FAQ - Robert M. Crites & Associates
Robert M. Crites & Associates
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Robert M. Crites
Attorney at Law
Robert M. Crites & Associates
You Have Questions...
...We Have Answers
Robert M. Crites & Associates
Over 25 Years Experience
Free Consultation
(810) 252-9185
Robert Crites & Associates
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SOCIAL SECURITY DISABILITY CLAIMS
“HOW THE SYSTEM WORKS”
FREQUENTLY ASKED QUESTIONS:
1. Question: If I become disabled, what do I have to do to receive Social Security Benefits (such as monthly payments, or Medicare or Medicaid?)
Answer: You have to apply to the Social Security Administration for those benefits.
2. Question: Where can I make application for Social Security Benefits?
Answer: You can apply on line (if you can use a computer and have access to the internet) or you can go to a local Social Security Office and make application. Flint has two offices: 1149 Robert T. Longway, Flint, MI 48503 and 2021 West Carpenter Road, Flint, MI 48505. Phone (888)318-7282 or (888)320-0961 Web site: www.ssa.gov
3. Question: What information do I need to supply to the Social Security Administration when I apply for benefits?
Answer: You must have identification that proves who you are and your date of birth, your Social Security Card (or at least your social security number) a list of any doctors, hospitals or other medical facilities with whom or at which you have treated within the last few years as well as a list of your employers within the last fifteen years and be able to describe in general terms, the type of work you did for each employer.
4. Question: What happens after I make application and supply the information to the Social Security Administration?
Answer: The Social Security Administration (SSA) will obtain, review and analyze the medical evidence, along with the information which you supplied to them, (hospital records, test results, treatment records etc), and then either grant or deny benefits. That process usually takes three to four months.
5. Question: What should I do if I am denied benefits?
Answer: You have two choices if you are denied benefits by the Social Security Administration after you make your initial application: (1) Submit a second application (i.e. start over) or (2) File an Appeal of the denial. In almost every case, it is advisable to appeal the denial because a very large percentage of the denials are over-turned on Appeal and people do get benefits after a hearing before an Administrative Law Judge. Reapplying usually results in another denial.
6. Question: If my application for benefits is denied and I want to Appeal, what do I have to do?
Answer: After notification of the denial, you have 60 days to file your Appeal. The various forms needed to file the Appeal are available from the Social Security Administration.
In addition, the attorneys who handle Social Security Disability Cases have the complete Appeal Package and if you contact an attorney to handle your appeal, that attorney will have you sign all the necessary forms and (with the information that you provide to him) will fill in and properly complete the forms and make sure that the entire package is delivered to the appropriate Social Security Office within the 60 days allowed.
7. Question: Should I have an attorney represent me when I Appeal my denial of benefits?
Answer: As you might expect, my answer to that question is yes, but I would like to add that there are several good reasons for saying so. First, it is not uncommon for people who have appealed their case on their own, to go for a hearing and have the Judge indicate to them that he believes they should hire an attorney to represent them. The effect is that if they choose to do so, the hearing is then postponed.
In addition, of course, people who apply for Social Security Disability Benefits or SSI Benefits are very often in rather desperate shape financially and it seems to me that it makes good sense for them to do everything possible to make sure that their case is presented in a forceful and effective manner. Keep in mind that they will owe the attorney nothing unless they win the Appeal.
Hiring an attorney who has spent years dealing with medical records and doctors, presenting proofs to various Judge(s) and handling Social Security Cases is the way to make sure that their case is presented in the most effective manner possible.
8. Question: How will having an Attorney help me win my Appeal?
Answer: Judges who decide Social Security claims, make their decisions on the basis of the law and the facts. The law and the regulations that the Judge applies are extremely complicated. The standards that a claimant has to meet at age 55 are different from the standards that he/she has to meet at age 50 and still other standards apply when that person is between the ages of 18 and 50. Whether the applicant is literate or illiterate also makes a difference. The claimant’s IQ is often a factor as well as his/her educational level and work history. Children often qualify on the basis of a completely different set of standards.
The point is, knowing what has to be proven in any given case, is very important and in approximately 98% of cases, the claimant really does not understand what he/she has to prove in order to be awarded Social Security Benefits.
In addition, Medical Records are extremely important in these cases and they can be voluminous. In many cases, there are hundreds of pages of medical records, all of them written in medical “jargon” and many of them illegible. (These records have to be analyzed and summarized) In addition, while it is true that the person seeking social security benefits has told the Social Security Administration about the medical treatment that he/she has received at the time of the application, very often there is an 18 to 24 month delay after the original denial but before the hearing date and during that time medical treatment has been ongoing and the medical records relating to that treatment are not in the file.
