Statistically, the majority (over 70%) of all Social Security Disability and SSI claims are denied at the initial application level. Approximately 88% continue to be denied at the Reconsideration level, which is the first level of appeal. Click here for a visual chart of Social Security’s allowance and denial rates for 2012 at each stage of the application process.
An attorney can help prepare you case at each of these levels to help improve your chance of winning at each of these levels. An attorney can help you gather the medical record evidence that will be critical in establishing the severity of your condition. An attorney can also help you obtain opinions from your treating medical providers that will be important in establishing your resulting impairments.
However, even with an attorney, most Social Security Disability Insurance (SSDI/SSD) and Supplemental Security Income (SSI) claims must continue on to a hearing before an Administrative Law Judge (ALJ) in order to be approved for disability benefits. It is at ALJ hearing level that having an experienced disability attorney can really help win a claim. While no disability attorney can guarantee that a claimant will be awarded Social Security Disability or SSI benefits, an experienced Social Security lawyer can guarantee that a case will be properly “developed” prior to your hearing date.
Developing a Disability Case
The simple fact of the matter is this: even after scouring the internet and reading up on disability claims, the vast majority of SSDI and SSI claimants will have no idea how to thoroughly and properly prepare a disability claim for a hearing. By comparison, an experienced attorney should have a high level of familiarity with Social Security’s policies, procedures, rules and regulations. Here at the Ortiz Law Firm, Mr. Ortiz has several years of invaluable SSDI and SSI claims experience to lend to his clients’ disability cases. He knows what a judge will be looking for with respect to a particular medical condition, and will know what questions to ask your doctor(s).
Because disability attorneys are paid on contingency (only if you win), they work hard to ensure that an SSDI or SSI claim will have the best chance of winning. These responsibilities include tracking down important medical records and test results, obtaining detailed opinion statements from a claimant’s treating physicians and other medical providers, and applying a thorough understanding of SSA regulations and prior rulings to the entire disability adjudication process.
The Odds of Winning Without Legal Help
Can a claimant who is not represented by an attorney still win an SSD or SSI disability claim on their own at an ALJ hearing? Yes. However, the odds of winning a disability claim before an ALJ are markedly decreased when a claimant does not hire an attorney. (Here’s a breakdown of statistics on win rates of those who hired an attorney versus those claimants who went at it alone.)
You must weigh the risk of going unrepresented to a hearing when your future income and health insurance (Medicare or Medicaid) is literally at stake against the percentage of your backpay that you’ll have to pay an attorney if you win (25%, limited to $6,000 for Social Security cases). Click here to learn more about how disability lawyers are paid.
Although an attorney is never required in an administrative disability claim (an appeal to federal court is the exception), going to a hearing before a judge without the assistance of an experienced disability attorney can result in a lost opportunity to win disability benefits.
Lawyers Can Also Help You Win More Backpay
Even where unrepresented claimants are successful and win their claims on their own, they may not obtain the most favorable “onset date” of disability. This affects how much backpay they will receive from Social Security. The established date of onset of the disability, as decided by the claims representative handling the claim, determines how much a claimant will receive in backpay. Therefore, proving the earliest possible onset is of extreme importance in an SSDI or SSI claim. (Learn more about onset date and backpay.)