Do You Need a Disability Benefits Attorney?
Each case is unique, but it is often in your best interests to hire a disability benefits attorney or a non-attorney representative when pursuing disability benefits offered by the Social Security Administration (SSA). The two main types of SSA disability benefits are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), which use a similar application and appeals process (see "What is the Difference Between SSDI and SSI?" for a comparison of the two).
Claimants are not required to hire legal help when appealing an SSDI or SSI decision by the SSA, although representation can help in a number of ways. Having a representative significantly increases your odds of not only winning a claim but also securing a favorable disability onset date, which ultimately affects your benefit amount.
Sometimes it is advantageous to seek legal advice for the initial filing process, but representatives usually don't get involved until the appeal process. If you choose to seek legal help, you may hire either a Social Security Disability lawyer or a non-lawyer representative. But remember, you have just 60 days to file an appeal and must notify the SSA first if you plan to hire a representative.
The following information is meant to help SSDI and SSI claimants make informed decisions about representation when pursuing disability benefits.
Should You Hire an Attorney or a Non-Attorney Representative?
If you choose to be represented, you will have to decide between a disability attorney and a non-attorney disability representative. Neither lawyers nor non-lawyer representatives get paid unless you win your claim; both are paid directly by the SSA from your benefits; and both are entitled to the same fees.
While non-attorney representatives must complete a certain amount of continuing education courses and pass an SSA-administered exam, attorneys must be admitted to a state bar after completing a juris doctorate degree (J.D.). But each type of representative has its pluses and minuses, so make sure you find the right fit.
Licensed disability attorneys are bound by the obligation to zealously represent their clients, a standard not officially required of non-lawyer representatives, and typically have many years of experience crafting legal arguments. Also, only attorneys may appeal your claim to the federal district court. And if you believe your attorney provided substandard counsel, you may file a formal complaint (not so with non-attorney representatives).
However, many attorneys who handle Social Security disability claims also practice different types of law (such as divorce or personal injury) and may not have the expertise required to properly handle a claim. Non-attorney disability representatives, on the other hand, are often solely focused on disability claims. Also, non-attorney representatives may be more willing to take on a client who has a slim chance of success, while some lawyers mainly take cases with a relatively high probability of prevailing.
Hiring a Representative to Appeal Your Claim
If your claim is denied or you are otherwise unhappy with the outcome, you may file a reconsideration appeal (see "Social Security Disability Appeals" for more details). While some claimants may seek representation at this level, reconsideration appeals usually result in a denial. Therefore, it can make more sense to wait until you get a hearing in front of an administrative law judge (or ALJ), which is the second appeals level.
Statistics show that claimants are twice as likely to be approved at a disability benefits hearing if they have an attorney or non-attorney representative. A representative can do the following on your behalf before and during the hearing:
- Gather the necessary medical records
- Obtain physicians' opinions of your condition
- Thoroughly assess your medical records
- Prepare you for questions asked by the Administrative Law Judge
- Ask the vocational expert (hired by the SSA for the hearing) critical questions during cross-examination
Also, an attorney or non-attorney representative likely is familiar with the various judges you are likely to face at your hearing. As such, your representative can adjust his or her approach to the hearing accordingly.
Rules for Representation in a SSDI or SSI Case
The first thing you need to do once you decide to hire a representative is inform the SSA in writing, using the SSA's Appointment of Representative form (PDF, Form SSA-1696-U4). If your representative is not a licensed attorney, he or she must sign their name on the form.
Social Security disability lawyers and non-lawyer representatives work on contingency, meaning they don't get paid unless you do. You and your representative will sign a contingency fee agreement, subject to SSA approval, which allows the agency to pay the representative directly (if you win your claim).
Your representative may be paid no more than 25 percent of your benefit amount (or $6,000, whichever is less). But he or she may additionally charge you for out-of-pocket expenses, such as the cost of obtaining medical records, without the SSA's approval.
If you decide you are unhappy with your representative, you may seek another one. But keep in mind that you end up paying more than the aforementioned $6,000 limit if you have to pay more than one attorney or non-attorney representative. You also may have to pay additional out-of-pocket costs.
Have an Attorney Provide an Initial Review of Your Claim for Free
Often, finding the right attorney can be just as overwhelming as determining whether you need an attorney in the first place. Don't let the search for the right attorney discourage you from getting the legal help you need with your Social Security disability claim. A good first step in the right direction is to have an experienced Social Security disability attorney provide an initial evaluation of your claim for free. That way, you'll learn more about the strengths and weaknesses of your claim and what the next move is for your case.