Plenty of myths surround applying for Social Security disability benefits. Some contain a kernel of truth, which can make mythbusting them more difficult. To help, we’ll give you a quick overview of some of the more common myths (find more in-depth info about Social Security myths here) and then walk you through the process, including how to hire a disability lawyer.
If you need legal help, experienced Social Security disability lawyers at Harrell & Harrell, P.A., will gladly review your claim, providing a free, no-obligation consultation to discuss your options.
Contact us online to schedule a free consultation or call (904) 251-1111.
Busting Myths on Social Security Disability
Here are commonly held myths about Social Security disability:
- People with a real disability don’t need a disability lawyer: Because of the strictness of eligibility requirements, an obvious disability is step one. After that, the applicant will need to prepare and present a strong case, filing everything properly.
- All disability claims are denied on round one: A good percentage of claims are—but not all. Social Security does not have a policy of denying the first claim of each applicant. An attorney can help an applicant shorten the process, whether on the first claim or in appeal, making sure the filing meets Social Security’s stringent filing requirements.
- You can only get Social Security if you’ve been unable to work for a year or more: This is a misinterpretation of a genuine requirement. It’s true that a physical or mental disability must be expected to last for at least a year for someone to potentially qualify, but we encourage clients to apply as soon as possible. They don’t need to wait a year to apply.
- If I go back to work, I can’t keep receiving disability benefits: Although it’s true that someone receiving benefits must inform the Social Security Administration (SSA) if their condition improves and/or they return to work, there are circumstances when someone can continue to receive disability benefits after returning to the workplace.
- Social Security disability benefits will replace my income: Although benefits vary, most people receive between $700 and $1,700 monthly. This benefit is intended to serve as a safety net to meet basic needs, not to replace an income.
- I have a note from my doctor, so that should be enough for me to receive disability benefits: Your doctor will play a key role in the process, providing detailed information about your medical condition. But the doctor doesn’t make the decision; the SSA does— and it’s a legal decision, not a medical one.
- Once a claim is approved, the SSA provides benefits for life: In reality, benefits last as long as a person is disabled, and periodic reviews will be needed to verify the person’s health status. If improvement was expected, the review may come six to 18 months after approval. If improvement was considered possible, then a review might come after, say, three years. If improvement was not expected, a review might not happen for seven years. Each case is unique.
- Social Security disability benefits are based on a person’s last few earning years: They are actually based on lifetime earnings, with the SSA making some adjustments. SSA’s formula is based on an average indexed monthly earnings over 35 years’ worth of data.
Social Security law is a unique type. To help, we’ll share insights into the application process and more.
Social Security Disability Act
The Social Security Disability Act (SSDA) defines disability as the inability of someone to engage in substantial gainful activity because of impairment: physical and/or mental. The impairment must be expected to last at least 12 contiguous months and be medically determined by a physician.
It’s important to note that what we’re talking about is Social Security Disability Income (SSDI). This program provides benefits to people who meet medical disability criteria and also have worked long enough and paid enough in Social Security taxes to qualify. There is another form of Social Security benefits, known as Supplemental Security Income (SSI). This is not what’s being discussed in this post. These benefits are for people who have little to no income of their own, such as people who are blind or aged.
How the Social Security Disability Process Works
If someone believes they qualify for disability, they can apply for benefits online, at their local Social Security office with an appointment, or over the telephone. At a high level, pieces of information needed will include your Social Security number and proof of age; an overview of your work history; and the most recent W-2 forms or, if self-employed, federal tax returns.
That part is usually fairly straightforward. It’s the medical portion of the claim that can become more involved. You’ll need to supply names and contact information of doctors, hospitals, clinics, caseworkers, and any others who have provided services, along with dates of service; medication names and dosages; medical records; and lab and test results.
Pieces of information about the applicant and their medical conditions are then placed into a grid to determine eligibility. Key factors (although not necessarily the only ones) include the applicant’s age, level of education, work history, skills, and residual functional capacity (RFC). RFC helps SSA to assess the functional capacity of the applicant after taking their disabilities into account. A person’s RFC could designate them as being sedentary, or capable of light, medium, or heavy work.
