Social Security for Disability
When people talk about disability benefits, there is often confusion: social security disability insurance and supplemental security income (SSI). The Social Security Administration administers both programs but the programs are different. The social security disability program (SSDI) that workers, employers and the self-employed pay for with their social security taxes provides disability benefits based on your work history and the amount of your benefits is based on your earnings.
SSI is a program paid for though general tax revenues, not through the social security trust funds. SSI disability benefits are paid to the people who have a disability, who don’t own much property or have income over the limit allowed, or do not have a sufficient work history to qualify for SSDI. It is possible and many people receive benefits for both programs under certain circumstances. The disability benefits from both programs is primarily the same. Children can receive benefits under the SSI program. The tests for disability for children are different than the tests for adults obviously because most children do not have a work history or a work record that can determine whether they can still work based on the disability that they have.
Like other government programs, the Social Security Administration proves an application level and levels of appeals if a person with impairments is denied. The simple fact of the matter is individual who are represented by trained social security attorneys have a 60% better chance of receiving benefits after denial than those who were not represented. The reason for their is quite simple. Although the Administration keeps attempting to be fair and to receive as much information as possible to justify their decisions, they simply do not spend the resources or the time in receiving all of the information that is necessary. They also treat younger disabled workers differently than older ones by law. A younger individual-less than 52- has much more difficult time getting benefits from the Administration than someone who is 52 or oder. Part of this is based on the way the law is written. Part of it is an economic detriment that is built into the law and is carried forward by individual evaluators at every stage of the disability process.
Once you apply for social security, the size of the government agency and the complexity of these programs will get in the way many times of a fair and accurate evaluation. Many times the program is changed and laws are passed. When that happens, it is a huge task to see that everyone within the Administration who needs to know the change in information actually gets that information. Often they do not.
To take one example of problems created by complexity, consider the Social Security Administration’s nationwide toll-free telephone number - 1-800-772-1213. In theory the toll free number is staffed by knowledgeable SSA employees capable of answering a wide variety of questions, including questions about entitlement to disability benefits. But that is not the reality. One test showed 25% wrong answers to questions involving SSI, by far the most complicated of SSA’s programs. The toll-free number, if you can get past the busy signals and the recorded messages, is useful only for very basic information, not for questions that a lawyer might have about disability benefit entitlement.
The Social Security Administration, like all bureaucracies, attempts to make complex decisions routine. But the more complicated the decision, the less effective this is. They publish rules, regulations, graphs, etc., on every issue they feel is important in deciding whether someone is disabled., i.e., whether the medical evidence is sufficient to show the disability and whether the other information shows you cannot do particular jobs. Unfortunately, state agencies are not equipped to assess the actual impact of a medical impairment on a particular claimant, which usually involves a credibility determination, ie.e, wether the claimant’s statements that they are unable to do a certain task are in fact the truth. These problems usually exist before the hearing stage where administrative law judges are appointed to hear the evidence when someone is denied benefits. For example, a study using SSA’s own methodology repeatedly concluded that state agency determinations are correct more than 93% of the time. However, this does not explain why the administrative law judges have always found people disabled more than half the time claimants who come before them, thereby leaving the 93% statement invalid.
The following must be proved by a claimant in order to be found disabled:
Most of the individuals who are denied benefits and who have the toughest time in getting benefits and who need an attorney the most are denied at the 5th step, i.e., they clearly have impairments that keep them from doing their former work, however, the Administration will hire vocational experts who can determine what other jobs the claimant can do even though those jobs do not exist as open jobs at that time but only exist in Department of Labor manuals.
Therefore, it is extremely important that an attorney is familiar with the various regulations concerning the functional abilities of an impaired individual to work.
What our office will do when faced with a claimant who has been denied benefits and who appears to be severely impaired and not able to do their former jobs, is to completely investigate all existing medical records by obtaining the Social Security file.
We will already have interviewed the claimant though an exhaustive analysis of the claimant’s own statements as well as what the claimant has told Social Security, then we focus on the medical evidence and follow up with important health providers by way of specifically detailed letters to focus on what the Social Security Administration looks for in deciding cases. It is simply not enough for a doctor to say that you are totally and completely disabled if he or she has not based an opinion on medical evidence that establishes you cannot do certain types of work based on your age and experience. The claimants who ask their doctors for a “letter” usually do not get sufficient information to prove their case. Our office has over 500 questionnaires for specific medical problems that can be appropriately modified to fit the claimant’s specific impairment when requesting information from a treating physician or other physicians.
