SSDI and Legal Representation: When to Seek Assistance

The application process for the Social Security Disability Insurance (SSDI) program can be challenging and difficult to navigate, especially for individuals who are already struggling with a disability. Fortunately, a Social Security Disability lawyer can help them go through the entire process. 

It’s possible to consult a Social Security lawyer at any time during the application process, and it is highly recommended to do so when your disability application has been denied and you want to file an appeal. Legal representation may increase your chances of approval during an ALJ hearing and Federal Court Review. 

This article provides in-depth information about legal representation during the SSDI process and when applicants should start seeking it. 

SSDI Application Process 

Applying for Social Security Disability benefits from Social Security is a multi-stage process. This process is essential for preventing exploitation of the system, but it needlessly burdens individuals who genuinely require these life-saving benefits. 

The SSDI application process essentially consists of the following steps: 

Initial Application 

The initial claim is submitted by the applicants and includes relevant information regarding their medical condition, job history, and other necessary details. This stage can be difficult because the SSA thoroughly reviews each claim. 

Potential Denial  

Unfortunately, almost 70% of initial claims end up being denied for Social Security Disability. This is the stage of the SSDI process that many people find most intimidating. Denials are commonly related to inadequate or insufficient medical information; therefore, it’s important to support your case by accurately and timely providing all necessary paperwork. 

Reconsideration 

If your initial application is denied, the SSA will allow you to request reconsideration. The reconsideration stage provides applicants with the opportunity to present further evidence in support of their claim.  

Administrative Law Judge (ALJ) Hearing 

If your request for reconsideration is also denied, you have the option of requesting a hearing in front of an ALJ. This provides claimants with the opportunity to present the case in person, which could prove to be beneficial. 

Appeals Council and Federal Court  

If the Administrative Law Judge rejects your claim, you can appeal the decision to the Social Security Administration’s Appeals Council and, if required, the federal court system. 

It can be extremely difficult to navigate this procedure on your own, particularly when you have to deal with the possibility of appeals and denials. In cases like this, having legal representation from a Social Security disability attorney is crucial. 

Is Legal Representation Necessary for SSDI? 

No, it is not required for applicants to have legal representation when applying for SSDI benefits, but for many people, depending on their case, it makes a difference.  

Many applicants can complete and submit their applications all by themselves. Whether or not to hire legal representation is a decision that is entirely up to the individual and is contingent upon the specifics of their case.  

However, having a lawyer work with you may significantly improve your chances of success. 

A lawyer can assist you in submitting your SSDI application and in obtaining the necessary medical records and other supporting documentation. They can accompany you to meetings or discussions with Social Security authorities and check your application for any errors or missing information that could affect your chances of success. 

When to Seek Legal Representation 

You are free to consult with a Social Security disability attorney at any point during the SSDI application process. Many individuals seek the advice of a Social Security disability attorney before submitting their initial claim.  

They may be unsure about what to include on the disability application or have concerns about filing the first claim without the guidance of a lawyer who specializes in Social Security disability cases. 

In some cases, individuals can complete and submit their claim for disability benefits without the assistance of a Social Security disability attorney. They seek the assistance of a disability attorney in case their application for SSDI benefits is rejected. 

In general, it is recommended to consult a lawyer in the event of the following: 

• Your initial application was rejected 
• Your application involves an impairment related to a mental health disorder 
• You applied in the past and were denied benefits 
• You require a Residual Functional Capacity exam to substantiate your claim 
• You have been requested to undergo an independent medical exam 
• Your impairment does not match any of those listed on the SSA’s Listing of Impairments 
• You are planning to appeal the SSA’s decision 

What Can a Disability Attorney Do for Your Claim? 

An SSDI attorney undertakes a lot of work on behalf of clients who are requesting benefits from the Social Security system. Here are just a few examples of what your attorney could do: 

Preliminary Review of Disability Claim 

An SSDI attorney will conduct a preliminary evaluation of your SSDI application during your first appointment with the attorney. Your lawyer may look over your job history, an overview of your medical evidence, and any previous disability claims you may have submitted.  

The lawyer may also ask you many questions regarding your impairment, your prior work, and the activities that you carry out regularly. 

The lawyer must gather additional information about you and your case during the initial session for them to be able to identify the most effective strategy to move your claim forward. A competent lawyer understands that to give good legal counsel in a disability case, they need to know just as much as the client. 

The Social Security Disability Claim Process 

After gaining an understanding of you and your Social Security disability case, a Social Security attorney will provide explanations about important topics such as the following: 

• Claiming Social Security disability benefits 
• Social Security disability law 
• Legal services for Social Security disability cases 
• Qualifying disability 
• Medical evidence 
• Substantial Gainful Activity 
• Benefit amount 
• Back pay 

An experienced lawyer can break down the complex process of claiming disability payments into language that the average person can understand. A Social Security disability lawyer can also help you determine if you require their services by answering your questions and addressing your concerns. 

