SOCIAL SECURITY DISABILITY FAQ’s

1. How do I prove that I am disabled?

2. What are the steps in applying for disability benefits?

3. What about having a lawyer represent you in your Social Security Disability claim?

1. HOW DO I PROVE I AM DISABLED?
To obtain Social Security Disability benefits, you must prove that you cannot do any substantial gainful work activity because of one or more physical or mental medical problems, backed up with clear medical evidence. This serious disability must last for at least twelve continuous months, or else be expected to result in death.

You must have hard medical evidence of some physical or mental problem, or combination of problems, which keeps you from working. For this reason, it is very important to be under regular medical care at all times.

In many cases, Social Security will also look at your age, education, and past work experience, including any skills you have learned at jobs you did over the last fifteen years. To put it another way, Social Security will pay benefits if there is a medical reason why you cannot do any job for which you might qualify. Whether you can actually get a job does not count.

2. WHAT ARE THE STEPS IN APPLYING FOR DISABILITY BENEFITS
All disability claims begin by filing an application with Social Security. This can be done by calling Social Security toll free at (800) 772-1213, or visiting any one of their local offices. A lawyer is not needed to file an application. The local office will order copies of your doctor, clinic or hospital records, and sometimes send you to see a doctor for an examination at their expense.

Over 70% of initial applications are denied. In Pennsylvania, if you are first denied, you must then request a hearing with an administrative law judge. This appeal must be in writing. Social Security or your lawyer will provide the correct form. No one should give up at this point. Everyone with a serious case should go on to at least the next step.

The hearing can be a person's best chance to get a fair decision. The administrative law judge, the official who will hear the case, listens to your testimony and evaluates the medical evidence. He or she makes an entirely new decision, paying no attention to your earlier denials. The hearing is informal and quite different from what you would expect in a courtroom. After your hearing, you will get a written decision in the mail, either granting or denying you benefits. Most people choose to be represented by a lawyer at a hearing, although it is not required.

3. WHAT ABOUT HAVING A LAWYER REPRESENT YOU IN YOUR SOCIAL SECURITY CASE?
Most people do have a lawyer at least by the time of the hearing before the administrative law judge, and you can consult a lawyer at any time, even before filing a claim. The government's own figures show that people who have a lawyer are more likely to win. A lawyer who is familiar with Social Security cases will know all the details of how to appeal. He or she should be skilled in sizing up your disability and counseling you on how the law applies to your condition. Your lawyer should know how to decide what medical proof is needed for your case, and how to get it. He or she will prepare you before your hearing, so you can explain your disability to the judge in the strongest way possible. Your lawyer should also be able to explain all of the government's decisions, and help you with any problems that come up about your payments if you are approved.

On most, but not all, Social Security cases, lawyers charge what is called a "contingent fee." This means that the lawyer's fee is a percentage (usually 25%) of any back pay the government owes you by the time you finally win the case, and if you do not get benefits the lawyer does not charge you anything.

There are some kinds of Social Security problems for which you may need a lawyer, but you will not be due any back pay if you win. A lawyer cannot take this kind of case on a percentage - there is nothing to figure a percentage on. The lawyer may want to charge by the hour (whether you win or lose), or you may make some other arrangement.

Fees should be clearly set out before you decide to hire a particular lawyer. All lawyer fees are regulated by Social Security. For most types of benefits (but not SSI), Social Security will hold out the 25% of your back pay, and send your lawyer a check for the fee they approve. In other cases, you will have to pay the lawyer yourself. Since 1991, a fee of 25% of any back pay due, up to a limit of $4,000, will be automatically approved in many cases.