Attorney fees in Social Security Disability and SSI cases
are covered by statute and regulation. Any fees are subject to review by the
Social Security Administration. In order to represent a claimant, an attorney
must submit an Appointment of
Representative form 1696, signed by claimant and attorney, after when the
claimant appoints the attorney to represent him or her, and the attorney
agrees to represent the claimant. In addition, in almost all cases, a fee
agreement is signed, pursuant to the guidelines of the Social Security Act and
regulations of the Social Security Administration.
There is a maximum attorney fee, set by the Social Security Administration. If the claim is allowed at the initial stages or at hearing, the maximum is $6,000.00, effective June 22, 2009. That maximum is set by regulation by the Social Security Administration.
Several years ago, in a case entitled, Gisbrecht
v. Barnhart, the United States Supreme Court, by an 8-1 vote, allowed
attorneys broader recovery of attorney fees in cases which had been appealed to
Court and sent back. Before that time, the Social Security Administration had argued that fees should be limited to the number of hours worked, even though the claimant signed an attorney fee agreement allowing fees of one-fourth of all back benefits, where the claimant had gone through more than one hearing. The United States Supreme Court decided that it was fair to follow the agreement of the parties. However, the Court cautioned any lower Courts that they are still to oversee attorney fees, to make sure that they are fair.
This particular page is for the use of physicians, who may be looking into the Social Security Disability system, either when they are considering performing examinations for the Disability Determination Services Bureau, or when a patient has asked them about a disability claim.
Doctors can contract with the Disability Determination Services Bureau (DDS) to perform examinations, particularly of their own patients. Click here to access information as to how doctors can examine patients for DDS.
While a statement by a doctor that a particular patient just can't work might be helpful, the Social Security Administration jealously guards its authority. The DDS will be more likely to defer to your medical judgment that your patient is restricted in specific physical tasks, backed by medical tests or findings on examination. Click here for a printable form, in Adobe Acrobat format, detailing information such as:
If a claim is denied at the initial stage, the claimant has the choice of filing a new claim, or filing a request for reconsideration within 60 days of the initial denial. Asking for reconsideration is almost always the best option.
The reconsideration stage will usually take 60 days, and usually a lot more than that. If a disabled worker is denied, he or she should contact an attorney immediately about representation, before filing a Request for Hearing. Just to the right of this article is a link to email the law office of H. Edwin Detlie. Please include name, address, telephone number, Social Security number and date of the Reconsideration decision. You need to make sure that you file a Request for Hearing yourself, within 60 days of the Notice of Reconsideration. The forms for doing that are listed above.
Contacting the office of H. Edwin Detlie does not mean that he will agree to represent you. He will want to review your disability file to determine if you have a reasonable chance on appeal, and what further information it will take to make sure that you have the best chance at hearing.
The Social Security Administration may reduce or eliminate potential Social Security Disability benefits if the same person has settled a work injury claim. This is a complex area, and anyone with questions should contact an attorney who is well-experienced in Iowa workers' compensation law and the impact of settlements on potential Social Security Disability benefits.
For an outline of a presentation on the ways that worker's compensation settlements may reduce the award of Social Security Disability benefits, and the ways to reduce or eliminate that impact, click here. However, the legal impact of any such settlement should only be made upon consultation with an attorney experienced in Iowa workers' compensation law and the possible impact of a worker's compensation settlement.
>>Social Security Office in Ottumwa Moves on 1/1/2010<<
On January 1, 2010, the Social Security office in Ottumwa moved to a new building, at 2429 Northgate Street, Suite A, just South of the North McDonald's in Ottumwa. The North side of the building, Suite B, is specifically for hearings, both in-person and videoconference hearings before Administrative Law Judges.
Claims that are denied at reconsideration are appealed to the Office of Disability Adjudication and Review, by filing a Request for Hearing.
When they reach the Office of Disability Adjudication and Review, claims for Social Security Disability are screened, to see if there are cases that can be allowed without hearing. That happens in a significant number of cases, and where a Fully Favorable Decision is possible, no hearing is necessary. In some of those cases, the claimant's attorney has obtained crucial records or an opinion from a treating doctor, which clarifies the case so that benefits can be allowed without hearing. An attorney who is knowledgeable in Social Security Disability will review your case, to determine if you are a candidate for a Fully Favorable Decision, and to determine what additional evidence may help to get a favorable decision without waiting. Very often, despite the attorney's best efforts, it is not possible to get a Fully Favorable Decision. It may depend on the Administrative Law Judge or office policy.
If a hearing is scheduled in Iowa, it is usually by videoconference. They work quite well, and have very few problems. Few other States have videoconference hearings, partly because Iowa set up a fiberoptic network over which videoconferences can be held. The videoconference has two major positive effects. First, since it drastically cuts the travel time for the Social Security Administration's Administrative Law Judges, who have offices in West Des Moines, it allows them to have more hearings in less time. That helps to keep the backlog of cases down, and means faster hearings for claimants. Second, many claimants feel intimidated in the presence of the Administrative Law Judge, and are more comfortable with the video connection.