Through the use of the grid, SSA could determine that two people, each of whom suffered the same type of accident and injury—say, a back injury because of a fall—should receive a different eligibility decision. One could be awarded benefits, while the other one may not.
If someone’s application is denied, they have the right to request an appeal within 60 days. In 2018, just 37.5% of disability claims were approved by Social Security after the initial application. More than half of the people who were denied didn’t appeal, potentially leaving behind benefits that might be approved during appeals.
More than half of the people who ultimately go through the appeals process, though, receive disability benefits. If you’ve been denied, it’s important to have an attorney who understands the appeal process and can expertly guide you through it.
What The SSDI Appeals Process Looks Like
When an applicant appeals a decision, the SSA will look at the entire application again, including sections favorable to the applicant. There are four levels of appeal:
- Administrative Law Judge (ALJ) Hearing
- Appeals Council Review
- Federal Court Review
During the reconsideration, someone who didn’t review the initial application would review the entire application, along with any new information submitted. Typically, the applicant doesn’t need to personally appear for this review.
If an application gets denied during reconsideration, the applicant can request a hearing by an ALJ who hasn’t participated in the initial application or reconsideration. Because the applicant may be asked to appear in person, they are typically scheduled within 75 miles of the person’s home (or, often, a video conference can be arranged). The applicant will receive a notification of time and place, and may be asked to provide more information before the hearing.
The applicant would be questioned at the hearing—and so would any witnesses, who can include medical experts. The applicant or their legal representative can also question the witnesses.
If the applicant doesn’t agree with the ALJ’s ruling, they can request a Social Security Appeals Council review. This council will look at all review requests but may decide to not act further if they agree with previous rulings. If they agree to the review, they may return it to the ALJ for a second look or they may decide the case themselves. If benefits are denied, the applicant can then file a lawsuit in a federal district court.
Recent Changes to the SSDI Application Process
A note about 2020: Because of COVID-19, all judicial and administrative systems have changed, adjusting to these unique times—and the SSA is no different. People can only enter a Social Security office during this time period when the need is considered dire; applications can still be submitted online.
Disability hearings are being held by telephone and, although no one is required to have a telephone hearing, the SSA notes that, because hearing offices will “remain closed for the foreseeable future, we encourage you to consider a telephone hearing if you cannot wait for an answer on your claim.”
A benefit of telephonic hearings is that they’re happening more quickly and often. If you have a claim, continue to seek medical care, as needed, during the pandemic, and our Social Security lawyers can guide you through the telephonic hearings.
How a Disability Attorney Can Help
We encourage anyone that is beginning the Social Security Benefits application process to seek legal counsel first, one does not need to be denied benefits before hiring a disability lawyer. Applicants that have legal representation throughout the entire process are more likely to be approved. Social Security lawyers that assist with the initial application will highlight the client’s disability claim in the best way from the start. The lawyer can advise on how to list the disability, advise on the disability’s onset date, and otherwise present the facts persuasively and well.
However, if someone has already applied for disability benefits and is waiting to hear back, it can make sense for them to get a ruling first and then consult an attorney if denied. Consulting an attorney after applying but before an initial ruling typically doesn’t benefit the applicant.
If an application is denied, then an attorney can be helpful during the reconsideration stage by collecting medical evidence and otherwise improving the chances for approval. If the claim goes to the ALJ hearing, the attorney can help to prepare the applicant for the hearing and craft appropriate documents to present to the judge. At the hearing itself, the attorney can ask questions that will bring out helpful information from the applicant and cross-examine witnesses to demonstrate the need for disability benefits.
