Social Security Disability Revealed by Spencer Bishins

Author:Spencer Bishins
Language: eng
Format: epub
Tags: Social Security Disability Benefits, Social Security Disability Appeal, Social Security Claim, SSDI, How to get disability, How to win my disability claim, Social Security Disability, Disability Rights, Social Security Administration, Social Security Reform, Why my disability claim was denied, how to hire a disability representative, What do I need for a disability claim, Evidence for disability, how disability works, Title 2, Title 16, SSI, Sequential Evaluation Process, Trial work period, universal basic income
Publisher: Bishins Publishing
Published: 2022-07-04T00:00:00+00:00

20. The Appeals Process

If the decision is fully favorable, the claimant will be happy. The claimant will be getting all the benefits to which the claimant is entitled. However, even after a fully favorable decision, the claimant will need to wait 60 days before benefits can start. This is also when the claimant’s representative will be paid. The claimant may also get a lump sum amount of past due benefits for the time when the claimant was disabled but was not receiving benefits because the case was in process. The representative’s fee comes out of these past due benefits only, and remember it is capped at 25% or $6,000 (increasing to $7,200 in November 2022), whichever is smaller.

Alright, now for the unpleasant part. What happens when the decision is not fully favorable to the claimant? If the decision is unfavorable, moving forward is easy: you appeal. Even if you think you have no grounds to appeal, you and your representative find the one or two best arguments and you assert them as best you can. The Judges and Attorney Advisor decision writers move very quickly, and as hard as they try, there are always gaps in the work. Medical opinions are not analyzed as thoroughly as they could be, the claimant’s allegations may be misconstrued, or perhaps the Judge completely missed an opinion, or an imaging study, or a blood test.

Something, anything, can work for an appeal. You have nothing to lose. You might as well try and see if maybe you can get something to stick. If you have a qualified representative, that person will usually handle the appeal to the Appeals Council. The representative can submit a list of specific errors for the Appeals Council to consider (called contentions), but the attorneys who review the decision at the Appeals Council will also review the decision and the evidence even without contentions, and often they find errors that you and your representative did not even know about.

Clearly, no one wants to receive an unfavorable decision. Almost all representatives will appeal those, because doing so requires nothing more than a one page form saying the claimant disagrees with the decision. Some representatives will also submit contentions. It’s a good idea to ask the representative, before signing a fee agreement with them, how they will handle an appeal in case it comes to that. This is something you will want to know ahead of time.

Even though you hope for a favorable decision the first time around, you want to be prepared for an unfavorable decision, so if that should occur, you and the representative are on the same page with the appeal strategy. You want to know whether the representative will file only the one page form and move on to the next case, assuming your case is a loser and that it isn’t worth the additional time or effort. But you also want to know if the representative believes in your case enough to spend additional time on an appeal by writing a list of contentions for the Appeals Council to review and consider.

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