Social Security Disability Insurance: Don't Go It Alone Without a Lawyer

 Posted on December 18, 2013 in Uncategorized

A new U.S. Senate subcommittee report raises serious concerns about the quality of decision making on applications for Social Security Disability Insurance benefits. The findings underscore the need for an applicant to have an experienced advocate at every stage of the process. A knowledgeable SSDI attorney can act as his or her client's watchdog before the Social Security Administration, or SSA, by looking at whether the agency is appropriately developing and evaluating the claim for disability insurance.

The SSDI Program

SSDI is a federal program that provides monthly payments to people disabled from working by physical or mental impairments, or combinations of impairments, that will either prevent them from working for at least a year or result in death. An eligible claimant must also meet certain detailed financial requirements that basically ask whether he or she has worked fairly recently and been employed on a mostly regular basis over the years.

SSDI by the Numbers

According to the Associated Press, roughly 11 million beneficiaries get monthly SSDI benefits of slightly under $1,000 monthly on average. Problematically in a time of tight budgets, the SSDI rolls have increased almost 25 percent in the past five years. Apparently, this type of increase is consistent with previous patterns in comparably tough economic times.

Decision Making Under Pressure

The SSA is subject to the current pressure on government to do more with less, and to do it better. In fairness this is no easy task when it comes to fairly evaluating SSDI applications to determine, according to detailed Social Security laws and regulations, whether claimants meet the definition of disability and properly qualify for benefits. The subcommittee report states that 'many' must wait up to two years for final decisions to be made on their SSDI applications, a tough thing to ask of people who are sick, disabled and sometimes dying without regular incomes.

But the medical evidence in a complicated disability claim can consist of hundreds of pages of detailed doctor and hospital records. To do an adequate evaluation of such a case, the review cannot be cursory or quick. Enough time for thoughtful consideration of the evidence is needed to properly evaluate it according to Social Security law and standards by an administrative law judge or other government evaluator.

The Subcommittee Study

The U.S. Senate Permanent Subcommittee on Investigations issued its minority staff report on 'improving the quality' of SSDI decisions in conjunction with a large study it conducted that reviewed 300 cases decided by the SSA at all stages of the application process that has three levels of appeal within the agency if needed (and later court review options):

• Initial application
• Reconsideration
• Administrative law judge, or ALJ, hearing
• Appeals Council review

A few of the important findings of fact in the report based on the reviewed cases include:

• More than 25 percent of the cases did not properly handle 'insufficient, contradictory, or incomplete evidence.'
• Some ALJs did not sufficiently consider the impact of relevant issues like substance abuse and obesity on medical impairment.
• Sometimes ALJ hearings lasted less than 10 minutes and did not include testimony necessary to resolve complex claims with contradictory written evidence.

As the SSA struggles to properly handle the flood of complex disability cases before it, each and every SSDI applicant would benefit from the representation of a skilled lawyer to discern at every step whether the agency is doing the claimant's case justice under the law.