Six Questions to Ask Your Social Security Disability
Advocate, Consultant or Attorney Representative …
Before You Sign On the Dotted Line
A Sequential Evaluation to Use When
Hiring Help to Win Your Adult Social Security Disability or SSI Claim
Now that you have received the “Notice of Denied Claim” from the Social
Security Administration in reference to your Social Security Disability or SSI (Supplemental
Security Income) application, you realize that you must do something to get that Agency to
really see how much your medical condition (physical and/or psychological) really limits your
ability to work.
"Oh, no! There’s been a mistake…"
Your claim will need to be
reconsidered because undoubtedly there has been some mistake. Maybe the disability examiner /
adjudicator did not receive that last batch of records from your treating doctor. You know, the
one that clearly stated that you were disabled and could not walk to your mailbox, let alone
spend eight hours everyday doing a full time job.
Or, perhaps this was just a
case of human error on the part of the disability examiner at the Disability Determination
Services office who was in charge of making the decision on your claim. Perhaps s/he had to
check a "yes” or “no” box when imputing the final decision into the computer, and instead of
registering the “yes—this person is disabled”, that examiner’s hands were shaking from too much
caffeine that morning, and the “no, this person is not disabled” box was checked in
Then too, it could have been
that with 6 out of every 10 initial applications being denied by Social Security workers, you
are just one of those six that will need to challenge the system to ensure that they do the
But no matter what the
reason is, all you know is that the decision will have to be changed.
While waiting on that
initial decision to reach you, you had accidentally stumbled across a disability article that
indicated that your chances of getting disability benefits approved increases dramatically if
you have a representative on your side. So you’ve decided to hire someone to help you win the
benefits you know you deserve.
So where do you start? Where
do you go to find the right person with the right credentials to handle your reconsideration and
any subsequent appeals?
You sit down. Just thinking
about it tires you out. You need to rest, tackle it in the morning fresh, after you’ve had your
herbal tea. The denial letter is enough for one day.
Who do you choose to help you …?
Whether you have decided to
employ the services of a Social Security Disability Attorney, a Claims Representative, a
Disability Advocate / Consultant or a Certified Paralegal to handle your claim for benefits, you
might want to consider just a few things before you commit to a contract, which will generally
have you sharing 25% of any back benefits that he or she may be successful in helping you win
from the Social Security Administration.
By asking these six
simple questions of your disability representative—either directly or subtlely--and
choosing the one who passes most, if not all, of the evaluation you put them
through, you can significantly increase your possibility
Receiving a favorable
decision on your claim, i.e. Social Security will issue an “Allowance” of Your
- Decreasing the
amount of time it takes to win your claim
- Decreasing the
level of frustration you will feel as you go through the process.
After all, if your claim has
been denied, chances are you failed to get pass at least one of the SSA’s sequential evaluation process, and that has left
you where you are now, so why not give your prospective representative just a taste of what
you’ve been through to see if they can make the grade.
As a former paralegal
handling Social Security disability claims in a Legal Services office, and as a former Social
Security Disability Examiner charged with allowing and denying claims, below are the six
questions I would seek to get adequate answers to if I ever needed to hire someone to represent
- What Social Security
translation school has the disability rep attended? Ok…maybe that is not the exact phasing
you would use. Let me explain, you see, in my mind Social Security Disability Attorneys and
Advocates and Representatives all provide the exact same service, and that is: they attempt
to translate your medical and vocational information into language that the SSA/DDS
understands and can use in making the best decision on your claim. So, to translate, the
first question you ask will be one to gain some understanding of the representative’s
knowledge of Social Security Disability Law. Where did they learn Social Security
disability policy and regulations? A class? A seminar? Perhaps they are a paralegal working
in a disability law firm whose job it is to receive and summarize medical and vocational
information from your files. And if this is the case, have they been exposed to the federal
policies and regulation s governing the SSA program, and can they analyze the data they are
As a disability examiner, I
have written many summaries of claimant conditions to be reviewed by DDSs medical consultants.
But what I know is that if you don’t know what you are looking for in the review of someone’s
medical file, it makes it harder to include information that may be critical to a claim. For
instance, if you don’t know that having an EF (ejection fraction) of 25% or under severely
limits the amount of exertional activity that can safely be done by a person with a heart
problem, you might see the term in the claimant’s medical history, but that fact may never make
it into the summary you write as a paralegal for the attorney you work for. So, in this
situation, where you are considering hiring an attorney who has several paralegals in his office
who process disability claims, you may want delve a little deeper into the background of those
paralegals. Do they have a medical background? Do they have experience or skills in interpreting
federal policy and regulations? Or are they fresh out of paralegal school and operating rotely?
