Understanding Disability Claims
Filing for disability Lawyer benefits can be a challenging and complicated process. There are several different types of disability claims, each with their own eligibility requirements and application procedures.
The most common disability programs are Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), Veterans Affairs (VA) disability benefits, and Workers’ Compensation.
SSDI and SSI
SSDI and SSI are both administered by the Social Security Administration (SSA). Here SSDI pays benefits to disabled individuals who have worked and paid Social Security taxes long enough to be insured. SSI pays benefits to disabled adults and children who have limited income and resources.
To qualify for SSDI or SSI, you must have a medical condition that meets Social Security’s definition of disability. This generally means you are unable to work due to a severe physical or mental impairment that is expected to last at least 12 months or result in death.
Some of the most common qualifying conditions include musculoskeletal disorders, cardiovascular disease, mental illnesses, neurological disorders, cancers, respiratory illnesses, and immune system disorders.
The SSA has a strict 5-step evaluation process to determine if you meet the criteria to receive disability benefits. They review your work history, medical records, and ability to perform work-related activities.
VA Disability
The VA Disability Benefits program provides tax-free compensation to veterans who have disabilities related to or aggravated by their military service.
To be eligible, you must have been discharged under honorable conditions and have a service-connected disability rated at least 10% disabling. The VA uses their own rating system and criteria to evaluate disabilities.
Common VA qualifying conditions include post-traumatic stress disorder (PTSD), injuries to joints and muscles, hearing loss and tinnitus, diabetes, and neurological disorders.
Workers’ Compensation
Workers’ compensation provides assistance for employees who become injured or ill on the job. Each state administers their own program with specific rules.
Generally, to qualify for workers’ comp disability benefits, your injury or illness must be caused by your work activities. This can include repetitive stress injuries, workplace accidents and trauma, work-related diseases, and occupational illnesses.
The workers’ comp process involves filing a claim, getting medical evidence, undergoing an independent medical examination, and having your claim reviewed at a hearing if denied.
Understanding the different types of disability claims and programs is an important first step in filing for the benefits you may be entitled to. Consulting with an experienced disability lawyer can help maximize your chances of approval.
Hiring a Disability Lawyer
Disability claims can be complex and intimidating to navigate alone. An experienced disability lawyer can provide valuable legal expertise to help strengthen your case and increase the likelihood of approval. There are several key benefits to hiring representation:
Benefits of Legal Representation
-
Navigating the process: The disability application and appeals process involves extensive paperwork, strict deadlines, and complex regulations. A lawyer understands these complexities and ensures proper protocols are followed.
-
Building the strongest case: An attorney gathers medical evidence, obtains doctor statements, and constructs the most persuasive arguments to highlight how your condition prevents you from working.
-
Increasing chances of approval: Statistics show claimants with representation are more likely to be approved for benefits. In 2019, claimants with representation had a 56% approval rate at the initial application, compared to 39% approval for unrepresented claimants.
-
Handling communication: Your lawyer fields inquiries from the Social Security Administration and serves as an intermediary so you can focus on your health.
Contingency Fees of Disability Lawyer
Most disability attorneys work on a contingency fee basis, meaning there is no upfront cost to hire them. The lawyer receives a percentage of any back-pay awarded if your claim is approved – usually 25% up to a capped amount. There are no fees if your claim is denied.
Experience and Track Record
Look for a lawyer experienced in handling disability cases similar to yours. Ask about their success rate in getting claims approved. Verify they are licensed in your state. It’s advised to choose an attorney who has represented clients before your local Social Security office previously. Their familiarity with the process can be an advantage.
An experienced disability lawyer can significantly increase your chances of getting approved for the benefits you deserve. Taking the time to find qualified local representation is worth the effort.
Finding a Local Disability Lawyer
When you’re ready to hire representation for your disability claim, finding the right lawyer can feel overwhelming. There are a few key ways to locate qualified disability attorneys in your area:
Bar Association Referral Services
Most states have a bar association that offers a lawyer referral service. These services connect you with attorneys based on your legal need and location. To use them, you’ll call the referral line or fill out a request form on the bar association website. You provide details on your disability case, and they match you with lawyers who specialize in Social Security claims. This is often a free or low-cost option.
