UNDERSTANDING SOCIAL SECURITY: Are Disability Claims Lawyer-Driven

BY MICHAEL P. BOYLE, ESQ./ The recent NPR series, “Unfit for Work: The Startling Rise of Disability in America” (see http://apps.npr.org/unfit-for-work/), mentioned what it termed “The Disability-Industrial Complex”.

The story’s clear suggestion is that lawyers looking for clients are to blame for the rise in people obtaining disability benefits. This is complete nonsense and is not based on any factual analysis.

To the contrary, a lawyer experienced in handling disability and SSI benefits will carefully screen potential clients and will proceed to hearing only with cases in which the medical evidence provides a reasonable chance of winning. The bottom line is that we only get paid if we win. This is a powerful incentive to avoid taking on weak or undeserving claims.

The NPR story states no lawyer represents SSA at the hearing. This is by design. Hearings are meant to be informal. The ALJ’s responsibility is to weigh the medical evidence and claimant testimony and decide if the evidence is legally sufficient to justify a finding of disability.

Assigning a lawyer to represent the government in each claim would be very expensive and cause even longer delays in claimants obtaining hearings and ALJs issuing decisions. There are about 30 ALJs who sit in three local hearing offices (two in Center City, one in Elkins Park). Assigning a lawyer to every courtroom would cost a minimum of $50,000 per year in salary and benefits, and require additional personnel to obtain and review medical evidence and perform other supporting tasks. That adds up to at least $1.5 million in added costs, just in the Philadelphia hearing offices. Implementing this nationally would require hundreds of millions in extra costs for an agency that is already significantly underfunded.

If a case proceeds to a federal court appeal, SSA employs attorneys to review and defend every case filed. This provides sufficient protection to the taxpayers. Adding lawyers to defend each case at the hearing level thus serves no useful purpose.

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