It is the attorney’s job to get those medical records into the Social Security file. It is also the attorney’s job to make sure that the pertinent parts of those medical records are found. In addition, it is the attorney’s job to spend a lot of time with the client and any witnesses he/she may have and to get them ready to testify.
The attorney will probably be familiar with the side effects of many medications and aware that in some cases lay testimony, i.e. friends or close relatives of the claimant, may give testimony that the claimant is not really capable of giving. This is often the case, when the person seeking Social Security Disability is disabled as the result of a mental condition, such as being bi-polar or schizophrenic, or has seizures. Therefore it is necessary for the attorney to interview the client in depth, find and interview any potential witnesses, correlate what the client/witness say with the medical records and then prepare a Brief which summarizes the testimony that the client will give, the testimony the lay witnesses will give and the medical evidence.
The attorney then, in that Brief, has to refer the Court to the specific section of the Federal Social Security Regulations which apply in that case and convince the Court that under those regulations, the Court should issue a Favorable Decision.
It is interesting to note that Administrative Law Judges have to decide over 500 cases a year and therefore they must decide, on average more than 2 cases a day. While they do have help in analyzing these cases, the fact is that the Attorney and his staff will typically spend (over a period of time) several days on a given case submitting all the medical records (which are filed electronically) into the file, interviewing the client and lay witnesses, writing briefs, and representing the client at hearing. All that work on the part of the attorney and his staff, often makes the difference between winning and losing an Appeal.
9. Question: What will I have to pay the Attorney to represent me?
Answer: Representation in Social Security Disability and SSI Appeals is almost always done on a contingent fee basis. That means that it costs absolutely nothing to be represented by an attorney (even if he spends money securing medical records) unless the Judge issues a Favorable Decision and grants benefits.
If the case is won, claimant will almost always have accrued benefits (back pay) coming. If an SSI appeal is granted, it usually goes back to the date of the original application and an SSD case can go back (effectively) 7 months before the original application date. The attorney’s Contingency Fee Agreement (which is approved by the Social Security Administration) states that the attorney will receive one-fourth of the accrued benefits (back pay) but no more than $6000.00. (Example-if claimant had back pay of $8000.00, the attorney would receive $2000.00; if claimant had back pay of $50,000.00, the attorney would receive $6000.00).
10. Question: How long will it take after I am denied benefits to get my Appeal heard?
Answer: The amount of time varies. The standard answer coming from the Social Security Administration is 18 to 22 months, however I have had cases which were heard within 6 to 12 months and in rare cases, the delay has been more than 24 months. There are exceptions; children’s cases are often heard more quickly. In addition, if the claimant has terminal illness (cancer, etc) the decision can be made on the basis of Medical Records alone (in almost all cases) and the client could be granted benefits rather quickly; within 30 days is not uncommon.
In addition, if the client is truly destitute and has no place to live, cannot afford food etc., a request for an accelerated hearing can be presented to the Office of Disability and Review (ODAR) and the hearing date can be accelerated.
This is not uncommon, however, remember that most people who apply for Social Security Disability or SSI Benefits are in some financial distress and they can’t all have their cases accelerated.
11. Question: Who hears my Appeal and decides whether I get Social Security Disability Benefits or SSI Benefits?
Answer: An Administrative Law Judge will hear your case. These are attorneys who have gone through special training and have been appointed as Judges by the Social Security Administration. There are five Judges at the local Office of Disability and Review (ODAR) and there are also several rooms with closed circuit televisions so that Judges from out of state, can hear local cases. If a claimant insists, he/she is entitled to have the Judge present (in person) however I have found no real advantage to insisting that Judges be personally present (in the same room). We have had great success with out of state Judges who conduct the hearing via closed circuit TV.
12. Question: What happens at a Hearing?
Answer: The hearings typically take place in a relatively small room. Present will be the Judge, the Claimant, the Claimant’s attorney, the Clerk and usually one or more expert witness.
These experts may include a doctor and almost always an employment expert who is familiar with all the jobs available in the state and/or nation and is also familiar with the qualifications for, and the physical and mental requirements of, those jobs.
At the time of the hearing, the Judge will have reviewed medical records and read the Brief submitted by the Attorney. The Claimant and any other witnesses (who are going to testify) will be put under oath and allowed to give their testimony. The Judge may do quite a bit of the questioning or in the alternative the Judge may ask a few questions and then turn the questioning over the attorney. After the testimony of all witnesses has been presented, the Judge may have some questions for the expert witnesses.
If there are medical issues involved, the Judge would question any doctor or PhD that is present, as to his opinion relative to the nature of the person’s mental or physical problem and the extent to which that problem would prevent the claimant from functioning normally. (For example, would it limit the claimant’s ability to lift, bend, stoop or interact with other people or work at an acceptable pace with persistence and concentration). The Judge will usually then present some hypothetical questions to the employment expert.