When the hearing is scheduled, a vocational expert is almost always called as a witness, and occasionally a medical advisor will be called. The vocational experts are almost always people with a good deal of traning and experience in evaluating and placing injured workers, and they have traning and experience in the hearing process. Claimants' attorneys worked hard for years to have vocational experts included in hearings, and more often than not, they help claimants' cases more than they hurt them.
The Administrative Law Judge will have read the medical evidence before the hearing, and if the claimant is represented by an experienced attorney, the ALJ will listen to the claimant's testimony. Sometimes there will be further questioning by the ALJ, to clarify issues. Then the ALJ will ask questions of the vocational expert, including obtaining a written summary of the claimant's past work over the last 15 years. Then the ALJ will ask the vocational expert what jobs would be available to the claimant under a particular set of restrictions. That question, usually referred to as a "hypothetical," will be fairly detailed. After the vocational expert has answered, the ALJ may ask a second and perhaps additional hypotheticals. People often want to predict the outcome of the case based on the vocational expert's answer to a second or third hypothetical, but that is usually not very accurate. Depending on the restrictions that the ALJ actually finds apply in the case, the ALJ may allow benefits, deny benefits, or decide that the person became more restricted at a certain point, and allow benefits only back to that point.
Decision
It usually takes four to eight weeks, sometimes longer, to receive a decision, and the claimant and attorney's copies will be mailed at the same time. If the decision is favorable, there are often other programs which are available only to persons with favorable decisions, and the claimant should look into those. H. Edwin Detlie's office sends out a brochure, developed over the years, entitled, "Favorable Decision Checklist," to clients whose claim has been allowed.
If the decision is unfavorable or partially favorable, claimants have the option of filing a new claim, appealing to the Appeals Council in Virginia, or both. The claimant has 60 days from the receipt of the decision, which is assumed to be 5 days, to file a Request for Review of Hearing Decision/Order . Persons who have not had an attorney at the hearing level may find it hard to find a lawyer to represent them at the Appeals Council, since the attorney cannot find much of the information in the 60 day appeal period. He or she may or may not be able to look at the medical records, but it will not be possible to review the testimony of the claimant or of the vocational expert.
Many people who offer free advice will tell you that a claimant cannot file a new claim and appeal to the Appeals Council at the same time. They are wrong. That is a very common missconception, and free advice like that has caused a great deal of hardship. There are a lot of people who think that they know the system, who have very little information, often outdated, and they tend to do more harm than good. They usually do so out of good intentions, including telling people to lie to the Social Security Administration. Not only will that harm your claim, it also exposes you to charges of fraud and perjury. You could go to jail if you rely on advice like that.
The Social Security Act requires that Social Security Disability benefits be paid where an individual is not able to perform work which exists in significant numbers in the national economy. The law treats persons who are 55 and over in a different way than those 54 and under. In many ways, they have two different standards of eligibility. The SSI medical eligibility standards are virtually the same as the standards for applicants for Social Security Disability, although SSI claimants also have income eligibility requirements that don't apply to Social Security Disability claims.
Persons who report income and pay Social Security taxes on those wages are treated as if they had paid insurance premiums to be covered under the Social Security Disability Insurance system. Of course, you can't choose not to pay those premiums in most cases. The longer you pay the Social Security tax on wages, the longer you are considered "insured" for the purpose of applying for Social Security Disability benefits. In order for you to be eligible for Social Security Disability benefits, the Social Security Administration has to find that you became disabled while you were still insured.
In a claim for Social Security Disability or SSI, it is necessary to file an application with a Social Security office. That can also be done by telephone, but most experience with the Social Security Administration's toll-free number has been pretty disappointing, and a lot of people have received bad information by calling that number.
To download a brochure prepared by the Social Security Administration to help in preparing to file a Social Security Disability claim, click here. To connect with the Social Security Administration's website to file an application for adult Social Security Disability, click here. For a child's application for Social Security Disability, click here. To complete the online Adult Disability Report, which is required to file a claim, click here.
More information
For more information, including a number of Frequently Asked Questions, go to the website of the National Organization of Social Security Claimants' Representatives by clicking here.
Contact Details
H. Edwin Detlie Attorney at Law
Ottumwa Office:
303 East Second Street Ottumwa, IA 52501-3001
Tel: 641-682-8119 or 800-747-8119 fax 641-682-8110
To place a free call to H. Edwin Detlie's office, click the phone image above, then type your name on the top line and your telephone number on the second line. Click Connect and your telephone will ring shortly - at no cost to you.
