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Top 10 Guidelines for Paralegals Working in Social Security Disability Law

10 July 2011
 
Top 10 Guidelines for Paralegals Working in Social Security Disability Law
by Sami K. Hartsfield, ACPGenerously reprinted with permission by the Institute for Paralegal Education (IPE). This article came from the IPE monthly newsletter and you can subscribe by contacting them at ipefeedback@nbi-sems.com.
Social Security disability law is a particularly exciting area for paralegals to work in because it’s one of the very few areas where paralegals can actually represent the client in a hearing. Because the disability hearings are administrative in nature, and held before an Administrative Law Judge, paralegals may attend and act as the claimant’s representative during a hearing. Keep in mind, however, that the federal government can and will make the awarding of disability benefits a hard-earned task, especially given the current economic climate. Through preparation and skill sharpening, paralegals may successfully win disability benefits for clients who are truly disabled, a prospect that is incredibly fulfilling – both professionally and personally. Following are my top ten tips for paralegals wishing to assist those workers who have, unfortunately, become disabled due to injury or illness:

  1. Understanding the Difference Between SSDI and SSI
    Social Security disability under Title II is an “insurance” program (Social Security Disability Insurance, or SSDI), as juxtaposed to Social Security Supplemental Income Title XVI, which is a “welfare” program (SSI). The former is based on what a claimant has paid into the system over her working years in the form of payroll taxes; the latter is based on a lack of income and assets (it may still be possible to apply for both in some cases however.) Claimants must have worked a sufficient number of years to be eligible for SSDI benefits (usually equates to about five years of work during the last ten years prior to the disability).
  2. SSDI Claimants and the Contingency Fee Agreement
    Social Security disability claimants and their representatives typically enter into a contingency fee agreement, which pays 25% of back benefits – or up to a cap of $6000 – to the claimant’s representative. The payment comes directly from the Social Security Administration per the required agreement filed with the administration prior to representation.
  3. The Assumption of Access to Other Support Resources
    Social Security program rules assume that working families have access to other resources to provide support, including workers’ compensation, insurance, savings and investments; therefore, the battle to win disability benefits is an uphill one.
  4. Always Shore Up the Client’s Claims With Medical Records
    Examples include MRIs, blood work, prescription records, etc. (of particular import are treatment records). Request doctors to write detailed notes or letters wherever possible, detailing the claimant’s illness, level of pain, and inability to work. The evidence will make or break your claimant’s case. Additionally, be mindful of HIPAA and its implications. Make sure your medical authorization is HIPAA compliant (for example, full legal name, Social Security number, birthdate, date and type of service, reason for the request, expiration date of request, patient’s right to revoke all or some of the request, patient’s signature and notarization). Many medical records can or will be provided directly to the SSA, but make sure you have copies for your records as well (see the SSA’s HIPAA-compliant authorization Form SSA 827 – Authorization to Disclose Information to the SSA).
  5. Ask the Client for Medical Records and Related Information, and Ask the Client to Keep a Journal of Symptoms
    Request that the client bring in all his medical records he has available, including prescription pill bottles. Urge him to keep a daily journal of pain, medical problems, trouble sleeping, or side effects from medication, etc.
  6. Retrieving Medical Records
    Check to see if you can receive records on behalf of the client for free in your state, and whether or not there’s a time limit for healthcare providers to supply those records (under Texas statutory law, for example, medical records requested by someone applying for Social Security disability must be provided free within thirty days – see Texas Health and Safety Code Sec. 161.202 et seq.)
  7. Go Paperless!
    It’s now possible (and encouraged) to submit the client’s medical records and other pertinent information electronically through Social Security’s Electronic Records Express online system. You must register to be able to use this service. For more information on ERE, visit http://www.socialsecurity.gov/ere/.
  8. The Key to Winning Disability Cases, in Addition to Medical Evidence, Is Tenacity
    For the fiscal year 2008, only 36% of claimants were approved nationwide at the initial application level, and just 13.8% were approved at the Reconsideration level (Recon). After that, claimants can appeal one step further and request an administrative hearing before an Administrative Law Judge (ALJ). This is the stage where most applications will be approved, provided the case is made for the claimant. (There are two further appeals’ steps after this one – the Appeals Council Review and federal court, but most claims are approved, dropped or denied at or after the hearing stage.) So, the name of the game is to keep appealing, and prevail at the hearing stage.
  9. Paralegals MAY Represent Claimants in SSDI Cases
    Because the Social Security Administration hearings are quasi-tribunal in nature, this is one area where paralegals may represent claimants at the actual hearing! (They are also closed-door hearings.)
  10. The Role of Experts in the SSDI Hearing
    The hearing will likely be attended by a Vocational Expert (VE) and may also include a testifying Medical Expert (ME). These professionals are not adversaries per se, but are there to testify as to the claimant’s ability to perhaps do other, alternative jobs the claimant might be unaccustomed to (the VE), or about the claimant’s medical condition, prognosis, and remaining functional capacity to work at all (via the ME based on the medical records provided ).
 Please see the “Quick Tips” article in this series.
Sami K. Hartsfield, ACP, is an insurance defense paralegal and freelance writer in Houston, Texas. She conducts medical, legal and factual research, investigations, and client interviews. Ms. Hartsfield prepares all manner of legal documents, including pleadings, witness lists and exhibits, trial notebooks, demand and settlement documents, and deposition schedules and summaries. She also coordinates and manages document production, locates and interviews witnesses and experts, and organizes pleading and trial exhibits. Ms. Hartsfield assists lawyers at trial, gathers and reviews medical records, and maintains general client contact. She recently worked as a Webmaster for a personal injury law firm in the Houston area, and started their social media marketing efforts. Ms. Hartsfield earned her AAS degree from the Center for Advanced Legal Studies and will graduate with a B.S. degree, summa cum laude, from the University of Houston Downtown later this year. She is a member of the National Association of Legal Assistants, the American Association of Notaries, and the Electric Data Extraction Network.

Institute for Paralegal Education • 1218 McCann Drive • Altoona, WI 54720 • © 2011, Institute for Paralegal Education, a division of NBI, Inc. All Rights Reserved.

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