Online Directories and Reviews
Another approach is using an online legal marketplace like Avvo or Lawyers.com. These sites let you search for disability lawyers by practice area and location. You can read profiles for each attorney and see client reviews. This gives you a sense of their experience with disability claims and client satisfaction. Compare ratings and reviews to choose potential lawyers to interview.
Recommendations from Others
Speaking with friends, family, healthcare providers, and disability advocates you trust is also wise. They may be able to recommend disability attorneys they or someone they know have worked with. While it’s not guaranteed their lawyer will be a good fit for you, personal recommendations can give you a starting point. You can still vet them thoroughly before deciding.
Taking the time to carefully evaluate disability lawyers in your community is essential. Make sure to check their credentials, experience with Social Security claims, and client reviews. This helps you find the right representative for your unique situation.
Initial Consultation
The initial consultation with a disability lawyer is a critical first step in building your disability case. This meeting allows you to get answers to important questions, provide key documentation, and review details of your situation with legal counsel.
What to Ask and Expect
Come prepared with questions for the attorney. Important items to ask about include:
- Their experience handling similar disability cases
- Success rate in winning disability benefits
- Estimated timeline for the case
- Fee structure and costs
Be ready to give an overview of your disability, medical history, work background, and limitations. The lawyer will explain the process and eligibility criteria in more detail. You’ll also discuss the best legal strategy for your particular case.
Bring Documentation
Bring copies of all documentation related to your disability and work history. This includes:
- Medical records outlining your condition, treatments, test results, etc.
- Statements from doctors
- Detailed list of medications and therapies tried
- Records of doctor visits and hospitalizations
- Former job descriptions and performance reviews
- Proof of previous disability claims and applications
Thorough records are vital for the lawyer to evaluate your case. The more evidence you provide upfront, the better.
Go Over Case Details
Clearly explain how your disability affects your daily life and ability to work. Specify:
- Diagnoses and all associated symptoms
- Functional limitations on physical and mental activities
- Changes in your condition over time
- Difficulties performing past work duties
- Accommodations you requested and results
Providing complete details allows the attorney to fully understand your situation and start building the strongest argument for your approval. Answer any additional questions openly and honestly.
With the right disability lawyer, the initial meeting will provide a frank discussion of your chances for benefits. You’ll gain valuable advice on steps ahead to position your case most favorably.
Building Your Case
Once you’ve filed your disability claim, it’s crucial to build a strong case by gathering supporting medical documentation. This evidence will make or break your disability claim.
Gathering Medical Records
-
Request records from all doctors, specialists, hospitals and clinics you’ve visited related to your disability. These records prove you received medical treatment and show your diagnosis, test results, treatment history and medication.
-
Medical records should include clinical notes from doctor visits, hospital discharge summaries, lab and test results, imaging study reports, therapy notes, and medication lists.
-
If a doctor refuses to release records, you can send a written request and they are legally required to provide the records within 30 days.
Getting Doctor Statements
-
Ask doctors who treat you to write a letter explaining how your condition prevents you from working. This helps demonstrate severity.
-
Specialist reports carry more weight than general practitioners. Include statements from any specialists you see.
-
Letters should list your diagnoses, symptoms, test results, treatment history, and explain specifically how your condition impairs your ability to work.
Crafting Personal Statements
-
Write a detailed statement on how your disability affects your daily life and ability to function and work.
-
Keep a journal detailing your symptoms and how they prevent activities. Use this to draft your statement.
-
Explain how your condition stops you from performing job duties. Provide specific examples.
-
Your statement puts a human face on your experience. It brings your medical records to life.
Thoroughly building your case provides compelling evidence to get your disability claim approved.
