FAQ

You do not need a lawyer. The real question is whether you want one. But it is like any other skilled trade. If your septic tank backs up; you want a plumber. If the wind blows a tree down on your house, you need a professional to move it and a roofer. Most people do not change the oil in their car or replace a fan belt. You can learn how to do pretty much anything with the right book and/or YouTube. Social Security Statistics show that in 2007, about 60% of claims were won at the hearing level but less than half were represented by a lawyer or other professional. In 2019, about 60% of claims were won at the hearing level, but 80% were represented by lawyers. That tells me that “having a lawyer” is not a big factor in whether your case will be approved. But having a good lawyer is. My results have been consistently better than the national average by at least 35%.

Convenience: Over the years, I have had several people come to me whose health conditions were so bad, I thought their claims would be approved without me and I have told them this. (I would tell you this.) The reason people hire me anyway is to take this burden off them. If you are out of work, in pain, depressed and face the reality that you are not going to be able to work again, you have enough on your mind. When you hire a lawyer, they should take care of the details. A lawyer should be able to tell you what to expect at a hearing. Cost Effective: It is against the law for an attorney to charge you a fee unless you win your case. Now or Later: If you choose to file on your own and are denied prior to a hearing, you can hire a lawyer at that point. What if I hire a lawyer but am dissatisfied? You deserve to be treated the way you expect any professional. Would you stay with a plumber who failed to return your calls? Would you stay with a painter who painted half your house the wrong color? Would you continue to go to a mechanic who would not explain the reason for the charges on the estimate? I assume you said: No. If you are not happy, change lawyers. My Two Cents: If you start wrong, you are likely to end wrong. I very strongly believe (based on my results) that my clients have a better chance of winning their case before a Hearing is needed if I file the initial claim. However, most things can be fixed and I do take cases if someone has been denied and needs to appeal; assuming I believe the case is solid.

You have to have medical evidence. You have to have recent medical treatment. Evidence of things that happened years ago is not enough. Decisions are made by looking at the medical records. You can say you have pain or other symptoms, but unless you have medical records of treatment, you will not win. You need to understand the rules. You need to be able to explain why your evidence fits within those rules.

Every case is different, you can never tell about your case by raw numbers alone. The statistics have remained fairly stable over the years. At the initial level, about 70% of claims are denied. At the first level of appeal, about 10% more are approved. But when someone presses on to the hearing level, 60% are approved. Therefore, your chances of winning depend on whether you are willing to go the distance.

From the time your case is filed until you have a decision, the process can take the better part of three years. It takes about six months from the date you file until the date you get the first answer from a Social Security Analyst. If your case is denied and you need to appeal, another Social Security Analyst looks at what the first Analyst did. It takes another 6 months or so. If your claim is denied again, you request a live judge to look at it.

Everyone who files for Social Security disability is in a dire circumstance. But there are some conditions (like brain tumors; organ transplants etc.) that are so bad, they really cannot wait. A claim will be paid before a decision is finally made. If they later decide they made a mistake, they can ask for the money back. Those conditions are called Compassionate Allowances. The list can be found here. https://www.ssa.gov/compassionateallowances/conditions.htm

Social Security has classified some medical conditions that cause such significant impairments, no one could be expected to work. The conditions are Listed in what amounts to a cookbook. You can find Listing conditions for adults here: https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm You can find Listing conditions for children here: https://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm If your condition does not meet a Listing, the analysis goes on to determine whether you have the capacity to perform your past work and if you have the capacity to perform other work.

For adults, the question is whether they have the ability to work. Since children do not work, the question is different. There are Listings for children. (https://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm) If the condition does not meet or equal a Listing, the question is whether the child has the capacity to deal with the world as well as an “ordinary” child of the same age. They look at six areas of functioning (called “six domains”): 1) Acquiring and using information; 2) Attending and completing tasks; 3) Interacting with and relating to others; 4) Moving about and manipulating objects; 5) The ability to provide for their own needs; 6) Health and well-being.

