Filing for Social Security disability benefits

The Savings Game

In past columns, I have encouraged people who qualify to learn about and apply for Social Security Disability Insurance benefits.

The Social Security Administration has a strict definition of who is disabled. You must have an impairment severe enough to prevent you from doing substantial work, and that condition must have lasted (or must be expected to last) more than a year.

Some with low income and resources may be eligible for Supplemental Security Income, which is a more modest benefit. It covers severe disabilities such as blindness, as well as the aged and people with very limited resources.

If you want basic information about eligibility for SSDI and/or SSI, the National Organization of Social Security Claimants’ Representatives website (nosscr.org/socialsecurity-basics) is an excellent resource. In addition to eligibility information, this site also has information about Medicare coverage and about the appeal processes if your initial application is not accepted.

An experienced attorney or a “nonattorney representative” can assist you in filing your initial application or appealing an initial denial. Social Security Administration regulations specify that the fees for all professional representatives are the same.

Representatives work on a contingency basis and receive fees from retroactive benefits. They are not awarded any fees until your application is approved. Specifically, the fee is limited to 25 percent of the past-due benefits you are awarded, with a maximum of $6,000. They receive their fee from the first payment(s) you receive after your application is approved. I recommend that before you hire a representative, you inquire about the expected out-of-pocket fees.

About one-third of initial applications are rejected. If your initial application is rejected, file a request for reconsideration within 60 days of receiving the denial notice. The reconsideration process generally takes about four months. If your request for reconsideration is denied, the next step is a hearing with an administrative law judge.

Some states do not provide the request for reconsideration, in which case you would request the judge appeal process after the initial denial. As of June 2017, the expected case process time for this stage of appeal is more than 620 days. There are other additional appeal processes after the judge appeal, which generally take longer than a year.

Representatives are especially advantageous during the appeal processes. History shows that experienced representatives are much more likely to prevail in a disability hearing with an administrative law judge than a claimant without representation. They understand disability impairment listing criteria, are familiar with vocational guidelines, understand the significance of past work history and are able to document the inability of the claimant to perform other types of work.

Because of the lengthy process times, using an experienced representative can be valuable both in getting an initial application approved and in mounting a successful appeal. In addition, if you file an initial application unsuccessfully by yourself, it can take time to hire a competent representative.

Naturally, it is advantageous to expedite the appeal process when required.

For all these reasons, I recommend hiring a representative, even for assistance with the initial application.

Elliot Raphaelson welcomes your questions and comments at raphelliot@gmail.com.