Filing Your Claim
Filing for disability benefits can seem daunting, but having an experienced disability lawyer guide you through the process makes it much more manageable. Here’s what to expect when filing your disability claim:
Forms Needed
There are two main Social Security Administration (SSA) forms you’ll need to file an initial disability claim:
-
Form SSA-16 – This is the main disability benefits application form. Your lawyer will help you provide accurate responses to all the questions about your medical conditions, work history, education, and daily living activities.
-
Form SSA-3368 – Your disability report form. This collects details about your illnesses, injuries, or conditions, as well as your medical treatments. Your lawyer can obtain the proper medical evidence and records to support your reported information.
In addition to these, you may need to file other forms for insurance purposes based on your work history. Your lawyer will determine exactly what’s required for your specific situation.
Submitting the Application
Once all forms have been thoroughly prepared with your lawyer’s assistance, they can be submitted by mail or online. Online filing through the SSA website is recommended when possible for faster processing.
Hard copies of supporting documents, like medical records, will still need to be mailed. Your lawyer will handle collecting all these records, making copies, and submitting them with your claim.
Following Up
It can take up to several months for the SSA to process your disability benefits claim. Your lawyer will closely track the status and follow up as needed to ensure proper handling of your case. This can help avoid long delays.
If your claim is denied initially, your lawyer will request a copy of your claim file and review the reasons given. They’ll prepare an appeal and make sure additional medical evidence is provided to overcome the original objections. With an expert disability lawyer guiding each step, you can feel confident your claim will be as strong as possible.
Tracking Your Claim Status
After you submit your disability claim, you will want to closely track its status through the Social Security Administration’s (SSA) review process. There are a few ways to monitor your claim’s progress:
Processing Times
Disability claims on average take 3-5 months to process from beginning to end. However, processing times can vary greatly depending on your local SSA office’s workload. Typically you will receive a decision within 90-120 days after filing your initial claim. If you appeal a denial, expect an additional 90+ days for a hearing date and decision. Check with your local office to get an estimate for current processing times.
Checking Status Online
The most efficient way to track your claim is through the SSA website. You can create an online account to view your application status, next steps, scheduled appointments, payments, and decision letters. This gives you 24/7 access to the latest updates as your claim goes through the system. The online dashboard will show at which stage your claim is currently at and provide an estimated completion date.
Communications from SSA
In addition to checking online, you will receive letters from the SSA at each major step. For example, after you first submit your claim, you will be mailed an acknowledgment letter. If the SSA needs any additional documentation from you, they will send a written request. When a decision is made, you will be informed by mail whether your claim was approved or denied. If denied, the letter will explain why and outline the appeal process. Make sure to read any letters promptly and follow up as needed. Proactively communicating with your disability examiner can also help speed up processing times.
Closely tracking your claim status enables you to stay on top of your case. Reach out to your disability lawyer or SSA office with any questions or if your processing time seems longer than estimated. They can look into your claim and ensure it is moving through the system in a timely manner.
Preparing for Your Hearing
After you receive the hearing notice from the Social Security Administration, it’s time to start actively preparing for your disability hearing. This is a critical stage in your disability claim process. Proper preparation and having your lawyer’s guidance can significantly impact the outcome.
Hearing Notice
The hearing notice will provide details like the time, date, location, and contact information for your scheduled hearing. Make sure to note these details. Your disability lawyer will also receive a copy of the notice.
Upon receiving the notice, contact your lawyer’s office immediately. Your lawyer will discuss the notice with you and start preparing for the hearing.
Strategy Meeting with Lawyer
Your disability lawyer will schedule a strategy meeting with you a few weeks before the hearing. This meeting allows you and your lawyer to align on the best strategy and prepare testimony and evidence.
During the meeting, you’ll discuss:
- Your background, work history, medical conditions and their impact on your ability to work.
- Questions the judge may ask and how to respond.
- Any additional medical evidence to obtain before the hearing.
- Who will attend the hearing to provide testimony (such as your doctor).
- Accommodations needed during the hearing, such as a wheelchair accessible location.