Once all the information is available to present the best case, it is necessary to understand the hearing process in front of the administrative law judge. Although most law judges are fair and will ensure you have an opportunity to present your testimony without an attorney, there are many questions that need to be asked that only the attorney may be aware of since that attorney has interviewed you and has obtained the medical evidence and other important information and sees that it gets on the record since these hearings are transcribed and the record can be used on appeal if a decision is unfair or goes against the weight of the social security law.
I have represented over 1,000 social security claimants since 1975. I believe our record will show that claimants are given the best representation possible with the existing facts and the success rate is greater than 60% at the administrative law level.
Unfortunately, many attorneys are representing individuals at social security hearings who may have represented the claimant before in other legal matters who are not aware of the special intricacies of social security administrative law. It is relatively easy to show up at a hearing and ask a few questions and hope that the case that has already been compiled by the Social Security Administration is sufficient to allow an award of benefits. However, without doing the detailed pre-hearing work necessary the chances of success are lowered by this type of representation.
We will not accept all claims for people who feel they are impaired if the medical evidence is not sufficient under Social Security rules. However, in every case we will review all information we have discovered and inform why we feel a case is not strong enough to go forward with our representation.
Our attorneys are paid on a percentage of any back benefits that are awarded to the claimant, ie.e., if a claimant is found disabled two years prior to the actual award decision being granted by the Administration, that award will create benefits going back to those tow years, and even though the first five months are not payable pusuant to law, it is possible that SSI can cover those first five months assuming that the income guidelines for SSI are met. Attorneys can only charge 25% of those back benefits, up to a maximum of $5,300 which the law allows. There are no attorney fees awarded in the event that you do not win your case. If any attorney attempts to charge a fee different than this, they must have approval by the Social Security Administration through a fee agreement process.
SSI is a program paid for though general tax revenues, not through the social security trust funds. SSI disability benefits are paid to the people who have a disability, who don’t own much property or have income over the limit allowed, or do not have a sufficient work history to qualify for SSDI. It is possible and many people receive benefits for both programs under certain circumstances. The disability benefits from both programs is primarily the same. Children can receive benefits under the SSI program. The tests for disability for children are different than the tests for adults obviously because most children do not have a work history or a work record that can determine whether they can still work based on the disability that they have.
Like other government programs, the Social Security Administration proves an application level and levels of appeals if a person with impairments is denied. The simple fact of the matter is individual who are represented by trained social security attorneys have a 60% better chance of receiving benefits after denial than those who were not represented. The reason for their is quite simple. Although the Administration keeps attempting to be fair and to receive as much information as possible to justify their decisions, they simply do not spend the resources or the time in receiving all of the information that is necessary. They also treat younger disabled workers differently than older ones by law. A younger individual-less than 52- has much more difficult time getting benefits from the Administration than someone who is 52 or oder. Part of this is based on the way the law is written. Part of it is an economic detriment that is built into the law and is carried forward by individual evaluators at every stage of the disability process.
Once you apply for social security, the size of the government agency and the complexity of these programs will get in the way many times of a fair and accurate evaluation. Many times the program is changed and laws are passed. When that happens, it is a huge task to see that everyone within the Administration who needs to know the change in information actually gets that information. Often they do not.
To take one example of problems created by complexity, consider the Social Security Administration’s nationwide toll-free telephone number - 1-800-772-1213. In theory the toll free number is staffed by knowledgeable SSA employees capable of answering a wide variety of questions, including questions about entitlement to disability benefits. But that is not the reality. One test showed 25% wrong answers to questions involving SSI, by far the most complicated of SSA’s programs. The toll-free number, if you can get past the busy signals and the recorded messages, is useful only for very basic information, not for questions that a lawyer might have about disability benefit entitlement.
