Social Security Disability Advocacy Representative

How a Social Security Disability Advocate Can Help You Apply for Disability

This article discusses the role, qualifications for, and fees earned by a Social Security Disability Advocate. But before we can focus on the advocate, we must look at the qualifications for Social Security disability in brief, and the the benefits of a disability advocacy service provider such as Binder and Binder and many competing firms that offer such services.

In theory, qualifying for a Social Security disability benefit is easy although the process is lengthy (three to five months). To qualify, you must have

1. Worked recently in jobs covered by Social Security, and
2. A medical condition that meets Social Security's definition of disability

Let us look at these two qualifications.

The Social Security Administration calculates employment in units it calls work credits. In 2011, an wage earner earns earn one credit for each $1,120 of wages or self-employment income. (This varies from year to year.) When a worker earns $4,480, he or she earns four credits for the year. Four work credits is the annual maximum.

According to the Social Security Administration, the number of work credits a person needs to qualify for disability benefits depends on their age when he or she becomes disabled. Generally, a person needs 40 credits, 20 of which were earned in the last 10 years ending with the year he or she become disabled. However, younger workers may qualify with fewer credits.

Determining if a disability qualifies is a process of answering three to five questions correctly. An applicant must pass through question No. 3, and possibly No. 4 and No. 5 before qualifying. The questions an applicant must answer successfully are:

1. Are you working?If you are working and your earnings average more than $1,000 a month (for 2011), you generally cannot be considered disabled. If the answer to this question is "no," then go to step No. 2.
2. Is your condition "severe"?According to the Social Security Administration, your condition must interfere with basic work-related activities for your claim to be considered. If "no," then you are not disabled. If "yes," then go to No. 3.
3. Is your condition found in the list of disabling conditions?The Social Security Administration maintains a list of medical conditions that are so severe they mean that you are disabled automatically. If your condition is not on the list, the Social Security Administration must decide if it is of equal severity to a medical condition on the list. If so, the Social Security Administration will find you are disabled. If it is not, go to No. 4.
4. Can you do the work you did previously?If your condition is severe but not at the same or equal level of severity as a medical condition on the list, then the Social Security Administration must determine if it interferes with your ability to do the work you did previously. If it does not, your claim will be denied. If it does, go to No. 5.
5. Can you do any other type of work?If you cannot do the work you did in the past, the Social Security Administration will see if you can adjust to other work. The Social Security Administration considers medical conditions and age, education, past work experience and any transferable skills you may have. If you cannot adjust to other work, your claim will be approved. If you can adjust to other work, your claim will be denied.

The Social Security Administration has rules for special situations, and offers a Benefit Eligibility Screening Tool (BEST) to help people learn if they are eligible.

Disability Advocate Fees

Most applicants complete the Social Security Administration's disability application process on their own. However, in some cases, it is necessary to get assistance from a disability advocate or advocacy service, such as those seen advertised by many local law firms or Binder and Binder.

According to the Social Security Administration, you can hire a representative, such as an attorney, to help you complete the application process. The representative first must file either a fee agreement or a fee petition. However, a representative cannot charge or collect a fee from you without first getting written approval from the Social Security Administration.

The Social Security Administration will approve a fee if it has these three elements:

1. Both client and representative signed the agreement;
2. Your claim was approved and resulted in past-due benefits; and
3. The fee you agreed on is no more than 25 percent of past-due benefits or $6,000, whichever is less.

According to the Social Security Administration, the amount of the fee its decide your representative may charge is the most you owe for his or her services even if you agreed to pay your representative more. However, your representative can charge you for out-of-pocket expenses, such as medical reports, without the Social Security Administration's approval.

If an attorney or non-attorney whom Social Security has found eligible for direct payment represents you, the Social Security Administration usually withholds 25 percent (but never more) of your past-due benefits to pay toward the fee. The Social Security Administration pays all or part of the representative's fee from this money and send you any money left over.

Sometimes you must pay your representative directly if:

• You must pay the rest you owe if the amount of the approved fee is more than the amount of money we withheld and paid your representative for you.
• You must pay the entire fee amount if:
  • Your representative is not eligible for direct payment;
  • The Social Security Administration did not withhold 25 percent from your past-due Social Security or Supplemental Security Income benefits, or both; or
  • Your representative made a timely request for a fee and the Social Security Administration sent you the money that it should have withheld.

You must pay for out-of-pocket expenses your representative incurs or expects to incur (for example, the cost of getting your doctor's or hospital records).

To learn more about fees, see Your Right To Representation. See also Statistics on Title II Direct Payments to Claimant Representatives.

Disability Advocate Qualifications

A disability advocate can be a lawyer, but this is not necessary. Under Code of Federal Regulations §404.1705, a representative can be an:

1. Attorney. You may appoint as your representative in dealings with us, any attorney in good standing who:
   1. Has the right to practice law before a court of a State, Territory, District, or island possession of the United States, or before the Supreme Court or a lower Federal court of the United States;
   2. Is not disqualified or suspended from acting as a representative in dealings with us; and
   3. Is not prohibited by any law from acting as a representative.
2. A person other than attorney. You may appoint any person who is not an attorney to be your representative in dealings with us if he or she:
   1. Is generally known to have a good character and reputation;
   2. Is capable of giving valuable help to you in connection with your claim;
   3. Is not disqualified or suspended from acting as a representative in dealings with us; and
   4. Is not prohibited by any law from acting as a representative.

A disability advocate must complete a Form SSA-1699 and Form SSA-1695 to receive a payment.

Disability Advocate Tasks

Either you or a representative must complete the Social Security Disability Insurance benefits application completely and accurately. A complete package will include the following forms:

1. Disability Application, including:
   • Military Service discharge information (Form DD 214) for all periods of active duty.
   • W-2 Form (or your IRS 1040 and Schedules C and SE if self-employed) from last year.
   • Social Security Number(s) for your spouse and minor children.
   • Checking or savings account number and bank routing number, if you want Direct Deposit for your benefit checks.
2. Disability Report, including:
   • Name, address and phone number of someone we can contact who knows about your medical conditions and can help with your claim.
   • Names, addresses, phone numbers, patient ID numbers, and dates of treatment for all doctors, hospitals, and clinics. NOTE: You may want to refer to any Medical Records you have.
   • Names of medicines you are taking and who prescribed them. NOTE: You may want to have your medicine bottles available.
   • Names and dates of medical tests you have had and who sent you for them.
   • Types of jobs and dates you worked for your last five jobs.
   • Information about any insurance or workers' compensation claims you filed, such as claim number and name, address and phone number of insurance company.
3. Authorization to Disclose Medical InformationA separate copy of this form is needed for each source, such as your doctor.
4. Function ReportA description of how your medical condition limits your daily activities and your ability to work.

An advocate will help you complete these forms completely and accurately.

Disability Advocate Appeals

If the Social Security Administration denies your application for Social Security Disability, you can appeal this decision. You can appeal it yourself, or hire an advocate. See the Social Security Administration resource The Appeals Process to learn more.