Although it is not required to hire an attorney for a disability reconsideration, it is usually a good idea. The Social Security Administration routinely denies three out of five initial disability claims. Of those that are appealed, only one disability reconsideration in five results in the claimant receiving benefits. Claimants in the Chicago area who do hire an attorney have better odds of winning on appeal.
There are several reasons that an attorney can improve a claimant’s chances of prevailing in a reconsideration. Many people who have their application for disability benefits turned down are not aware of all of the criteria that the Social Security Administration (SSA) uses. Most claimants are not aware of the administrative procedures that the SSA uses when reconsidering an application. The SSA is bound by law to ensure that people who are not actually disabled do not cheat the system.
The SSA does not make a simple yes or no decision on whether a medical condition will prevent a person from working. One of the first things they consider is whether the condition will keep a person from working for more than a year. Depending on the type of benefit applied for, they must also consider how many years a person has worked before they applied for benefits.
A person who applies for Disability Insurance Benefits must have worked at least five out of the last ten years to be eligible. Similar criteria exist for those who apply for Disabled Widow’s or Disabled Widower’s Benefits. These individuals must be at least 50 years old. These benefit programs do not require a person to demonstrate need or poverty, only to demonstrate disability. A person who requests Supplemental Security Income (SSI) benefits does need to demonstrate poverty as well as disability, but there is no requirement for having worked for a certain amount of time.
Those who win a disability reconsideration are usually able to do so because they are able to demonstrate to the SSA that the agency did not have all of the facts when they made their initial determination. Many claimants are embarrassed to show that they have a psychiatric condition or that they had difficulty in school. Others do not want to admit that their age makes it more difficult for them to adapt to new equipment or new procedures in the workplace. These are factors that the SSA considers in addition to a medical condition.
A person who wants the SSA to reconsider can ask for a case review, an informal hearing or a formal hearing. A case review means submitting more facts through paperwork. An informal hearing is a meeting with the person who will decide the case plus anyone else the claimant invites that he or she thinks will help. A formal hearing is similar to an informal hearing, but the claimant can have witnesses subpoenaed. There are rules for when a hearings can be requested. They cannot be requested for blindness or medical condition determinations.