A Social Security Judge is a lawyer who demonstrated that they understand the rules. They take a fresh look at what the Analysts did. Because Social Security Judges have a deeper understanding, they will look at it independently just like a lawyer would and reach an independent decision. If you are not represented, Social Security Judges will help you get the evidence you need. Social Security Hearings are complicated. Since many claimants do not understand what the words actually mean and do not understand the rules, they do not understand why the Judge is asking a specific question. Since they do not understand the question, they cannot give an accurate answer. A lawyer can prepare you for those questions. At the hearing, there is usually an expert witness called a Vocational Expert who will give the judge information about how many jobs are out there and what it takes to do those jobs. (How many hours sitting, standing, walking. How much carrying and lifting. Whether the job is “skilled.” The Judge will decide how much you can do (sit/stand/carry/walk/push/pull/manipulate objects) and then decide whether there are any jobs you have the capacity to do. It doesn’t matter whether you can find one of those jobs. It doesn’t matter whether there is a job like that even close to you. Even if your commute would require a four-hour drive to get to work, as long as a job exists that you have the ability to do, your claim will be denied. My Two Cents: In my opinion, no one should go to a Social Security Hearing without a lawyer – just like no one should try to repair their own septic tank, unless they are a plumber. If you have done your own case and are at the Hearing level, you can change your mind and tell the Judge you want to find a lawyer or non-lawyer representative.

In my opinion, the biggest mistake is failing to file an appeal. Many people just give up. They think the Government is telling them they are a liar, cheat and a thief. They aren’t. They are just telling you, “based on the evidence we have you do not qualify under our rules.” If you truly believe that you cannot work because of physical and/or psychological conditions, do not give up. Go get more evidence.

Yes. In my opinion, you should work as much as you can, for as long as you can. Try; fail. Try; fail. That is pretty good evidence that you can’t do it. If you are only working part time, a few hours a week, that will not necessarily disqualify you. The general rule of thumb is monthly gross earnings (earnings before taxes are taken out) need to be less than $1,000. Don’t try to game this system, however. A judge will decide whether you could be actually working full time. To find the rules (and not my opinion) about working while you have a pending claim, go to www.ssa.gov and type your question into the search engine.

Yes. But there are limitations. Go to www.ssa.gov and type your question into the search engine.

You have 60 days (plus 5 more for mailing) from the date on the denial letter in which to file an appeal. If you miss that date, there are a couple of things that can be done, depending on how much time has passed since the claim was denied. If it has been a short time (less than 3-months or so) and you have a good reason (like: you were too physically ill; you were too depressed; you did not have transportation; you did not receive the letter because it was sent to the wrong address) you only need to write a letter and ask them to accept the appeal even though it was late. If they refuse, you can appeal it. If it has been within 12-months of the date of the denial, you can ask that they “reopen” the prior claim.

Some claims can be reopened. (The law itself is too complicated to explain here.) You ask that the claim be reopened. If the claim is reopened, your benefits may go back all the way to the date of the initial claim.

The law does not allow “two bites at the apple.” If you are denied by a Judge, you must file an appeal to the Appeals Council to potentially collect benefits based on the claim; if it is denied by the Appeals Council you must file a Federal Court appeal. If you are denied by a Judge and do not file an appeal with the Appeals Council, that decision will stand forever unless you have a material change in circumstances. If you do have a material change in circumstances, you can file a new claim based on those changes. (Actually, you can always file a new claim; but the new claim will not be approved unless you show a material change in circumstances.) There are two types of material changes. 1) you change age categories (for example, you were under age 50 when you filed; and are over when you file the new claim; or under age 55 when you filed; and turn 55 when you file the new claim) that could change the analysis. At one age, a person does not qualify. But as soon as they change to the higher age category, they may even if there is no new medical evidence. 2) There is a new condition, or your old condition has gotten much worse.

No lawyer can charge a fee unless you win your case. The actual amount of the fee is based on the amount of the accrued benefits. Typical language in a fee agreement is If I am awarded benefits the fee will be limited to 25% of the benefits accrued while my claim has been pending; or, $7,200 [or a higher amount according to 42 U.S.C. §406(a)(2)(A) [the fee schedule rules set by the Social Security Administration] which ever is less. Accrued benefits are any and all benefits received from the date an application is first filed to the date on which benefits are paid by Social Security. The date, called the established eligibility date, is determined by the Social Security Agency. If I disagree with the ALJ’s decision, I have a right to appeal the decision to the Social Security Appeals Council. [LAWYER] may or may not agree to help me with this appeal. If Ms. Tracy proceeds with the appeal, the fee may be higher than $7,200 but never more than 25% because of the additional work involved. [LAWYER] will decline to file an Appeals Council Appeal in the event that s/he believes the ALJ made a legal error. For example, if you win following a hearing, and if your accrued benefits total $12,000; the fee would be $3,000. If your accrued benefits are $28,800; the fee would be $7,200. If your accrued benefits are $76,000; the fee would be $7,200. If your claim is denied at the hearing; but appealed; remanded and eventually approved, your fee will not exceed 45%, but may exceed $7,200. No matter how many lawyers you have/had, you will never pay more than a total of 25% of your accrued benefits. When there is more than one lawyer, the Judge decides how much each lawyer should be paid.

