12 Things You Need to Know
(Click on a question to see the answer)
- Am I disabled?
- What do I do if I have been denied benefits?
- Do I need an attorney?
- When should I contact an attorney?
- How much does it cost to hire an attorney?
- What information will my attorney need?
- What would my attorney do to represent me in my Social Security case?
- Will I be approved on reconsideration?
- What is a hearing?
- What if I’ve already lost a hearing?
- Overpayment & LTD cases
- Cessation case
Am I disabled?
To receive benefits under a private LTD insurance company policy or the Social Security DIB or SSI program, you must have physical or mental health problems (or a combination) severe enough to keep you from working in any regular paying job for at least 12 months. The test isn’t whether or not you can do your job or even if nobody will hire you, the test is whether you are capable of doing any job available in the national economy based on your experience. By using an extensive set of regulations, the Social Security Administration will take into account your medical condition, your age, your abilities, training and work experience in determining your right to benefits.
What do I do if I have been denied benefits?
You must file several appeals. Many disabled people become disheartened after they receive a disability benefits denial notice and just give up. Big mistake.
There are up to five (5) appeals. Over 90% of all applicants, in Texas, Oklahoma and Kansas, are denied benefits initially. Therefore, if you are disabled, but have been denied benefits, you should call us immediately to file your appeal. We will help you file your appeal for free even if you don’t hire us.
Do I need an Attorney?
You have the right to have an Attorney represent you in your Social Security case. Statistics show Attorneys have been much more successful (about 70% more successful) than people representing themselves. There are a lot of confusing forms and procedures to wade through with the government. Whether you hire an Attorney is entirely up to you. If you do not hire an Attorney, you should be prepared to:
- examine evidentiary exhibits for accuracy and admissibility
- cross examine witnesses on your behalf as well as expert witnesses called by the SSA
- meet the deadlines proscribed by law
- file legal briefs to win appeals in your case
Expect it to be hard, especially when you are battling your own illness and impairment.
When should I contact an Attorney?
The sooner the better. We prefer that you contact us immediately, but certainly not later than when you first get denied. It’s very important that you arrange for Attorney representation early enough to allow time for case and hearing preparation. That’s why we think it’s best to start looking for an experienced Social Security Attorney immediately.
Excellent Attorneys in Social Security cases do much more than sit in at a hearing and ask a few questions. Excellent Social Security Attorneys do a lot of pre-hearing preparation, analysis and evidence-gathering. (If your lawyer is not doing this you probably don’t have one with expertise in Social Security Disability) The earlier you Attorney is able to start preparing for you hearing, the better your chances are of winning. The longer you wait, the harder it is to win.
How much does it cost to hire an Attorney?
Attorney fees are not negotiable. Congress has set current Attorney fees on a contingency fee basis of twenty-five percent (25%) of past-due benefits up to $6,000. There is no fee if you lose. The SSA will withhold 25% of your past-due benefits for payment of the authorized Attorney fee. Your regular and future monthly benefits will not be charged. There is no up front cost.
What information will my Attorney need?
When you go to your first meeting with your Attorney, be sure to take along all you Social Security papers denial notices, decisions, appeal forms, medical evidence, etc. We will also need:
- Names, addresses and dates seen for all doctors related to your disability
- Names, addresses and dates of all hospital visits
- Names and addresses of your employers during the last 15 years & job duties
- Type of Medications and dosages
What would my Attorney do to represent me in my Social Security case?
Every case is different. Your Attorney’s role depends on the particular facts of your case. However, a few of the things an Attorney may do are:
- Gather medical and other evidence
- Analyze your case under SS Regulations
- Contact your doctor and explain SS Regulations to obtain a report for you
- Request that SS send you to a doctor for a consultative examination
- Obtain documents from your SS file
- Review actions taken by the SSA
- Ask that a prior application be reopened
- Seek waiver of a time limit
- Request subpoenas for witnesses/documents
- Prepare you to testify at your hearing
- Present a legal brief at your hearing
- Submit evidence and argument to the Judge
- Prepare interrogatories for SSA witnesses
- Refer you to additional doctors
- Send you out for a vocational report
- If you win, make sure that SS pays you properly
- If you lose, request review of the Hearing Decision by the SSA Appeals Council
- If necessary, represent you in a federal court
Will I be approved on Reconsideration?
Probably not, but don’t be discouraged. Only about fifteen percent (15%) of the applications win on Recon. If you are denied at recon, you should request a Hearing within 60 days. The same people who made the decision to deny you initially make the reconsideration decision, so they are unlikely to change their mind unless there has been a major change for the worse in your condition.
What is a Hearing?
The Hearing is a crucial step. This is your best chance of winning your case.
The hearing is conducted by a judge at the SSA ODAR. This is not the same agency that denied your Initial Application and you Reconsideration. Although an Administrative Law Judge will preside and testimony is taken under oath, it’s not like Hollywood shows on TV. It is more informal. Strict rules of evidence do not apply, but you do need legal experience because you will likely have to enter evidence and cross-examine witnesses.
The Hearing is private. The people present will be the Judge, the Judge’s assistant, you, your Attorney, any witnesses you may want to present and any witnesses called by the SSA. The Judge may ask a vocational expert to testify about your ability to work and may call a “medical expert” or doctor (whom you don’t know) to testify about your case. Be Prepared. You will need to cross-examine these witnesses if you don’t have an Attorney.
Medical records will be entered as evidence. The Judge or your Attorney will ask you about your present medical condition, medical history, abilities, education, training, work experience an the limitations in your daily life caused by your disability. You or your Attorney may make a closing argument specifying what Regulations entitle you to benefits under Social Security.
What if I’ve already lost a Hearing?
If you are still within 60 days of the date on your Notice of Unfavorable Decision denying you benefits or even a denial decision from the Social Security Appeals Council, it may not be too late. You should contact an Attorney immediately. Sometimes an experienced Attorney can still find a way to win your case at the Appeals Council or in Federal Court. However, if you were not represented at your hearing, or if you were represented by a non-attorney or an inexperienced attorney at your hearing, you will have a hard time getting an experienced Social Security Attorney to represent you after you have been denied at a hearing. The reason is because there are probably mistakes which were made by you or your attorney which might not be able to be corrected.
Overpayment and LTD Cases
Our office is one of the few in the Southwest who assist Clients with overpayment and Long Term Disability (LTD) cases. These fees are negotiated by our firm directly with the Client based upon work involved. The Social Security Administration and LTD companies regularly make mistakes on these difficult cases. We have successfully handled hundreds of these cases.
In cases involving the termination of benefits for current disability recipients, a different sort of hearing is conducted at the Reconsideration Stage. Because it is important to have representations at all hearings, if you are going to have a Reconsideration hearing to determine whether you get to keep your benefits, you should contact an Attorney as soon as you receive your Termination Notice. The Attorney Fee for a cessation case is negotiated by our Firm directly with the Client based upon the amount of work involved and the amount of your monthly payments.