Disability applicants who hire an attorney or advocate to handle their Social Security disability (SSDI) or Supplemental Security Income (SSI) disability claim are more likely to be approved than those who don't. The reasons for this are many, and knowing them may help you decide if hiring a legal representative is the right choice for you.
The single most important factor to winning a claim is having the right medical evidence. Applicants frequently don't know exactly what to give the Social Security Administration (SSA) and may end up submitting too much irrelevant information and too little of what matters.
Represented applicants are more likely to win because, in part, disability attorneys and advocates know how to develop the evidence needed for an approval for that client's particular medical conditions. When a good disability attorney or advocate gets a case, he or she reviews the applicant's file carefully to determine whether any additional tests or medical records are necessary. The representative will then work with the applicant to get the necessary records and submit them on time to the SSA. The representative will also make sure that irrelevant information is not submitted, which is important if the claim goes to the hearing level, because administrative law judges (ALJs) often become aggravated if they have to sift through pages of irrelevant records.
A supportive opinion from your doctor(s) is vital to winning a disability claim. However, doctors are sometimes unwilling to help disability applicants. There are many different reasons why doctors may not want to help; for example, a doctor may be unsure about how the disability process works or may be too busy to fill out forms. Some doctors may have personal opinions about Social Security benefits that make them unwilling to help. Also, a doctor simply may not believe the applicant is disabled.
Doctors are sometimes more likely to respond to another "professional," like a disability attorney or advocate, rather than to their own patients. Disability attorneys and advocates have experience dealing with medical professionals and are often better able to address their questions or concerns than the applicant. This ability often makes doctors more willing to help.
Applicants with lawyers are more likely to win on appeal is because most disability attorneys have extensive experience with the appeal hearing process. This experience gives attorneys the specialized skills needed to win your appeal. Experienced disability attorneys have also learned to work through the process correctly so there are as few additional difficulties as possible.
Disability attorneys are familiar with the administrative law judges (ALJs) in their district. This is important because the attorney understands, for example, how each ALJ likes a hearing to be conducted and whether the ALJ has any biases towards certain medical conditions. This foreknowledge allows the attorney to prepare for the hearing in the way best suited for the particular ALJ assigned to hear the case.
It is not uncommon for an applicant's medical records to contain information that can be harmful to the case (attorneys often call these "bad facts"). Sometimes "bad facts" come in the form of a doctor's opinion that states that the applicant is not disabled or that the applicant is exaggerating symptoms. Other times, an applicant has not seen a doctor for many years or has been inconsistent with following a treatment plan, either of which can hurt the applicant's chances. Regardless of the specifics of the "bad facts," disability attorneys are often able to confront and explain the issues to the ALJ in ways that minimize damage to the applicant's case.
Vocational experts (VEs) are experts hired by the SSA to testify at hearings about what work they think applicants can do in light their medical conditions. At the hearing, the ALJ will pose a series of questions to the VE called "hypotheticals." These questions use the applicant's documented symptoms to see what kinds of jobs an applicant can do. If the VE testifies that a claimant can still work, the ALJ will almost always deny the claim.
Disability lawyers are trained to counter negative testimony presented by the vocational expert and to elicit supportive opinions. This skill requires an understanding of the complex way in which different jobs, and the skills needed to do them, are categorized.
During the hearing process, the ALJ will ask the applicant numerous questions to find out information such as:
An attorney is also given the chance to ask the applicant questions. This is important because if there are any areas in the applicant's testimony that weaken the case, the attorney is trained to spot the problem and to use further questioning to correct or clarify the applicant's testimony. An attorney can also ask questions in a way that helps the applicant better explain, and the ALJ better understand, how the applicant is affected by the medical condition.
There are numerous "arguments" that can be used to win a disability claim. An attorney can identify the argument that will work best because he or she knows and understands Social Security's rules and regulations on which they are based.
Once the attorney has decided on the best argument, he or she can determine how to meet the requirements of the rules and regulations using the facts of the case. This also means that an attorney can anticipate weaknesses in a case and decide how best to manage them. These arguments can be difficult to understand without being specifically trained in disability law.
Here are a few examples of arguments, or theories, for why an applicant is disabled:
For more on what to expect of your lawyer, see our section on Disability Lawyers & Advocates.