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Understanding Social Security Disability

Written by: Kevin Lee Linder

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Posted about 3 years ago. 3 helpful votes, 0 comments

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The "basics"?

One time a representative from Martindale Hubbell called me and asked “Did you know that your firm is one of only 74 firms in Illinois that concentrate in Social Security Disability law?” Our office currently receives 8-10 phone calls per week from individuals who have been denied Social Security benefits. Speaking from statistics, only 1/3 of people who initially apply for benefits are approved. At the next step, Reconsideration, only 10% of individuals are approved but at the Administrative Law Judge level about 80% of people are approved.

What are the types of Social Security and what are they meant to provide?

Social Security Disability Insurance (SSDI) is a program meant to provide disability benefits for individuals who have worked and paid into Social Security through payroll deductions and because of their health condition cannot continue to work. Claimants must have a medical condition and also must not be able to perform past (relevant) work or other work. Supplemental Security Income (SSI) is a program designed to provide monthly payments to individuals who are disabled but who have not paid into the Social Security system to be deemed “insured”. These individuals must also meet certain income/asset guidelines. This program is set up for lower income individuals.

Why would someone need legal representation?

Sadly, most cases are not clear cut. An applicant must have medical evidence of record (MER). Some people get treatment for conditions and some people do not. Even if treatment is sought, the doctors/hospitals must send in the medical records. The records must be specific. A doctor who notes a patient “can’t work” is making a subjective (and legal conclusion) statement and Social Security will ignore that comment. A lawyer will assist individuals in making sure all medical records are gathered. Social Security practitioners also have access to “Residual Functional Capacity Questionnaires” which can assist a client’s physician to develop real limitations such as lifting, bending, use of hand, leg problems, etc.

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The process – The three basic levels of a claim are as follows; an initial application, reconsideration and a hearing before an Administrative Law Judge. If denied at all three stages, there is an “Administrative” Appeals council who could possibly review and amend the decision made. If a person is denied at the Appeal

How do attorneys get compensated? I cannot afford a lawyer.

The Social Security Administration controls how much compensation may be charged. Usually a percentage of back benefits are given to the representative. A “fee petition” may also be used if there is a certain amount the representative is requesting. The Administrative Law Judge approves or disapproves the amount of fees. At the US District Court (and Appellate Court level) the attorney is paid by the US Government.

My child is sick – can I get benefits for them?

Children’s cases are often the most difficult but most satisfying cases. Children can have physical problems- bones, joints; problems of blood and immune systems; respiratory problems (asthma, allergies) and mental or emotional problems (ADHD, OCD, ODD, bi-polar, mental retardation and conduct disorder). Helping a parent secure a good future for their most precious person in their life is very professionally rewarding.

Why should I be aware of this as a parent?

Tragedy strikes everywhere and at anytime. A car accident, a stroke, a child born with special needs (vision, joint problems, mental/emotional issues) are things that can affect anyone of us. My ex-wife and I are blessed with a happy, healthy child but we frequently say “Only by the grace of God is that us”.

What are two really rewarding cases that you have won that probably would have been denied if not for your assistance?

Two cases come to mind. One was a Vietnam Veteran who Social Security only worked up the physical side of his claim. They had requested no psych records. We secured the mental records and arranged for the VA counselor to testify. After 15 minutes of testimony, the judge ruled favorably from the bench. The client told me, “This is the first time since I left for Vietnam that I feel respected”. The second case was a lady who suffered from obsessive compulsive disorder. She would not throw anything away. She had a spotty record of medical treatment. We introduced medical testimony and circumstantial evidence – pictures of house full of trash; divorce records; records of eviction proceedings; etc. The Judge (after a remand from the Appeals Council) awarded her benefits going all the way back to December 1998.

What should I look for in selecting a Social Security Disability attorney?

In this area there are three full-time Social Security attorneys. Someone who devotes a significant amount of their practice will generally be a member of a professional organization. There are three main organizations: National Organization of Social Security Claimants & Representatives (NOSSCR), The National Association of Disability Representatives (NADR) and The American Association of Justice (AAJ). Our office belongs to all three.

I see television ads all day long-why shouldn’t I choose them rather than someone local?

The most important thing in winning a Social Security case is developing a good medical evidence of record. A local regional attorney can work with a client to get proper medical evidence and prepare the client for a hearing. We have, at our office, a nurse consultant who reviews all cases prior to hearing so that we have a well developed case. We also employ two disability case coordinators.

I or someone I know might need help, where do I go?

The phone book lists the three most active Social Security attorneys in this area. All of us are competent and caring individuals who strive to do a good job for our clients. Everybody is affected by disability-the claimant, their spouse and children (whether or not they have custody). Life is not over if you or a loved one has a medical condition which prevents them from working. Children can also qualify for benefits if they are unable to function normally. Contact our office (or one of the other Social Security disability attorneys) to explore your options with a free consultation.