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Is it necessary to have an attorney to pursue a Social Security Disability or SSI Claim?

There is no requirement that a claimant be represented in the process, but statistics show that claimants who are represented are more likely to win their claims. Our attorneys help with all aspects of the claim, including completing paperwork, filing appeals, and talking to Social Security. We know what it takes to win a case, and work to make sure that all necessary evidence gets into Social Security's file. Before the hearing the attorney meets with the client two to three times to prepare him or her for the hearing, and writes a pre-hearing brief to the Judge. At the hearing, we advocate for our client, including cross-examining the experts who testify at the hearing. If the hearing is successful we work to make sure that our clients are paid quickly and accurately. If the claim goes to the Appeals Council, our attorneys file a brief, and represent you at the remanded hearing if the case is sent back to the Judge.

How much does the Law Office of Elizabeth Gade charge?

The standard fee charged by all attorneys in a Social Security Disability case is 25% of the client's retroactive benefits, not to exceed $6,000. The fee is contingent: if our attorneys do not win the case, the client does not owe a fee. The claimant will also reimburse the office for any out of pocket expenses incurred for obtaining medical evidence, including copying medical records. No attorney is allowed to charge a fee unless that fee is first approved by Social Security. There is no charge for the initial consultation, even if the claimant decides not to hire us.

What is the difference between Social Security Disability Insurance and SSI?

The definition of medical disability for both types of benefits is the same. Generally, a claimant applies for both types of benefits at the same time. The difference is what makes a claimant financially eligible for either program. Social Security Disability Insurance (SSDI) benefits are paid to claimants who have paid a sufficient amount of Social Security taxes out of their wages over a certain period of time. If the claimant is found medically disabled, the amount of monthly benefits is determined by how much money the claimant has paid into the system over his or her working career. Dependent children of eligible claimants are sometimes eligible for benefits as well. Benefits are also sometimes available to the widow or widower of a person who paid a sufficient amount of money into the system before he or she passed away. Supplemental Security Income (SSI) benefits do not depend on how much a claimant has paid into the system. Instead, these benefits are available to people who have been found medically disabled and have income and resources below a certain level. It is possible to receive some amount of benefits from both SSI and SSDI.

What medical benefits are available to people eligible for SSI or SSDI?

If a person receives Social Security Disability Insurance they will be eligible for Medi-Care. A person who receives SSI will be eligible for Medi-Cal, which is California's name for Medicaid. If a person receives both SSDI and SSI benefits, they will receive both Medi-Care and Medi-Cal/Medicaid.

What is Social Security's Definition of Disability?

The Social Security Act defines "disability" as: "[the] inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." In making a disability determination, Social Security uses a five-step assessment known as the "sequential evaluation."

At Step-1, the claimant must show that he or she is not currently working. Social Security has specific rules for evaluating work activity and earnings to determine if that activity will preclude eligibility for benefits.

At Step-2, the claimant must establish that he or she has a "severe impairment." Social Security defines an impairment as "severe" if it significantly limits a person's physical or mental abilities to do basic physical and/or mental work activities such as: standing, lifting, pushing, pulling, reaching, seeing, hearing, speaking, using judgment, following simple instructions, responding appropriately to supervisors and coworkers, and dealing with changes in a routine work setting. A claim can be denied as "non-severe" if the evidence shows only a "slight abnormality."

At Step-3, Social Security reviews the claimant's medical signs and symptoms to determine whether his or her condition automatically meets the criteria of disability for that claimant's specific impairments. These criteria are known as "the Listings." The Listings have detailed requirements corresponding to certain types of medical conditions. If each of those requirements is met or "equaled," disability is automatically established. Even if the claimant's condition is determined not to meet or equal a Listing, the evaluation continues.

At Step-4, Social Security determines whether the claimant can return to his or her "past relevant work." In order to qualify as past relevant work, the job must have lasted long enough for the claimant to learn how to do it, have been performed at the substantial gainful activity level (the same standard used at Step-1) and performed in the previous fifteen years. If the claimant can do that work, the inquiry ends and he or she is found not to be disabled.

If the claimant is unable to perform his or her past relevant work, Social Security must proceed to Step-5 and determine whether there are other jobs which exist in significant numbers in the national economy the claimant can still perform in spite of the impairments. Sometimes, this determination is made based on application of Social Security's rules. Other times, this determination requires the Judge to consult with a "vocational expert" who will appear and testify at the hearing.