Questions answers and information for Social Security Disability Applicants Seeking Representation.
Social Security disability applicants can see benefits when they hire a representative to help them apply, according to Allsup, which represents tens of thousands of people in the Social Security Disability Insurance (SSDI) process each year.
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 Administration1. More than 765,000 people are waiting just 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. "This is another reason to get representation earlier in the SSDI process, for example, at the initial application or after you've had your first denial of benefits."
SSDI is a federally mandated insurance program overseen by the Social Security Administration (SSA) that operates separately from the retirement and SSI programs. 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. More details are provided in the SSDI Overview on Allsup.com.
Each month, thousands of people contact Allsup for information about the SSDI process. The wait for benefits can last from two to four years. Customers who have chosen Allsup for representation often cite the convenience and time savings as well as the expertise. Read more by visiting the Personal Stories section on Allsup.com. One story features a former math teacher who experiences chronic pain and other symptoms.
Top 10 Questions When Choosing A Representative? 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 like Allsup, which has 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
You should 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 their local influence. It's highly unlikely that they have special power over local SSA staff or can ensure your hearing will take place in front of a specific judge.
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. "Your representative should regularly follow up with the SSA to ensure your claim is in order," he said. "You don't want to show up at a hearing only to learn critical information, such as your most recent medical tests showing your illness has worsened, did not make it into your file in time."
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. "Knowing the communication approach of the representative you choose is essential in making sure you're not disappointed."
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. For example, about 70 percent of Allsup customers at the hearing level never have to attend a hearing because many judges will make a decision without the need for an oral hearing based on the information Allsup presents.
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.
For example, individuals Allsup represents at the hearing level generally receive an award four months faster than the national average. "The faster you receive your benefits, the sooner you'll have that monthly financial support and eventually become eligible for Medicare," said Swierczek. "It also lowers your representation fee."
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, you should ask a representative if they charge for costs in addition to the representation fee, such as travel or medical records.
1 - SSA Strategic Plan Fiscal Years 2008-2013. www.ssa.gov/asp/index.htm.
Reference: Allsup, Belleville, Ill., is a leading nationwide provider of financial and healthcare related services to people with disabilities. Celebrating its 25th anniversary in 2009, Allsup has helped more than 110,000 people receive their entitled Social Security Disability Insurance and Medicare benefits. Allsup employs more than 550 professionals who deliver services directly to consumers and their families, or through their employers and long-term disability insurance carriers. For more information, visit www.Allsup.com