Gather and Arrange Medical Documents 

Evidence from medical professionals is one of the most important components of a disability claim. Your qualifying disability needs to be supported by medical documentation. A disability lawyer can help you collect and organize medical records to submit to the Social Security Administration.  

If your initial claim is denied, the SSA may request further documentation from your medical providers, but if you have the medical proof available, you will be able to request reconsideration right away. 

Gather and Arrange Supplementary Evidence 

Your application for SSDI benefits can be supported by further evidence that you can provide to the Social Security Administration. This may include statements from past employers, acquaintances, family members, and social workers.  

An experienced attorney who is familiar with the SSDI process is aware of the significance of this kind of evidence and knows how to organize it in a manner that makes a compelling case for disability payments. SSDI lawyers and advocates are well versed on the requirements and on how to navigate the SSA’s system, and their expertise can save you time and money in the long run by increasing your chances of approval.  

Coordinate With the SSA 

When applying for SSDI benefits, there are several stages that you may experience where you may feel concerned that the Social Security office is not moving your claim forward. 

Your Social Security Disability Insurance attorney will coordinate with the SSA office to make sure that the SSA agent has all of the necessary information to process your claim. If there is a problem, your Social Security attorney will resolve it immediately to prevent your case from being delayed. 

As your Social Security disability case progresses, your attorney will diligently keep track of all due dates. Ignoring deadlines could be detrimental to your claim. Disability lawyers ensure that the necessary documents are submitted well in advance of the deadlines set by the SSA. 

Filing an Appeal for Your SSDI Claim 

Unfortunately, many disability claims are rejected at the initial application stage. In the event that the initial application gets denied, applicants have a very limited amount of time to submit a request for reconsideration to appeal the original determination.  

The process to appeal an SSDI denial consists of four stages, as mentioned above. If you did not consult a lawyer for your initial application, it is highly recommended that you do so while you go through the appeals process. The appeals process can be difficult to navigate without the help of a competent Social Security disability attorney.  

Help Prepare for an ALJ Hearing 

You might have to show up to a hearing at some point while you’re appealing a disability case. The administrative law judge will likely preside over the hearing. To ensure that you are fully prepared for your hearing, your Social Security disability attorney will go over the following: 

• What to expect at the hearing 
• Potential questions the ALJ may ask  
• How to conduct yourself in court 
• Where the hearing will take place 
• Which documentation should you take with you to the hearing 
• Any queries or concerns you may have about the hearing 

Represent You at Disability Hearings 

The ALJ hearing is an important point in the SSDI application process. You get the opportunity to provide supplementary medical evidence and witness testimony at the hearing.  

As the hearing is a formal legal action, having an attorney who specializes in Social Security disability appeals represent you at the hearing is highly recommended. An experienced lawyer who is well-versed in Social Security law can help you present your case in the most favorable light to maximize your chances of receiving SSDI benefits. 

Where to Find an SSDI Lawyer 

The United States is home to thousands of attorneys and professional advocates who are experts in the field of Social Security disability. Some advocates have even previously worked for the Social Security Administration, either as disability examiners or claims representatives. 

The Social Security Administration office in your area can provide you with a directory of nonprofit groups—including bar associations and legal support organizations—that can give you legal assistance or point you in the right direction.  

The National Organization of Social Security Claimants’ Representatives also offers a recommendation service or you can explore online legal directories to seek out attorneys who are experts in disability claims and located in your region. 

You can also get a free consultation with some SSDI lawyers who are willing to hear about your situation and provide helpful information regarding your case. 

Once you have selected a lawyer to represent your case, you need to provide Social Security with written notification of the change.  

You can do this by obtaining an SSA-1696 form from the Social Security website and then sending the filled-out version to the Social Security office in your area. 

You also have the option to have your representative electronically file it on your behalf. However, the SSA will require an electronic signature from both you and your representative to verify your identity. 

Costs Involved in Legal Representation 

The majority of disability attorneys practice on a contingency basis, which means that they only receive payment if your claim is accepted. The Social Security Administration must give its approval for any fee agreement that you and your representative enter into. 

If the application is approved, Social Security will pay your lawyer out of the proceeds of your “back pay.” Back pay refers to benefits that have been overdue while you were waiting for a decision and can be awarded if the SSA determines you were medically eligible for benefits. 

According to federal law, the maximum amount that an attorney can be paid under a normal fee agreement is either 25% of the back pay or $6,000, whichever amount is lower.  

There are a few cases in which your representative might ask the SSA for more than the $6,000 limit.  

For instance, if your claim entailed numerous appeals, which required a lot of extra work, or if you changed lawyers in the middle of the process and both of them are seeking payment, keep in mind that every additional fee must be approved by the SSA. 

Because of this, SSDI lawyers act in your best interest since their fee is contingent upon you getting benefits approved.  

Conclusion 

So, while it is not necessary to consult a Social Security lawyer when applying for disability benefits, it is highly recommended that you do so anyway. Working with a Social Security lawyer can help you navigate the process and may improve your chances of approval.