state; unfortunately it could take months before you get your hearing. Now is the time to consider a professional Social Security Disability representative if you do not already have one.
Most disability applicants have no idea what information a judge needs to approve a disability claim. Nor do they know how to analze a case to understand why the claim was previously denied, what evidence was considered (or not considered even though it was part of the file), whether or not a medical-vocational rule was improperly applied, or whether the claimant's work history was not properly taken into consideration.
The function of a disability representative or disability lawyer at the hearing level will be to ensure that the case has the maximum chance of approval. A representative will do this, primarily, by attempting to obtain the most effective and relevant evidence. However, obtaining the evidence is only the beginning the of the process.
The attorney or representative will need to examine the evidence to see if A) the claimant has a specific medical condition (physical or mental) that automatically qualifies the individual for disability benefits (because the evidence satisifies certain criteria in the Social Security list of impairments) or B) if the claimant's functional limitations (that result from their condition, or conditions) effectively limits their ability to work at one of their past jobs, as well as ruling out their ability to switch to some type of other work.
Proving that the claimant cannot return to their past work or do some type of other work will require that the disability attorney or representative fully understands the medical evidence as well as the various aspects of the claimant' work history.
In addition to obtaining and analyzing the claimant's medical records, a lawyer or representative will typically attempt to secure a supporting statement from a treating physician, defined as a doctor who has a history of providing treatment to the claimant and is, therefore, qualified to issue a prognosis regarding their condition, as well as an assessent regarding their functional capabilities (i.e. ability to engage in work activity).
Representation on a Social Security Disability or SSI disability claim should always be in place if a disability hearing will be attended. The statistics are fairly consistent in illustrating that represented claimants have a much higher likelihood of being awarded benefits by a federal judge than unrepresented claimants. Which of course, is logical considering that Social Security Administrative law is fairly complex and the unrepresented claimant will have difficulty comprehending even the most basic concepts such as DLI (date last insured), periods of disability, recency of evidence, substantial gainful activity, sequential evaluation, and the application of grid rules.
However, representation on a disability claim can also be useful for claimants when it is obtained much sooner. For many claimants, being represented from the very beginning will ensure that crucial deadlines are not missed, that appointments for consultative examinations are not missed, and that appeals are filed appropriately. Representation can also result in a claim being won sooner, sometimes eliminating the need for a hearing which can add many months of time to a disability claim.
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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