Why does Representation increase the win ratio at a Social Security Disability or SSI Hearing?
Why does representation result in a higher win ratio at a hearing? The answer is fairly simple. Disability hearings are similar to various types of court proceedings in which:
A) solid case preparation and
B) a proper presentation of the relevant arguments and positions--specifically, pertaining to why the individual should be approved to receive disability benefits--are both necessary in order to win the case.
Hiring an attorney will increase your odds of winning more than just a non-attorney representative. To explain, we should sum up what a disability attorney or non-attorney actually does before a hearing.
What will my representative do before my hearing?
Before the hearing, the representative will begin to gather updated medical records. These updates will be reviewed and evaluated to see if the case can be strengthened. They will also be sent to the administrative law judge (ALJ) who has been assigned to hear the case.
Getting medical record updates is crucial because, by the time a case gets to a hearing, there will be no recent medical records in the file as it is the Claimant's responsibility to get the records submitted to the record.
Why will there be a lack of recent medical evidence in the file?
Because the case development that is done on a disability claim is the Claimant's responsibility and this includes:
- such as getting the records together,
- obtaining information on the claimant's work history,
- contacting individuals who are knowledgeable as to the claimant's condition and daily activities, etc, stops after the reconsideration appeal phase is completed.
To reiterate, once a case has been denied at reconsideration, the social security administration will no longer do any work on the case. Which means that when a case gets to the hearing level, the only records that will be in the case file will be many months old, making the chance of getting an approval.
Many unrepresented claimants who may be completely unaware of the fact that all case development becomes the responsibility of the claimant or their attorney once the case gets to the hearing level.
Sometime before the hearing, the disability representative obtain a medical source statement (MSS) from a claimant's treating physician if the physician will cooperate.
While it may be true that not all disability claim representatives do this anyone you hire better have their own forms and do what they can to hep get this crucial form filled out. A Social Security Disability Attorney that did not help his clients do this probably lacks the skill and competence necessary to be representing those applying for SSDI.
A medical source statement from a claimant's treating physician can help summarize the claimant's various physical or mental shortcomings (their residual functional capacity.)
Is the medical source statement the same thing as getting a handwritten or typed statement from one's doctor?
Claimants who are not represented will attempt to procure a statement from one of their doctors. Generally, because the claimant is completely unfamiliar with what the social security administration is looking for (with regard to evidentiary requirements), they will be given a short statement from their doctor that simply states that they cannot return to work. This is not always what the judge or disability examiner is looking for.
Doctors will put conclusions and not restrictions based off of the severe and non-severe medical conditions of the Claimant. For example, the doctor may write a note and it says something like Mr. Dumas can't work because he is sick. This statement is not helpful because the doctor has tried to do the judges job instead of focusing on such things like:
- how much can the Claimant lift
- how far can the Claimant walk
will the Claimant be off task and if so what percentage of the day?
Now does everyone see what a conclusion is verse providing the judge with evidence so that the ALJ can make the appropriate determination.
When a disability attorney or a non-attorney representative attempts to obtain a medical source statement (mss), they send a prequalified form to either one or several of the claimant's treating physicians. Typically, the form will be geared to whether or not the impairment in question is physical or mental. And in some cases the form may be completely geared to a specific condition such as degenerative disc disease.
Disability representatives, whether of the attorney or non-attorney variety, will usually employ time-proven, systematic techniques for establishing the credentials of a case. This fact alone tends to answer the question "Why does Representation increase the win ratio at a Social Security Disability or SSI Hearing?".
Preparing to win a disability hearing is, in many ways, no different than developing an investment portfolio or developing a game plan. It all begins with having the proper management (a disability representative would be analogous to a portfolio manager or a coach) and then following a strategy that has demonstrated past success. In other words your Social Security Disability Attorney is your fiduciary and if you choose someone who has done thousands of cases like Betz & Baril you will be in a much better position than if you try to Bob Villa (home depot DIY guy) your disability hearing.
This is not to say, of course, that unrepresented claimants do not win disability cases. Many claimants who go to hearings alone manage to win their claims, but usually this is because the case was strong enough that the administrative law judge had already decided, based on the strength of the evidence, and often prior to the hearing taking place, to award disability benefits.
Considerations for claimants who go to hearings without the benefit of SSD attorney (non-exhaustive list).
1. Be prepared to answer questions from the administrative law judge and your own representative (if you have elected to have representation). This includes questions regarding your daily activities, functional limitations and your work history.
3. Make sure that you know how to get to your local hearings office, because you need to be at your hearing on time. Showing up late is a great way to get denied in a close case. How much do you really care when you can not even make it to court on time. Being late even by ten minutes can mean that your disability hearing may have to be rescheduled (because most judges schedule multiple hearings back-to-back), which can take weeks or months.