Filing a Social Security Disability claim for benefits is a process that most people have never experienced before. Forms are lengthy, the medical documentation is strict and the decision-making process is drawn out. Many applicants find it to be a foregone conclusion that they will be denied, especially when they know that most claims initially get rejected. Nothing else has a greater impact on that picture – consistently – than qualified legal representation.
If You've Been Denied Social Security Disability Benefits, Here's Why:
The Social Security Administration will only approve about 20 percent of claims during the initial review process. It doesn't imply that four of every five of those applying for the SSA are ineligible, it's just that it's not easy to meet the SSA’S evaluation criteria, especially if you don’t have a thorough understanding of the process.
There are many claimants who are disabled but have been denied. They have real, documented, and debilitating conditions which prevent them from sustaining employment. Lack of qualification is not the issue, it is usually the opposite. Rather, it is the manner in which the claim is presented, such as failing to provide the SSA with adequate medical records, failing to meet deadlines for medical records, failing to describe functional limitations, and even failing to discuss what the SSA is evaluating at each step.
That's why a Social Security Disability attorney is trained to fill in this void.
What an Attorney’s Role is with Your Claim
The involvement of an attorney goes well beyond submitting paperwork. A seasoned disability lawyer leads the legal approach to your claim as soon as they start working with you.
Supplementing Medical Evidence
Medical evidence is the key to any successful Social Security Disability Claim. An attorney reviews what you have, looks for shortcomings, and takes proactive steps to address them, such as requesting more physician notes, having a formal residual functional capacity evaluation or requesting mental health evaluations that directly address your limitations.
One of the most important documents in a disability case is called the RFC (or residual functional capacity) report. It spells out the physical and cognitive abilities of a claimant and what they are not able to do on a sustained basis. An attorney is the person who understands how to properly draft an RFC in order to maximize the likelihood that it will be approved rather than denied, especially when it comes in to accurately represent a claimant's condition.
Framing the Claim Around the SSA's Five Step Process
Each claim is processed by the Social Security Administration in the same five-step process. Each step poses a specific question: Is the claimant currently at work? How bad is the illness? Is there an impairment that is listed that it matches or is equal to? What is the remainder of the claimant's functional capacity? Is there any other work in the national economy that they can do?
Most unrepresented claimants are unaware that there is this framework, and they are not aware of how to tackle each element with supporting evidence. An attorney constructs the claim with this in mind and makes sure each document submitted addresses a question that the SSA will be asking.
Managing Correspondence of SSA and Deadlines
The appeals process is time-sensitive; a single day late can force one to begin all over again. Attorneys keep tabs on all of the filing deadlines, track all correspondence with the SSA, and ensure that evidence requests and hearing notices are responded to correctly and in a timely manner. Giving that administrative burden to someone who knows what they're doing is a kind of relief for someone suffering from a serious medical condition.
Why is the Hearing Stage the Most Critical Time Attorneys Can Make a Difference?
If a claim is denied the first time it goes to reconsideration, the claim will then proceed to a formal hearing with an Administrative Law Judge (ALJ). This is where attorney representation is most directly and documented to affect outcome.
The hearings before an ALJ are court proceedings. Evidence needs to be arranged and displayed in a strategic manner. The judge can ask the claimant themselves questions. The opinions of medical or vocational experts are often heard, and are usually influential in the decision. An unrepresented claimant in the situation of expert evidence is at a great disadvantage.
The claimant is prepared by an attorney for the judge's questioning, and the full medical and functional record is presented, with the attorney challenging the adverse testimony of the vocational or medical expert(s). Where a vocational expert provides testimony that there are jobs that a claimant may still be able to do, an attorney can ask what the basis for that opinion is and can present rebuttal evidence, which not many unrepresented claimants are aware of doing and may never be able to execute effectively.
ALJ hearings approve claims more often for an attorney-represented claimant than for an unrepresented claimant. That is no small margin. It is a structural advantage which is provided at each stage of the hearing by legal preparation.
What It Costs, and What It Doesn’t
When people decide to hire a lawyer, they think that they will have to pay huge sums of money initially. The fee structure is quite different in Social Security Disability cases.
These cases are handled by disability lawyers on a contingency basis. There is no cost to get
started and there are no fees due on non-settled cases. In a winning case, the lawyer is entitled to the maximum of 25% of the back pay awarded to the claimant, capped by a federal maximum which the SSA regulates periodically. The fee is not an out-of-pocket cost to the claimant, but is deducted from the back pay settlement.
The system is designed to enable easy access to legal support, irrespective of economic status. It also makes the attorney's interest directly aligned with the claimant's: both the attorney and the claimant are only better off if the case is successful.
When is the Best Time to Call a Social Security Disability Lawyer?
When it comes to when to get an experienced attorney for your disability case, the most common response among experienced attorneys is “as soon as possible.” A lawyer can join at any point, including initial application, reconsideration, ALJ hearing, or even the SSA's Appeals Council, but the sooner they are involved the more the claim will likely be successful.
A lawyer who has been hired from the very beginning of the filing process can have the paperwork set up appropriately, and help minimize the risk of being denied before it occurs. Once rejected, an attorney will also have to deal with the question of what went wrong and what the missing requirements were, and then try to come up with ways to make up for the shortcomings in the record within a relatively short period of time.
However, if a claimant is already in the appeals process, they should not be afraid to hire representation. It is never too late to get a good lawyer involved and add value to the claim.
Selecting an Appropriate Representation
Not all Social Security Disability attorneys have the same amount of experience in the field of Social Security Disability. This area has its own procedures, its own evidentiary rules and its own dynamics during a hearing, which are quite different from other areas of the law. An attorney or law firm that works on a disability claim as a sub-service is not the same as a firm that specializes in SSDI and SSI cases.
Frequently Asked Questions
Is it necessary to have a lawyer to apply for Social Security Disability benefits?
Although you don't legally need an attorney, represented claimants are approved at much higher rates, especially at the ALJ hearing stage. Submitting the application without any guidance on what the SSA is looking for means you take on ultimate responsibility for ensuring you have the correct medical evidence and follow the proper procedures for the SSA to approve the application.
What is the fee for a Social Security Disability Lawyer?
Disability attorneys work on a contingency basis, and make no up-front fees. When the case is successful, the fee you would pay does not exceed the lesser of the federal cap established by the SSA and the 25 percent of your back pay award. You are not responsible for paying any kind of attorney fees if your case doesn't get benefits.
What if I've already had my Social Security Disability claim refused? Can an attorney still help me?
Yes, and there are many disability attorneys who specialize in just this case. Denial is not final, it's usually the first step in an appeal, which, when done correctly, can be successful with the right representation. Attorneys can help at the reconsideration stage, get you ready for an ALJ hearing or bring the case to the SSA's Appeals Council. Hearing is the stage in which representation is most critical in achieving results.
What is the effect of hiring an attorney on the Social Security Disability process?
Attorney representation does not increase processing time. It helps to avoid delays in many situations by ensuring that applications, appeals and responses to SSA evidence requests are completed and submitted on time. Attorneys also track the progress of their case and remind the SSA if they are taking longer than normal to process cases (which many unrepresented claimants aren't effective at doing).