If you’re preparing for a Social Security hearing, areas where you an your attorney will likely prepare include the following about your work history:
- Your job background and the work you did
- Whether you worked part-time or full-time
- Dates of your employment
- Why you left your last job
- Whether a medical condition played a role in stopping work
Questions may also be asked about exertion levels that were required at work. These could include:
- The heaviest amount of weight you needed to lift
- How long you needed to lift the heaviest object
- How far you needed to carry it
- How much time was spent sitting, standing, and bending
For disability claims that involve environmental elements, the judge may ask about them. These could include:
Additional work-related questions may focus on:
- Skill levels
- Technical training
- Supervisory experience/capability
- Stress tolerance for speed or complexity
You may also be asked to explain why, specifically, you can no longer perform the work that you previously did.
Another area of questioning may focus on your medical history, including:
- Professionals who are currently treating you and their specialties
- How long you’ve seen each of the medical professionals and why
- Levels and types of pain
- Degrees of fatigue
- Current medical treatments
- Current medications, including dosages and frequency
- How much the treatments and medications help you
- Side effects of medications
- Reasons why a treatment or medication hasn’t been tried or was stopped
If the claim goes further—to the Appeals Council and, next, to the federal district court—the attorney can present legal arguments for the applicant.
In general, the sooner an attorney is involved, the better. With legal representation, the disability claims process can move along more quickly, something that’s especially important when financial constraints exist or health conditions are especially challenging.
What to Look For in a Social Security Disability Lawyer
When considering Social Security lawyers, there are two key considerations:
1. Does this attorney have the skills and knowledge necessary to help you secure your benefits?
2. Do you feel comfortable with the attorney and staff?
It’s crucial to hire an attorney who can navigate the Social Security disability process, including the reconsideration and appeals process. This legal process is like no other, and not all attorneys have the experience to assemble and present evidence, provide the appeals judges and councils with what’s being requested, and otherwise handle this process appropriately and well at each of the stages.
Questions to ask Social Security lawyers you’re considering include:
How many disability cases have you handled for people applying for Social Security benefits?
This will help you to determine how much experience each has, but don’t assume that the one with the largest number is best. Some attorneys specialize in volume, which ups their numbers—but this may not allow them to provide personalized attention to your case. You’ll want to find the sweet spot: an experienced attorney who will also provide time and attention to you.
Have you handled cases where my kind of disability was involved?
Although disability cases, in general, share many similarities, the SSA has also developed disability-specific criteria. For example, the information needed for a chronic condition is not necessarily the same as a disease that’s potentially terminal. So, you’ll want an attorney who knows how to present your medical evidence in the most effective way possible. Sometimes, the disability involves multiple medical conditions. If this applies to you, does the attorney you’re consulting with have experience in presenting this type of case?
How should I expect the case to proceed?
In general, the answer should give you a sense of how the process works; what might be expected from you; and an anticipated timeline. This also gives you an opportunity to see how confident the attorney seems in their answers.
What reviews and testimonials can you share with me?
Take a good look at what clients have to say. Do they focus on the attorney’s skill and knowledge? Willingness to take time to answer questions? Outcomes? Patience throughout the process?
More importantly, do the comments being made dovetail with what you’re looking for in an attorney?
Additional questions can include:
- Who will take the lead in handling my case?
- What staff member will be my main point of contact?
As you’re asking questions, pay attention to how attorneys and their staff answer your questions and how comfortable you feel discussing your disability and sensitive medical information with them. Do you feel listened to? Do you believe that the attorney and staff care about you and your case? Do you have a good opportunity to ask follow up questions if there is something you don’t understand?
When you leave a consultation with a Social Security disability lawyer, you should be confident with their skills and knowledge, and also feel comfortable communicating with them.
Dedicated, Experienced Social Security Lawyers at Harrell & Harrell, P.A.
Our Social Security lawyers will guide you through every step of the process, listening to you and answering your questions in clear and understandable ways. We are dedicated to helping our clients receive the benefits they’re entitled to, so they can provide for themselves and receive medical care.
From the initial consultation through the collection of evidence, and throughout the appeals process, we’ll be with you all the way. We’ll even have two attorneys analyze your case. That way, we can proceed with confidence, knowing that every angle has been thoughtfully considered to create the best approach possible.
To schedule your free consultation, contact us online or call (904) 251-1111.