Do I Need an Attorney?

In preparing to file for federal disability benefits, it’s important to understand the chances of a claim denial are high.

The Massachusetts Disability Determination Service (DDS) reports that in Fiscal Year 2013, of the 16,182 claims processed for Social Security Disability Insurance (SSDI) and Supplemental Security Income benefits, nearly 70 percent were denied in the initial phase. Of the fraction of denials that were reconsidered, 77 percent were again denied. Cases that went on to a hearing before an administrative law judge had a 41 percent denial rate.

Obtaining federal and state disability benefits is not easy. At Jeffrey Glassman Injury Lawyers, our experienced legal team works tirelessly to ensure those who are entitled to benefits have everything necessary to prove it.

Each case is unique, but it is almost always in a person’s best interest to hire a disability benefits lawyer when pursuing these claims. To be clear: There is nothing in the law that requires claimants to obtain legal help. This is true whether a person is filing an application or appealing a denial.

However, there are many ways that having a lawyer to represent you can help. In general, an attorney improves the odds of a finding in your favor. An attorney also increases the chances the DDS reviewer or administrative law judge will submit a finding of a favorable disability onset date. That decision ultimately affects the amount of benefits received.

Because the statistical odds are against SSI and SSDI applicants from the start, the chances a claim will need to go before an administrative law judge are high.

Many people wait until this phase to hire an attorney. Certainly, it’s extremely valuable to have one at that point. The process involves collection, interpretation and presentation of complex medical and occupational records. It’s best to have on board someone with experience. Still, there is a case to be made for hiring one sooner.

• To start, many of the people who are filing are grappling with serious illnesses or injuries. The whole process of filing can make them anxious or even completely overwhelmed. In some instances, that person may even be totally incapable of handling it on their own. An attorney can be very helpful here.
• Secondly, an experienced disability attorney can help claimants avoid common errors. What we’re dealing with here is a government bureaucracy. Although the fact of one’s disability might seem crystal clear to the claimant and his family, proving it to the government using the standardized criteria is another matter.
• Finally, failure to present a strong case during the initial filing can hurt your chances of success later on. The appeals process can be arduous and lengthy. It’s best to avoid it altogether if you can. The way to optimize your chances is by hiring an experienced attorney.

If your claim was initially denied, the next level of appeal is a “reconsideration.” This is when a different reviewer analyzes the same facts to determine whether a different conclusion is warranted. Most of the time, the second reviewer does not break rank with the first.

Overall, one’s chances of winning their case at the reconsideration level are low. Nationally, about 85 percent of cases are denied on reconsideration. The best way to win at a reconsideration is to submit new, convincing medical evidence regarding your condition or indicating it has deteriorated. We know what the examiner is looking for, and we know the best way to present it.

But we tell our clients to avoid being discouraged if the reviewer does not approve the claim. This is practically to be expected. Know that the odds of succeeding before an administrative law judge (ALJ) are much better.

Even though an administrative law judge hearing is formal, you do not HAVE to hire a lawyer. But you should. Keep in mind that your attorney is not paid unless you win your case. This is an important point for those who are struggling financially, as many SSI and SSDI applicants are.

At the ALJ hearing, the judge is going to consider all the medical evidence, the claimant’s testimony and other witness testimony. There may be doctors and vocational witnesses who may not provide favorable testimony, and claimants must be prepared to effectively counter that.

An attorney can also help claimants ensure their medical records are complete, consistent and up-to-date, that all relevant written doctor opinions are included and that the claimant is prepared to answer the judge’s questioning about the situation.

If the ALJ rejects your claim, claimants can request a review by the Social Security Appeals Council. This board can choose to review the case to determine whether the ALJ made a mistake or they might choose not to review it at all.

A claimant who disagrees with either of those decisions has 60 days to file an appeal in federal court. No one in the Social Security Administration can assist you in court. You can file this complaint yourself, but that’s inadvisable. In addition to the complexity of the case material, you’re also dealing with the tedious procedural rules for filing a federal complaint. Failure to follow even a seemingly minor rule can result in a case dismissal.