The employment expert will then tell the Judge what, if any, jobs the claimant could do if the Judge determines the claimant has a certain set of physical and/or mental limitations.
When the hearing has been completed and all relevant evidence submitted, the Judge will render an Opinion. That Opinion may be rendered on the hearing date from the bench, but more often the Judge takes the matter under advisement and issues a written opinion either a few days or a few weeks later.
Because we write very comprehensive Briefs, our experience is that the Judges quite often indicate from the bench, that based on the material(s) presented, they will find in our client’s favor, however that it certainly not always the case and sometimes the decisions are delayed.
13. Question: What factors should I consider when I decide to hire an Attorney to Appeal my Social Security Disability or SSI Claim?
Answer: My personal view is that since you need to spend quite a bit of time with whoever represents you, you should hire a local attorney. Local attorneys deal with a certain set of Judges and they have a pretty good idea of what these Judges are looking for when they decide a case.
In addition, I find that the face time that I spend with a client is very valuable as quite often it is the little things that win cases. You have to go through the client’s life in great detail to discover the small ways in which his/her impairment affects his/her ability to function.
14. Question: Why should I retain you to represent me?
Answer: I would like to give you several reasons however I can sum it all up simply by saying that I and my staff do good work and we have a lot of very satisfied clients to prove it.
15. Question: If I win, how will I get paid?
Answer: If you win your Appeal , you will be contacted by the Social Security Administration and will be asked to set up a bank account. Almost all payments are made into these accounts, electronically and the payments are made once a month. Only rarely are Social Security checks mailed out any more.
16. Question: How does the Attorney get paid?
Answer: The Attorney Fee Agreement is approved by the Social Security Administrative Law Judge. The attorney (as I said before) is paid out of past-due benefits and that money is automatically deposited into the attorney’s account.
17. Question: Can I have a job and still draw Social Security Benefits?
Answer: Yes, you can work and still draw Social Security Benefits. Earned income always has to be reported to the Social Security Administration but it does not necessarily result in the loss of benefits. If a person is on Social Security Disability (SSD) that person can work for a nine (9) month period (called a trial work period) and make any amount of money and still draw full Social Security Benefits.
That person can also work and make less than a certain limit (approximately $1000.00 a month-in 2010) and still be entitled to benefits, and that can be done for an indefinite period of time. If a person is on SSI and works, there is an offset from earnings that is approximately two to one; that is $2.00 of earnings results in $1.00 of loss of SSI Benefits.
18. Question: If I own a lot of property and have a lot of money, can I still draw Social Security Benefits?
Answer: The amount of money you have in the bank and/or the amount of property that you own has no effect whatsoever on the amount of Social Security Disability Benefits you can draw. The only question to be determined is whether or not you are disabled from employment and interest on bank accounts, stock dividends or any unearned income does not affect your right to draw Social Security Disability Benefits. SSI however, is a welfare program and if you have more than a certain amount by way of assets ( money in the bank or a car worth more than a certain amount of money) you will be denied SSI Benefits. In addition, non wage income is set off on a dollar for dollar basis.
19. Question: Once I win my case and start receiving payments, do payments ever stop even though I don’t go back to work?
Answer: Yes, the Social Security Administration periodically reviews cases and in the event they decide to review your case, they will send you to one or more of their doctors who will determine whether there has been a change in your physical or mental condition and report their findings to the Social Security Administration. In the event that your condition at the time of the review is such that you are capable of working, the Social Security Administration will terminate benefits.
You have the right to Appeal that decision and in fact if you notify the Social Security Administration (within 10 days of the notice that they intend to stop payment) of your intent to appeal, those benefits will continue until you can have a hearing on the matter.
If at the hearing, it is determined that your benefits will be terminated, you may vey well be in a position where you have received over-payment and the Social Security Administration will of course collect that over payment from you and if you again go on Social Security Disability, or SSI, your benefits would be reduced until the over payment was paid back.
20. Question: If I have questions about Social Security Disability or SSI, can I call you for information or make an appointment and see you in your office?
Answer: Yes, I will be happy to talk with you, either on the phone or in person. There will be no charge.
Robert M. Crites
Attorney at Law
FREE CONSULTATION
NO CHARGE UNLESS WE ACCEPT YOUR CASE AND WIN IT
FLINT OFFICE
1030 S. Grand Traverse
Flint, MI 48502
OFFICE HOURS
Mon-Fri 9am-12pm & 1:30pm-5pm
(810)252-9185
E-Mail: criteslaw@sbcglobal.net
SWARTZ CREEK OFFICE
9001 Miller Road
Swartz Creek, MI 48473
OFFICE HOURS
Tues & Thurs 7:30pm-9pm