More Social Security Disability applicants seek representation

The Social Security application process is complicated and difficult to go through. Social Security disability applicants can see benefits when […]

The Social Security application process is complicated and difficult to go through. Social Security disability applicants can see benefits when they hire a representative to help them apply, according to the company Allsup, which represents tens of thousands of people in the Social Security Disability Insurance (SSDI) process each year. Allsup is a leading nationwide provider of financial and healthcare related services to people with disabilities. In fact, more people are getting representation, especially at the hearing level (level 3) of the SSDI application process. About 90 percent of all hearings involved representatives in fiscal year 2007, compared with about 84 percent in fiscal year 2004, according to the Social Security Administration. More than 765,000 people are waiting at the hearing level to see if they will be awarded benefits.

“Once people quit working because of a disability, it’s important to realize that their situations are not likely to get easier—but rather more complex,” said Ed Swierczek, senior claimant representative.

SSDI is a federally mandated insurance program overseen by the Social Security Administration (SSA). SSDI provides monthly benefits to individuals who are under full retirement age (age 65 or older) and who can no longer work because of a disability (injury, illness or condition) that is expected to last for at least 12 months or is terminal. Individuals must have paid FICA taxes to be eligible. The wait for benefits can last from two to four years.

The following questions are among the most commonly asked about SSDI representation.

What are your options if you want to hire representation?

Typically, there are two major types of paid SSDI representatives: specialized organizations with multiple representatives and specialists experienced in handling SSDI claims in local communities across the country; and law firms that may or may not have attorneys solely dedicated to SSDI claims.

How knowledgeable and experienced is the organization in representing individuals applying for SSDI?

Look for a representative who specializes in SSDI and understands the complexities and nuances of the process. Don’t be fooled if a representative tries to impress you with claims of local influence.

Will the organization help you file the initial application for SSDI? 

The myth that you cannot have a representative help you file your initial application for SSDI may stem from the fact that many attorneys only accept SSDI clients after their applications are denied. “Finding help from the beginning can improve your chances of getting approved earlier and cost you less in representative fees as a result,” said Swierczek.

What specific activities will the representative undertake on your behalf?

It’s important to choose a representative who consistently works the claim on your behalf throughout the process and removes the burden from you. For example, you should ask:

• Will you contact my doctors and collect or update medical records for my file independently of the SSA?

• Will you regularly query the SSA for status of my claim or confirm my claim file is up-to-date? 

The SSA’s Disability Determination Service may arrange for you to visit a doctor or compile your medical records, but a representative can ensure the medical evidence is supplied by your treating physician.

Does the organization have experience representing someone with your disability?

Not all disabilities are alike—the SSA has specific Disability Impairment Criteria for hundreds of specific conditions, from back injuries and arthritis to fibromyalgia and strokes. It’s essential to prepare each case with details and in the language required by the SSA to avoid unnecessary delays, a reduced award or denial of benefits.

How does the organization – and who within the organization – will keep you informed on the progress of your claim?

Disability applicants should make sure that the representation organization they choose will keep them regularly updated on the progress of their application, including timely notices of deadlines, documents required or scheduled hearings. Sometimes people assume they’ll have regular in-person meetings throughout the duration of their case, Swierczek said.

Will you have to attend any hearings?

Approximately one-quarter of SSDI cases proceed to the hearing level where there are hearings before judges. However, this might not be necessary if the representative asks for and receives an “on-the-record” decision, where the judge makes a decision based on a review of information in the file. It does require that your representative create a well-written brief that provides a thorough, factual record of your claim.

What is the organization’s success rate?

No organization has a 100 percent track record, but consumers should look for a representative with a high success rate in gaining SSDI benefits for its clients. This indicates the representative not only can deliver the desired result, but also likely has strong credibility in the industry.

How much faster can the organization help you win your award?

There is no guaranteed timeline. External factors, including the growing backlog at the SSA in processing claims, can affect the timing. But a representative should know on average how long it takes their clients to get through the various stages of the SSDI process.

What does it cost?

The SSA determines the maximum fee that any organization can charge for SSDI representation. Currently, it is 25 percent of the retroactive dollar amount awarded, not to exceed $5,300.

(Note: The SSA has approved a fee-cap increase to $6,000 for SSDI awards effective June 22, 2009.) Those who are approved quickly at the application level and receive no retroactive award typically pay much less. You should not pay a fee if you don’t receive your SSDI award. However, ask a representative if they charge for costs in addition to the representation fee, such as travel or medical records.

The preceding information was submitted by Allsup