Your lawyer will provide guidance to ensure you put your best case forward. They will also prepare exhibits, summon witnesses, and handle all communication with the judge’s office leading up to the hearing.
Gathering Evidence
A disability hearing focuses on the medical evidence. Your lawyer will gather all the relevant medical records, treatment notes, and test results. They may also request your doctors provide medical source statements about your conditions and limitations.
You’ll want to supply your lawyer with any additional evidence that supports your disability, such as:
- Prescription records
- Medical equipment invoices
- Physical therapy reports
- Journal of symptoms
- Letters from family about your limitations
Any documentation related to your condition will help build a strong case. Your lawyer will review all evidence to determine what to submit.
Thorough preparation and working closely with your disability lawyer gives you the best chance for approval. Keep in contact leading up to the hearing and follow your lawyer’s advice.
Attending Your Hearing
The disability hearing is your opportunity to present your case in front of an administrative law judge. It’s important to adequately prepare to ensure the best outcome.
What to Expect
The hearing will likely take place at the local Social Security office or federal building. Arrive early and dress professionally. You’ll likely wait in a waiting room until the judge calls your name. Your disability lawyer will accompany you into the hearing room.
The judge will explain the process and swear you in. Your lawyer will provide an opening statement highlighting the main facts of your case. The judge will then ask you questions about your medical conditions, limitations, work history, and daily activities. Answer honestly and don’t exaggerate. Take your time to make sure you understand each question before responding.
Your disability lawyer will object if the judge asks inappropriate questions. They may also ask you clarifying questions. Bring a list of medications, assistive devices, and any notes to help you remember important information. Don’t worry about remembering every detail – your lawyer and the judge have your full case file.
Question Types of
The judge will ask about your past work, medical treatments, and limitations. For example, they may ask:
- What jobs have you held in the past 15 years?
- How do your conditions prevent you from working?
- What treatments have you received and how have they helped?
- How far can you walk without rest?
- How long can you sit before needing to change positions?
Be prepared to go into detail about your limitations and how they prevent you from working full-time. Focus on objective facts like appointments, surgeries, assistive devices, therapy, etc. Avoid subjective statements about pain levels or severity unless you have medical evidence to back it up.
Video vs In-Person
Due to COVID-19, many hearings now take place by video conference instead of in-person. The process is largely the same. Make sure you have a stable internet connection and private, quiet room with no distractions. Position the camera at eye level and dress as you would for an in-person hearing. Let your lawyer know right away if you have any technical difficulties during the video hearing.
While video hearings provide convenience, some claimants feel an in-person hearing allows the judge to better understand their limitations. However, disability approval rates are similar for video and in-person hearings. With proper preparation, you can have an effective hearing no matter the format.
The most important part is working closely with your disability lawyer to make sure you put your best case forward. Being open and honest while highlighting your limitations will help the judge understand how your conditions prevent you from gainful employment.
After Approval
Once you receive an approval on your disability claim, there are several things that will happen next:
Awards Letter
You will receive an awards letter from the Social Security Administration that outlines the monthly benefit amount you will receive, when benefits will start, and any back pay you may be owed. This letter serves as official notice of your approval. Be sure to review the information carefully and let your disability lawyer know if you have any questions.
Start of Payments
After approval, it usually takes 1-3 months for payments to begin. Your first payment will include benefits owed from your established disability onset date through the current month. Ongoing monthly payments will begin the following month. Direct deposit is the fastest way to receive payments each month.
Reporting Responsibilities
Once approved, you have certain responsibilities to continue receiving disability benefits. You must report any changes that could impact your eligibility, such as an improvement in your medical condition, increase in your work activity or income, or incarceration. You’ll need to check in periodically to confirm you remain eligible. Failure to report changes can lead to benefit termination and overpayment demands.
Staying in touch with your disability lawyer during this time can help ensure you understand your ongoing responsibilities. They can also assist if you need to appeal a termination of benefits down the road due to a continuing disability.
