Appealing a Social Security disability claim can seem like a daunting task, but the chances of that claim being successful increase significantly with the help of a qualified attorney.
Many claimants balk at the idea of hiring an attorney because of cost, but they often do not realize that there is no up-front cost in SSDI representation. Everyone has the right to be represented during the appeals process and the Social Security Administration has strict rules about the fees associated with that representation.
In fact, an attorney or representative cannot charge a fee without written approval from the SSA. In many cases, the lawyer only gets paid if the appeal is successful and even then the fee comes from the past-due benefits, according to the SSA’s website.
The SSA determines how much the representation was worth, which is usually 25 percent of the past-due benefits. A claimant never owes an attorney more than this except if there were fees associated with medical record acquisition. If a claimant comes to an agreement with the attorney about a fee structure before the appeal, the SSA will consider that agreement as long as the total is not more that 25 percent of the past-due benefits.
Hiring an attorney for a SSDI appeal could be considered a steal at this price since in most other types of cases attorney’s fees would be greater than that. If the appeal is won, then the lawyer is paid directly by the SSA and the claimant receives a check for the remainder of the past-due benefits.
There are clear benefits of having legal representation when filing a SSDI appeal. An attorney will be able to access a claimant’s file and act on his or her behalf before the SSA. An attorney also will be able to help a claimant access medical records or other information that supports the appeal of the claim. Accessing medical records can be a challenge and attorneys with Social Security appeal experience will know how to get that information in a timely manner.
A claimant can bring an attorney to any interviews, conferences or hearings with the SSA. An attorney also will be experienced at preparing witnesses for a hearing, which can be critical to the appeal.
The Social Security Administration will need to approve the fee structure even if a second party like an insurance company is paying the attorney’s fees, according to the SSA website.
Claims for Social Security Disability Insurance take a long time to be processed and decided these days. An increase in the number of claims in recent years has caused wait times for some applicants to stretch into the hundreds of days. It is in everyone’s best interest for this backlog to be eliminated so that every new application can be decided in a timely manner.
To that end, the Social Security Administration (SSA) encourages its administrative law judges (ALJs) to hear between 500 and 700 claims each year – they call the numbers a “goal.” But some judges claim that the numbers constitute an unlawful “quota.” And now the judges are taking the SSA to court.
The Association of Administrative Law Judges (AALJ) recently filed suit on behalf of 1400 of its members, claiming that the SSA’s expectations cause them to have to improperly rush evaluations. It also creates an incentive to approve cases because approvals are faster than denials. This leads to the potential approval of claims that should be denied, which results in greater fraud, abuse, waste, and expense to taxpayers, the judges say. Their specific legal allegation is that the agency’s directive violates the Administrative Procedure Act and the Social Security Act. They also claim, contrary to the agency’s statements, that judges who do not hear enough cases are subject to reprimands, “counseling,” and “threats and intimidation,” according to the lawsuit.
SSA Commissioner Michael J. Astrue, who was appointed by President Bush, stepped down in February, 2013. President Obama has not yet named a successor – the agency is currently headed by acting commissioner Carolyn Colvin, a former secretary of the Maryland Department of Human Resources. Judge Randall Frye, president of the AALJ, says a lack of permanent leadership may be contributing to the problem.
“One way to protect the treasury and help deserving claimants is to end the quota system,” Frye said. “However, an acting commissioner may not feel that she has the authority to make the necessary changes and correct problems.”
Meanwhile, the Disability Insurance Trust Fund, from which disability benefits are paid, is currently paying out more than it is taking in. It is projected to reach zero in 2016. If that were to happen, it would result in an immediate 21 percent cut in benefits to nearly 11 million Americans with disabilities.
Disability insurance, like most government programs these days, faces intense budgetary pressures. Even in good economic times, ALJs will scrutinize disability claims to make sure taxpayer money is not wasted. If you are disabled, it pays to have an experienced Social Security Disability attorney on your side to get you the benefits you deserve in a timely manner.