YES. One of the little known facts is that if you are filing for early retirement because you are physically and/or psychologically not able to keep your job, you can (and in my opinion should) file for both. Why? Because there is more money in it. The Full Retirement Age has changed. See https://www.ssa.gov/pressoffice/IncRetAge.html Benefits at your full retirement age will be about 1/3 more than the benefits you would receive if you retire at age 62. The Disability Benefit is about $150 more than the full retirement rate.

Long ago, the Social Security Agency mailed a statement to everyone who paid the payroll tax that funds Social Security Retirement and Disability programs. That got to be too expensive and unwieldy; and, was not very secure. They started putting that information online. That was too confusing, so they started sending the information by mail again. That got to be really confusing, so they stopped mailing the information again. (Yes, your government at work.) To find out what your benefits would be you can call the toll free number (1-800-772-1213) and ask. Or you can create a “My Social Security Account” online. To create a “My Social Security Account.” click https://www.ssa.gov/myaccount/ A few years ago, I was able to quickly and easily help clients do this during an initial consultation. However, now it is much more easily said than done. Click here to see what the process on the website will look like. Creating a “My Social Security” account has become so frustrating and time consuming (hours). I strongly recommend you call the National Call Center 1 (800) 772-1213. To talk to a live person, say “Agent” (over and over) when the mechanical voice asks what you want to do. Then when you reach a live person, tell them you want help creating a “My Social Security Account.” Unless you want them to file a disability claim for you, Do Not tell them that you want to file. Just ask for help creating the “My Social Security Account.”

I do not take cases that I do not believe I can win in the long run. It is rare that we have all the evidence we need at the first consultation. I develop a theory based on the initial consultation help build on that, so we have enough medical evidence to prove the theory. I will help get medical records, assessments by your treating doctors and explain what is happening at every stage of the case. I practice predominantly North of Oakland to South of Oregon. For adults and children, I file Initial claims; Requests for Reconsideration; Requests for Hearing and Requests for review by the Appeals Council. I do not do Federal Appeals of Appeals Council denials. (But I know someone who does.) My case management software creates a secure, encrypted portal through which I can text clients, send them documents for signature and receive documents clients want me to see. (It’s very cool.) My goal is to win every case in the shortest amount of time possible. I expect to win cases at the Hearing level, or I wouldn’t be there in the first place. It is at the earlier levels, where most cases are denied that really (in my opinion) sets me apart from other lawyers. Because lawyer fees are based on the accrued benefits, the longer your case lasts, the more money a lawyer will make. In other words, cases that drag out the longest generate the highest fee. Yes, I too like money. But, I am really competitive; my goal is to beat the national average at the earliest levels – where 70% of cases are denied. Some lawyers stop once your case has been one and the lawyer has been paid. I will work with clients until I am satisfied that benefits have been calculated and paid correctly.

Call, email or stop-by. We will make an appointment either in the office or over the phone. If you are sure what you want to do and you think want to file on the day of your consultation, we may be able to do that. If that is the plan, you will need to fill out both sections of this form. In order to file, you will need to create a “My Social Security Account.” https://www.ssa.gov/myaccount/ This turns out to be much more easily said than done. Click here to see what the process on the website will look like. Creating a “My Social Security” account has become so frustrating and time consuming (hours online) I strongly recommend you call the National Call Center 1 (800) 772-1213. To talk to a live person, say “Agent” (over and over) when the mechanical voice asks what you want to do. Then tell them you want help creating a “My Social Security Account.” Do Not tell them that you want to file a claim. Just get the User Name and Password and bring it to your appointment. I will take it from there. Is it absolutely, positively required to have an office appointment? No. I personally would never hire a lawyer who I had not actually met – but, whatever works best for you is fine. We can have a regular call or video call if getting into the office is difficult.