The Role of the Representative

If you are applying for disability benefits under the Social Security Administration (SSA), then you may be wondering whether you need representation to assist you with your claim. Although there is no requirement that you be represented (with the exception of an appeal to the federal court), it may be in your best interest to enlist the services of an attorney or qualified representative, particularly if your claim reaches the hearing level.

There are four “levels” of a Social Security disability claim: the initial application, the reconsideration appeal, the hearing in front of an administrative law judge (ALJ), and the appeal to federal court. The initial application and reconsideration appeal involve forms that can be completed online. While you may feel comfortable in your ability to fill out online forms, hiring a disability attorney or non-attorney representative during these stages will increase your chances of approval in the long run because he or she will make sure your forms are filled out timely and correctly, and that your case is properly developed.

Statistically, your chances of being approved at the initial and reconsideration levels are low, regardless of whether you have representation. For this reason, your claim, likely, will need to go to a hearing in front of an ALJ before you can hope to receive disability benefits. At a Social Security disability hearing, an ALJ will hear your case in a court of law, and make a decision based on your testimony as well as your records.

What does a representative do?

The primary function of a disability attorney or non-attorney representative is to act as a liaison between you and the SSA. After being notified that you have named a representative, the SSA must provide copies to your representative of all correspondence sent to you as the claimant. In addition, the SSA must ask your representative’s permission before speaking directly with you. This is to protect your interests.

Your representative’s main objective is to win your claim. Initially, your representative will conduct an interview with you and check your eligibility for Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), or both. He or she then will review the evidence in your file to understand why your claim has been denied, if it has. Your representative will gather your medical records, as well as medical support statements from your treating physicians, mental health professionals, and other service providers. He or she also will collect information on your work history and educational background and prepare an argument that will provide the best chance of success. Periodic status updates will be requested from the SSA and development of your claim will continue until a decision has been made.

The best opportunity for being awarded disability benefits is by presenting before an ALJ at a hearing. At your hearing, your representative will present your case to the presiding judge, and cross examine any medical and/or vocational experts who have been called to testify. Having a disability representative with you at your hearing really can help win your claim.

If your claim is denied at the hearing level, you can start a new claim or appeal the decision to the federal appeals court. However, before your claim can be heard in the appeals court, it must be determined that a technical error or error of law was made in the ALJ decision. Your representative can help you make that determination.