Statistically, the vast majority of Social Security Disability (SSDI/SSD) and SSI claims are denied at the initial claim and reconsideration levels, and this typically happens regardless of whether or not a claimant is represented by an attorney or non-attorney disability advocate.
For this reason, most SSD and SSI claims will need to go to a hearing in front of an administrative law judge (ALJ) before a claimant can hope to receive disability benefits. It is at the level of an ALJ hearing that having a disability attorney can really help win a claim. While a disability attorney can’t guarantee that a claimant will be awarded Social Security Disability or SSI benefits, a Social Security lawyer can guarantee that a case will be properly “developed” prior to a hearing date.
The simple fact of the matter is this: the vast majority of SSDI and SSI claimants will have no idea how to properly and thoroughly prepare a disability case for a hearing, whereas an attorney has a high level of familiarity and expertise with Social Security rules and regulations. And, in many cases, an attorney will have several years of invaluable SSDI and SSI claim experience to lend to a claimant’s disability case. A disability advocate will know what a judge will be looking for with a particular medical condition, and will know what questions to ask your doctor.
Because disability attorneys get paid only if you win, they do a great many things to ensure that an SSDI or SSI claim will have the best chance of winning. This includes tracking down important medical records and test results, obtaining detailed statements from a claimant’s treating physicians, and, at the time of the hearing, applying a thorough understanding of SSA regulations and prior rulings to the disability adjudication process.
If your medical records are incomplete, or there are inconsistent reports or gaps in your treatment history, the ALJ may have grounds to deny your claim. Therefore, one of the most important services a disability attorney can perform is gathering the proper medical records and submitting them to the court. Although you can request records yourself, an attorney can usually get them more quickly. An attorney will also know when your medical records need updating.
In addition to contacting physicians and medical facilities to obtain your medical records, a disability attorney will review the records in detail and decide if they should be submitted to the SSA. This is important because it allows the attorney to determine whether your case needs additional medical evidence and whether any key test results or documentation is missing spot other issues that may arise at the hearing.
A disability lawyer will also contact your treating physicians to obtain their written opinions (usually on a lengthy form) about your ability to work. Often, doctors are more likely to respond to an attorney’s request than to a patient’s. Additionally, if your medical history is insufficient to support your claim, a disability attorney can request that the SSA schedule psychological or physical exams.
You may be nervous before your hearing, which can make you more likely to make a mistake. Your attorney will be very familiar with the procedure of hearings than you will be and can tell you what to expect. This can help allay any fears you have before your hearing.
Your lawyer will no doubt want to practice asking you questions the judge might ask and helping you with your answers (testimony). Being well prepared to answer the judge’s questions can calm your nerves and make it less likely that you’ll say something that might inadvertently hurt your case.
A vocational expert (VE) is a consultant hired by the Social Security Administration (SSA) to testify at your hearing as to his or her opinion about your ability to work based on your impairments. During the hearing, the ALJ will ask the VE questions about your ability to work based on certain documented work restrictions. These questions are called hypotheticals; here is an example: “Consider an individual of the same age, education, and work history as this claimant. Consider that the individual can frequently carry ten pounds or more and sit or stand at least six hours a day. What jobs could this person do?” The VE would then name a number of jobs that a person with those abilities could perform. If a VE affirms your ability to work, your claim will be denied.
However, once the ALJ has finished questioning the VE, the applicant’s attorney will have a turn to cross-examine the VE. At this point, the knowledge and experience of a disability attorney are invaluable. If the VE tells the ALJ that you can do certain jobs, your attorney will ask a series of hypotheticals based on your medical records to counter the VE’s testimony. Because the attorney is more familiar with your medical record (ALJs often don’t review your records until the morning of your hearing), he or she can use supporting facts that the ALJ may have overlooked. An attorney will use these facts to create hypotheticals that lead the VE to state that you are unable to perform any jobs at all. Without an attorney, it is extremely difficult for a claimant to do this successfully.
Another factor to consider is that disability attorneys are familiar with the personalities and decision-making processes of the ALJs in their area. Your lawyer may have conducted hearings before this particular ALJ before and will know their “style” in advance. This is a tremendous benefit, because going into the hearing, an experienced disability attorney will know best how to handle any weaknesses in your case and how to play up the strengths of your case, given his or her knowledge of the ALJ.
In addition, a disability lawyer can help you skip the hearing and go straight to approval if you are eligible for an on-the-record decision.