In North Carolina, a disability representative or attorney can help you win benefits at all levels of the system. Some representatives will take your case no matter what level your claim is at. Other representatives will prefer that you have been denied before taking your case. Our office will assist you at all levels, and will help you get your claim started if you have not applied for disability yet.
One thing, however, is certain: if you are turned down for disability in North Carolina, you should probably seek representation.
This is because, in North Carolina, if you receive a denial and you file a reconsideration appeal (this is the first appeal you may file), this will likely be denied as well.
Reconsideration appeals in NC typically get approved only between 10% and 15% of the time. This means that most people who get denied on an NC disability application will end up having to request the second hearing which is a hearing before a federal administrative law judge.
Several years ago, federal statistics released by the Social Security Administration indicated that claimants who appeared at hearings unrepresented were likely to receive an approval of the claim 40% of the time.
Claimants who went to hearings with representation, meaning their case was represented by either a disability attorney or a non-attorney disability representative (very often, a non-attorney disability representative may be a former Social Security field office worker, or a former disability examiner such as myself, which very effectively gives that individual an in-depth expertise as to how disability decisions are made, as well as how to spot errors that have been made on the case) were likely to be approved, however, as much as 62% of the time.
This essentially means that representation resulted in as much as a 50% increase in the chance of approval.
Why is this the case? Most likely, this is true because claimants who go to hearings unrepresented are not likely to have properly updated their case evidence, nor properly prepared it for presentation to the ALJ, or Administrative law judge.
An unrepresented claimant will typically not be familiar with the medical vocational grid rules that are used to make decisions on the majority of SSD and SSI disability claims. They will likewise not be familiar with the specific definition of disability that is used by the Social Security Administration, or the definitions of past work, other work, Residual functional capacity, substantial gainful activity, etc.
These terms are tied to concepts that undergird how the Social Security Disability and SSI system works. They are part of the five-step sequential evaluation process that can lead to an approval or denial based on a medical vocational allowance (a decision in which it is found that a person cannot return to their past work or use their skills and education to do some type of other work, and therefore may be found disabled), or an approval granted through meeting or equaling a listing in the Social Security bluebook.
As a disability examiner, I used this type of in-depth information on a daily basis to decide the outcomes of disability claims. Therefore, I can certainly state, that while a person should never go to a hearing unrepresented, they should likewise not use a disability representative, attorney or otherwise, who has only a limited familiarity with how the federal disability system works.
And by this I mean, you should never choose a representative who handles a variety of different types of cases. For example, an attorney who also dabbles in traffic cases, medical malpractice cases, bankruptcy cases, etc. This type of individual will be extremely unlikely to have developed a legitimate expertise regarding Social Security administrative procedure, and will certainly be unfamiliar with the applicable parts of the Code of Federal Regulations, as well as the pertinent Social Security rulings.
As I have been involved in disability claims since the 1990s, both as a disability examiner and in the representation of claimants, I have come across a number of individuals such as this. And I have been often surprised and stunned to learn that they were attempting to represent claims when they, in fact, had very little knowledge of how claims are developed, how decisions are made, and how to prepare a case that will actually win.
Translation: if you decide to seek assistance on your disability claim, make sure your representative specializes in Social Security Disability and SSI cases only. To win your NC disability benefits, you want a specialist handling your case, not a generalist who has a limited knowledge of the system.