Social Security Disability
Why You Need a Social Security Disability Insurance (SSDI) Attorney
Get Representation before Filing Your Initial Claim, as it may shorten the process and reduce the number of appeals you must file before receiving your benefits!!
The bottom line is that hiring a SSDI attorney is going to increase your chances of prevailing before the Social Security Administration (SSA). An experienced SSA disability attorney has more of an ability to cut through the “bureaucratic red tape:” writing letters in support of the disabled worker and getting the SSA the evidence they need to enter a favorable decision. Additionally, the appeals process can be a long and drawn out affair. Hiring an attorney may decrease the amount of appeals you have to file before finally receiving your benefits.
The unfortunate truth is that the SSA wrongly denies thousands of people each year who are truly disabled. It is hard to know exactly why this happens. It may occur as a result of the claim not being thoroughly evaluated. Some people theorize the Social Security Administration is on secret instructions to deny a given percentage of cases each month. While the SSA would strongly deny this explanation, and there is little to no evidence this occurs, given the sometimes-bizarre denials it makes both attorney and disabled person wonder.
The truth, however, is that a common practice is for the SSA to consult with a D.O. or a M.D. to give a disability opinion on your case, and that doctor may or may not be a specialist in your particular medical disorder(s). That doctor will issue an opinion, based upon their alleged review of your medical records, of how much they believe you are able to perform in the course of a day. This decision is made, in many cases, without them ever meeting you and without sending you for a functional capacity exam. For example, it is common for the SSA to hire internal medicine doctors, allergists, or even pediatricians to give expert opinions in fields of medicine far outside their area of practice. This means an allergist might be giving an opinion in an orthopedic case or even that a pediatrician could be providing an opinion in rheumatology or neurology case. Hiring an attorney, means you are retaining someone who can help you fight against these unfair practices and assist you in obtaining the benefits you have earned over the course of your working career.
In many cases, for those who wish to retain Thomas & Thomas, we will meet with the disabled worker in our office or conduct a phone interview. While we would rather meet in person with all of our clients, we recognize that sometimes the poor health of a client prevents someone from traveling to our office. During the initial interview, we will gain an in depth understanding of your disability, develop a plan to provide the best chance of prevailing in your case, and decide how long remains for the denied claim to be appealed. We will then assist you with filing your appeal and fight to assist you with obtaining your benefits.
Social Security work is what is called contingency work. There are no legal fees unless we assist you with obtaining your benefits. If you prevail, the SSA will then deduct 25% of your back pay and issue a check to Thomas & Thomas. The SSA caps attorney’s fees at $6,000 for legal work done at the initial, reconsideration, and hearing levels. This means if the past due benefits are $12,000, the maximum fee in the case is $3,000. If the past due benefits are $24,000, the maximum fee in the case is $6,000. If the past due benefits are more than $24,000, the maximum fee in the case cannot rise higher than $6,000. HOWEVER, if the case has to be appealed to the Appeal’s Council or higher, the cap disappears and the attorney’s fee becomes 25% of all past due benefits. This is because of the increased amount of legal work done that must be accomplished at the Appeal’s Council level or higher.
Social Security Disability Forms
Frequently Asked Questions
In short, for a finding of disability, the SSA must find that as a result of all your combined severe, medically determinable impairments:
- You are prevented from returning to any of your past relevant work (generally defined as work you performed over the last 15 years);
- AND, as of the date you claim disability, you were not even able to perform an unskilled, sit-down job (not lifting more than 10 lbs and sitting up to 6 hours a day). This is one that SSA considers to be the easiest type of job that there is.
Once a person turns 50 years of age, and up until retirement age, SSA disability theoretically becomes easier to get.
In other words, if you:
- Are age 50 or older;
- Have not performed a sit-down job (sitting 6 hours, no lifting over 10 lbs) in the last 15 years;
- Have no transferable skills to the sit-down level,
—the SSA must still find you to be disabled even if they believe you can “now” only perform a sit-down job. This also applies to if you have done a skilled sit-down job and things, as of the date you are claiming disability, were so severe you would have only been able to perform an unskilled sit-down job.
Once a person turns 55, the above is equally true. Now, however, if a person is only capable of light work (standing and/or walking for 6 hours a day and not lifting more than 20 lbs), they have:
- Not held a light job in the last 15 years;
- Have no transferable skills to the light occupational level
—SSA must still find that person disabled. This also applies to if you have performed a skilled light job and things as of the date you are claiming disability were so severe that only an unskilled light job would have been available.
The sequential analysis is the method the SSA is required to use to determine if you are disabled.
It is broken down to a 5-step method:
- Step 1: Is the person working? If no, the SSA continues to step 2. If the person is working and is making more than SGA (substantial gainful activity, $1,180 for the 2018 year), this person is automatically disqualified from obtaining SSA benefits.
- Step 2: Does the person have any severe medically determinable impairments (SMDI)? If yes, the SSA proceeds to step 3. If no, the analysis does not proceed and a finding of not-disabled is issued. A SMDI is a fairly low bar, and it is defined as a medical impairment that would have more than a minimal effect upon a person’s ability to perform even basic work activities, has lasted or is expected to last 12 months, or can reasonably be expected to result in death.
- Step 3: Does the person meet a listing? A listing is criteria that the SSA has set forth for various medical conditions. If these criteria are met, the person is defacto disabled and it is not necessary to proceed onto steps 4 and 5. If a person does not meet a listing, the analysis then goes onto steps 4 and 5.
- Step 4: As a result of the person’s combined severe medical impairments, can they return to their past relevant work? If no, the SSA proceeds to step five. If yes, the person is not disabled, and an opinion of not-disabled is issued.
- Step 5: If the person cannot return to any of their past relevant work, do they possess the ability to engage in other jobs, existing in significant numbers in the national economy? If the answer is no, the SSA then issues a favorable decision. If yes, the person is deemed not disabled.
The date last insured is the date in which a disabled workers’ work credits have or will expire. If you will recall, earlier we discussed how the payment of federal taxes over the course of someone’s career is what qualifies them for the potential payment social security disability benefits. The payment of federal taxes earns what is referred to as “work credits.” The nasty trick the SSA plays, however, is to give these work credits an expiration date.
On average, the work credits expire within about 5 years after a worker stops working. Once the work credits expire, it does not prevent a disabled worker from filing a disability claim. It does, however, add an extra layer of complexity. It does mean, however, that for a disabled worker to receive regular disability insurance benefits, they must prove they were disabled no later than the date their work credits expired.
If your DIB or SSI case has been denied, in most cases you will only have 60 days to appeal an unfavorable decision. This means that as soon as you receive your unfavorable decision, the time clock beings to tick. If you do not appeal, in most cases you will have no choice but to start from scratch. If you have been denied, contact Thomas & Thomas immediately for information and to see if we are able to assist you.