Does Having an Attorney Determine Whether You Win or Lose Your Social Security Disability Case?
Did you know you can increase your odds of winning your Social Security (SSA) Disability case by more than 50% if you are represented by an attorney? Simply put, that’s a dramatic difference and one that every Social Security disability applicant should heed.
Congressional and SSA’s own statistics confirm this statement is true. The statistic came to light in November 2001, during Congressional testimony provided by Congressman Robert T. Matsui of California. During the hearing Congressman Matsui provided the following testimony:
“Professional representation is a valuable-and indeed vital-service. The disability determination process is complex. Claimants without professional representation appear to be far less likely to receive the benefits to which they are entitled. For example, in 2000, 64% of claimants represented by an attorney, but only 40% of those without one, were awarded benefits at the hearing level.”
At the same hearing, Congressman E. Clay Shaw, Jr. of Florida provided the following testimony:
“As many of you know, filing for Social Security benefits-especially disability benefits-is so complicated that many claimants must hire attorneys to guide them through the process.” 
Please understand I am not suggesting that you must have an attorney in order to win your disability case. People can and do win their cases on their own. In fact, SSA does not require you to have an attorney, you can represent yourself; but why on earth would you? Congressional and SSA’s own statistics show dramatic differences in the outcomes of cases depending on whether an attorney is involved.
I have debated for years on whether to write an article on why one should hire a disability attorney. I did not want the article to be viewed as self-serving for either myself or my profession. I am aware of the unfortunate stature attorneys hold in our society, some of which is deserved. I always enjoy the look in a person’s eyes when they learn I am an attorney; it is clear they are searching their mind to share the latest attorney joke…and most are very funny!
However, the testimony of Congressmen Matsui and Shaw confirms what SSA and many disability attorneys have known for years. With such a compelling statistic, it is my hope this article is viewed as educational, rather than self-serving.
So you know the difference a disability attorney can make in your case…what can do you do about it? For those of you who are now considering hiring an attorney, let me provide you with some basic information to assist you in your decision.
1. You only pay an Attorney’s fee if you win your Case!
The number one question on people’s minds is, “How can I afford an attorney when I am not working?” The answer is simple…you only pay the attorney a fee if you win your case. You do not pay an attorney upfront. Generally, every disability attorney will represent you on a contingency fee basis. Simply put, this means you do not pay an attorney’s fee unless you win your case. Thus, everyone seeking disability benefits can afford an attorney. The question you should be asking yourself is “can I afford not to be represented by an attorney?”
2. General information regarding the attorney’s fees
The SSA and federal law set the attorney’s fees in disability cases. The standard fee agreement most attorneys use states the attorney’s fee is contingent upon winning your case. The fee is 25% of all past due benefits for you and your family, up to a maximum of $5,300, or whichever is less. Some attorneys may use a fee agreement which provides for a maximum fee of $7,000.
It is worth noting that on February 1, 2002, SSA increased the maximum standard fee amount to $5,300 from $4,000. This is the first time the fee has been increased since 1990 and simply represented a cost of living adjustment.
Thus, the attorney’s fees are usually only a fraction of the benefits you receive; depending on the amount of your past due benefits, it can be a very small fraction.
3. What is my case worth if I win?
The answer to this question depends on a number of factors including…how long you have been disabled, when or if you will ever return to work, the amount of your monthly benefit and whether you have eligible dependents.
For example, if you are 45 years old, your monthly benefit amount is $1,000, and you do not return to work before age 65; your case can easily be worth $250,000! This amount does not include the value of the Medicare or Medicaid insurance you will be eligible for after being found disabled. As many of you know, the price of medical insurance in middle age, with pre-existing medical conditions, can be staggering and not affordable. This of course assumes that an insurance company is willing to insure you.
4. Why you increase your odds of winning your case if you hire a Disability Attorney
There are many reasons hiring an attorney can significantly increase the odds of winning your case. One significant reason is that disability attorneys understand the complicated laws and regulations that determine success or failure. Two questions I always ask potential clients are, “Do you know what you need to prove in order to win your case?” and “If you do not know, how are you going to go about proving it?
You should hire an attorney who specializes in Social Security disability law. Furthermore, I believe it is important to hire an attorney who has expertise in representing people with your type of diagnosis. It is important that your attorney believes in your case and that they can win it. I suggest you ask the attorney how much experience they have with your type of diagnosis and how often do they win? Any disability attorney should be willing to provide you with this information.
5. What an Attorney should do to increase the odds of winning your case
From the beginning, the attorney should set forth a strategy that you both of you should follow to win your case. It is critical to understand what is necessary to prove your case and how you will go about winning it. The sooner you know this, the sooner you can take steps to execute the strategy and thereby increase your odds of winning. Thus, you should consult with and hire an attorney either when you file your claim or as soon thereafter as possible.
Based on my experience in representing clients nationwide (remember Social Security is federal law and not state specific); literally none of them had a strategy or plan on how to win their case before they hired me. This is important because most of them were simply “doing whatever SSA told them to do” while their claim was being processed. This included seeing SSA’s doctors for an examination that often results in a denial of their claim.
It is important to understand that SSA is only obligated to investigate your case and is not charged with approving it. I am not suggesting that SSA denies every claim; I’m simply stating that my experience after having successfully represented many clients whose claims were previously denied by SSA because evidence was not obtained, not reviewed or SSA focused on what it wanted to in order to support a denial.
In conclusion, if you are contemplating filing a claim for SSA Disability benefits, I encourage you to consult with an attorney as soon as possible to help you understand the process. The consultation should not cost you anything except your time. By understanding the process and having a strategy, you will significantly increase your odds of winning your case.
Congressional and Social Security’s statistics do not lie – it is penny wise and pound foolish not to hire a disability attorney.
 November 16, 2001 CONGRESSIONAL RECORD, Testimony of Honorable Robert T. Matsui of California, regarding the Attorney Fee Payment System Improvement Act 2001.
 November 16, 2001 CONGRESSIONAL RECORD, Testimony of Honorable E. Clay Shaw of Florida, regarding the Attorney Fee Payment System Improvement Act 2001.