Representation by an attorney leads to quicker and more successful outcomes in Social Security Disability cases. Here are some things to consider when deciding to hire a lawyer.
Social Security Disability Programs
There are two Social Security Disability programs. Social Security Disability Insurance (SSDI) is available to disabled individuals with a sufficient work history. Most people who complete ten years of work before they become disabled will be “insured” under the Social Security system. However, insured status also depends upon the recency of employment. Younger workers may be insured with a shorter work history. Disabled children of insured workers might also qualify.
Supplemental Security Income (SSI) is available to disabled individuals regardless of their work history. As a means-tested program, SSI is available only to disabled individuals who have few assets of value. Some assets, including a home, are not counted. To qualify for SSI, disabled individuals must often “spend down” their assets. They may want to obtain legal advice before doing so, because giving away assets or spending them improperly could disqualify the individual from SSI eligibility.
Both SSDI and SSI use the same definition of “disability.” A failure to persuade the Social Security Administration (SSA) that an applicant meets that definition is the usual reason why applications for SSDI or SSI are denied.
The SSA regards an individual as having a disability when the individual:
1. is unable to engage in any substantial gainful activity
2. because of a physical or mental impairment that doctors can document
3. which has lasted or will probably last for a continuous period of at least 12 months or will probably cause death within 12 months.
“Substantial gainful activity” generally means work that pays a threshold wage. In 2022, that wage is $1,350 a month. Individuals who earn, or are capable of earning, more than the threshold wage do not qualify for SSDI or SSI benefits.
Deciding Whether to Retain an Attorney
Most initial applications for SSDI or SSI are denied. Some are denied for technical reasons. For example, eligibility for SSDI benefits depends in part on work history, as measured by work credits. An applicant for SSDI who has insufficient work credits will be denied. Applicants for SSI are often denied because they own assets with a total value that exceeds the SSA’s eligibility limit.
Consulting an attorney at an early stage of the process can help applicants avoid a technical denial. An attorney can quickly determine whether a disabled individual has sufficient work credits to be eligible for SSDI. The attorney may advise a client to apply for SSI rather than SSDI if the client has a limited work history.
When clients are not eligible for either SSDI or SSI, an attorney can help a client understand how to lawfully “spend down” assets to qualify for SSI. When a client may be eligible for either SSDI or SSI, an attorney can evaluate the benefit that each program would pay and help the client make the right choice. Under unusual circumstances, a client might be eligible to apply for both SSDI and SSI. An attorney can help clients understand all their options.
Asking for legal advice at an early stage can also help clients avoid wasting their time. An individual who earns more than the threshold income probably won’t qualify for either SSI or SSDI. The attorney might be able to suggest other sources of disability income while saving clients the stress of applying for benefits they clearly cannot receive.
While many claims are denied for technical reasons, others are based on the failure to establish that the applicant’s impairment meets the definition of a disability. In many cases, inadequate medical documentation is the barrier to approval. An experienced lawyer will review medical records and can assure that the medical record supports the claim before the application is filed.
Choosing the Right Disability Lawyer
Experience is a key factor in choosing a lawyer who gives clients the best opportunity to obtain disability benefits. Lawyers who dabble in disability cases might not stay up to date on changes in regulations and new court decisions that affect awards of disability benefits.
Lawyers who regularly handle cases that involve disability — including Social Security Disability claims, workers’ compensation claims, and disputes involving disability insurance —develop the knowledge and experience that builds a track record of success. Experienced lawyers handle cases efficiently. They can quickly tell a client whether they have a reasonable chance of success. They may also be able to give hope to a client who has been advised by other lawyers that their condition is not disabling.
A law firm’s reputation for excellence is another key factor. A bit of research will help clients learn whether a firm’s lawyers are respected by other lawyers and recommended by former clients. Satisfied clients are usually the best measure of a law firm’s reputation.
After narrowing a list of lawyers to those who have the right experience and solid reputations, clients should meet with the lawyers who seem the most promising. Not every client will be a good fit with every lawyer. An attorney-client relationship should be based on trust and mutual respect. Clients should find a lawyer with whom they can work comfortably.
When interviewing a lawyer, answer questions fully and honestly so that the lawyer can give you a preliminary appraisal of the merits of your disability claim. You should expect your lawyer to be courteous and professional at all times. You may be working with paralegals and other staff members at times, so get a sense of whether support staff are helpful and responsive.
Don’t be afraid to ask whether the lawyer has handled cases with facts that are similar to your own. Ask the lawyer to share his or her success rate in similar cases. Ask the lawyer about the strengths and weaknesses of the facts in your case. A good lawyer will not sugarcoat bad news but will point out reasons why your claim might or might not be approved.
Don’t trust a lawyer who promises a particular outcome. Lawyers can use their experience to predict outcomes, but how a case will be decided — and how long it will take SSA to decide any particular case — is beyond a lawyer’s control. Ethical lawyers make clear that they are providing opinions about the strength of your case and expected outcomes but are not promising a result with certainty.