The Social Security Administration, like all bureaucracies, attempts to make complex decisions routine. But the more complicated the decision, the less effective this is. They publish rules, regulations, graphs, etc., on every issue they feel is important in deciding whether someone is disabled., i.e., whether the medical evidence is sufficient to show the disability and whether the other information shows you cannot do particular jobs. Unfortunately, state agencies are not equipped to assess the actual impact of a medical impairment on a particular claimant, which usually involves a credibility determination, ie.e, wether the claimant’s statements that they are unable to do a certain task are in fact the truth. These problems usually exist before the hearing stage where administrative law judges are appointed to hear the evidence when someone is denied benefits. For example, a study using SSA’s own methodology repeatedly concluded that state agency determinations are correct more than 93% of the time. However, this does not explain why the administrative law judges have always found people disabled more than half the time claimants who come before them, thereby leaving the 93% statement invalid.
The following must be proved by a claimant in order to be found disabled:
- The claimant was not engaging in “substantial gainful activity” which has a specific meaning under social security law, determined by the amount of money you make and the type of job you were actually doing, but if you were working forty hours and making more than $950.00 a month, you would not be eligible under that test.
- The claimant has a “severe” impairment. Therefore, the impairment must be proven to effect your ability to work in some way.
- The impairment meets or equals one of the impairments described in the Social Security regulations known as the “Listing of Impairments” or,
- Considering the claimant’s residual functional capacity (RFC), that is, what the claimant can still do even with his or her impairments, the claimant is unable to do past relevant work, and,
- Other work within the claimant’s RFC considering age, education, and work experience, does not exist in the national economy in significant numbers.
Most of the individuals who are denied benefits and who have the toughest time in getting benefits and who need an attorney the most are denied at the 5th step, i.e., they clearly have impairments that keep them from doing their former work, however, the Administration will hire vocational experts who can determine what other jobs the claimant can do even though those jobs do not exist as open jobs at that time but only exist in Department of Labor manuals.
Therefore, it is extremely important that an attorney is familiar with the various regulations concerning the functional abilities of an impaired individual to work.
What our office will do when faced with a claimant who has been denied benefits and who appears to be severely impaired and not able to do their former jobs, is to completely investigate all existing medical records by obtaining the Social Security file.
We will already have interviewed the claimant though an exhaustive analysis of the claimant’s own statements as well as what the claimant has told Social Security, then we focus on the medical evidence and follow up with important health providers by way of specifically detailed letters to focus on what the Social Security Administration looks for in deciding cases. It is simply not enough for a doctor to say that you are totally and completely disabled if he or she has not based an opinion on medical evidence that establishes you cannot do certain types of work based on your age and experience. The claimants who ask their doctors for a “letter” usually do not get sufficient information to prove their case. Our office has over 500 questionnaires for specific medical problems that can be appropriately modified to fit the claimant’s specific impairment when requesting information from a treating physician or other physicians.
Once all the information is available to present the best case, it is necessary to understand the hearing process in front of the administrative law judge. Although most law judges are fair and will ensure you have an opportunity to present your testimony without an attorney, there are many questions that need to be asked that only the attorney may be aware of since that attorney has interviewed you and has obtained the medical evidence and other important information and sees that it gets on the record since these hearings are transcribed and the record can be used on appeal if a decision is unfair or goes against the weight of the social security law.
I have represented over 1,000 social security claimants since 1975. I believe our record will show that claimants are given the best representation possible with the existing facts and the success rate is greater than 60% at the administrative law level.
Unfortunately, many attorneys are representing individuals at social security hearings who may have represented the claimant before in other legal matters who are not aware of the special intricacies of social security administrative law. It is relatively easy to show up at a hearing and ask a few questions and hope that the case that has already been compiled by the Social Security Administration is sufficient to allow an award of benefits. However, without doing the detailed pre-hearing work necessary the chances of success are lowered by this type of representation.
We will not accept all claims for people who feel they are impaired if the medical evidence is not sufficient under Social Security rules. However, in every case we will review all information we have discovered and inform why we feel a case is not strong enough to go forward with our representation.
Our attorneys are paid on a percentage of any back benefits that are awarded to the claimant, ie.e., if a claimant is found disabled two years prior to the actual award decision being granted by the Administration, that award will create benefits going back to those tow years, and even though the first five months are not payable pusuant to law, it is possible that SSI can cover those first five months assuming that the income guidelines for SSI are met. Attorneys can only charge 25% of those back benefits, up to a maximum of $5,300 which the law allows. There are no attorney fees awarded in the event that you do not win your case. If any attorney attempts to charge a fee different than this, they must have approval by the Social Security Administration through a fee agreement process.