- What is your
prospective representative’s approach to SSA? What is their presentation method? Do they
believe you can catch more flies with honey than with dung? Do they have a pleasing
personality or do you get the impression that they are impatient and prong to fits of anger
when they do not get their way? Such characteristics can end up hurting your chances of
getting a quick decision because such attitudes are—believe it or not--transferred over the
telephone when these reps communicate with your disability examiner. How a disability
examiner handles such perceptions is anyone’s guest, but could you imagine that it may
result in your case being put on the back burner because of something your representative
said or did not say to your disability examiner?
- What is your
representative’s average caseload size? 25, 50, 100, 200, 250? The lower this number, the
better for you. Just as students assigned to classes of 50 get less attention than those
assigned to classes of 20, you can guess that if a disability caseload is over 100-150
cases, that there will be some juggling that is going on. Managing a big caseload in a
program as complex as SSA means your representative will not have the time to do all the
extra work that may be required in preparing your claim to be presented to an
Administrative Law Judge.
- Find out from your
prospect how often you will be updated on the status of your disability claim? This
question is designed to get at your representative’s a) customer relations skills, and b)
their knowledge of the disability process and what things happen within the DDS offices.
Customer service skills are critical in any profession that works with the general public,
and particularly in any profession which serves people who are under stress as a result of
their impairments and/or dwindling financial resources. If, for example, your
representative is juggling 200 cases, you might actually get very few phone calls regarding
the status of your claim. How will they be able to update you if they have not had the time
to call your examiner to find out the status? Good customer service means the
representative will have a management system in place that provides that you will be
updated on the status of your claim at least every six weeks or less depending on what
stage of the process you are in. Getting updates on the status of your claim will also help
you emotionally as you wait to receive the results of your reconsideration or appeal. By
eliminating the prospective representatives that you speak to that are managing high
caseloads as a matter of course, you will be doing yourself a big favor and avoiding the
“neither my disability examiner nor my representative returns my phone calls!”
The second part of this is
that if your rep is too busy to return your phone calls, you can pretty much surmise that all
they are doing is waiting out your claim until the DE issues a decision. This means they are not
taking any steps to proactively get you a faster decision by calling to the attention of your DE
critical information your doctor may have provided. And if all they are doing is waiting out
your decision, isn’t that something you can do on your own without paying someone 25% of your
back benefits or up to $5,300 if they should accidentally win your claim by
- What is your
prospective representative’s success rate when it comes to winning claims before the SSA?
Is it more than the overall average? You can take a look here to see what is happening on
average nationally? This factor, I will admit, is not as critical as the other four items
above if you claim is one that has gone beyond the reconsideration level. For example, when
your initial application is denied, you then file for reconsideration and are denied again.
Both the initial application and the reconsideration application are handled by the DE in
the DDS office who will generally never get to see you. Once your claim goes to an ALJ—a
person who currently has more latitude and flexibility in terms of applying SSA rules and
regulations, then your chance of convincing the ALJ of the severity of your impairments may
- Finally, item number 6
in your sequential evaluation of your prospective disability rep is the amount of fees that
will be charged to you if they are successful in winning benefits for you. Fees are
generally pretty standard and not a thing to be concerned with because SSA determines the
fee amounts. These fees are generally 25% of the back benefits SSA owes you, or $5,300,
whichever is less. Read your contract to be sure there is no small print stating extra
charges for copying your disability record or mileage to the SSAs office for picking up
your file, etc. This type of language should not be present in the contract, especially if
the rep or attorney has advertised that you will not have to pay any out of pocket expenses
in the development of your claim.
So, aren’t you glad that you
didn’t tackle this article on the same day you got your denial notice? Aren’t you glad you
decided to sleep on it first?
Choosing a representative to
handle your claim can be a daunting task, but keep in mind that anyone you choose will have the
same goal in mind. They will want to assist you in winning your claim because when you win, they
win. However, if there are inherent challenges that they have, such as having to handle too many
cases, or not having the people skills necessary to deal effectively with DDS or just not having
the knowledge of federal programs and the interpretation of policy and regulations, then you may
want to move on to the next one.
“Nothing personal”, you can
tell them, “I’m just trying to get a favorable decision in the least amount of
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Copyright © 2006 Loretta Crosby. Pupil of the Eye Publications