Why was my Social Security Disability Case Rejected by a Lawyer?
When a potential client contacts a Social Security disability law firm, either an attorney, their paralegal or a legal assistant will handle the "intake". An intake, is the process of vetting a case to determine if the attorney will ultimately take the case. You will be asked various questions such as your age, your medical condition and diagnosis, how frequently you see your doctors, whether you've been hospitalized for your condition, and whether you are still working. The law firm or lawyer will then determine if the case is worth taking. Experienced and well established attorneys or law firms may only take cases in which they feel confident they can win.
Here are some of the factors lawyers consider when they determine if they will take a disability case or not.
Your Medical Condition(s) and Diagnosis
Having a severe medical condition or diagnosis will certainly help an attorney decide if its worth taking a case. There are certain medical diagnosis that may deter a lawyer. Fibromyalgia is one of them. This is because fibromyalgia is a catch all diagnosis. Many doctors will diagnose a patient with this diagnosis if they cant identify the correct diagnosis for the pain a patient is having. Historically it's been difficult to receive benefits for fibromyalgia, however that doesnt mean you cannot win a fibromyalgia case. Although it is tough, SSA will look at rheumatology records to determine if you meet the criteria. Other diagnosis that attorney may avoid is anxiety and depression. Unless youve been hospitalized for mental health or have other additional medical diagnosis that should be considered, if the only diagnosis you suffer from is anxiety and depression, it will be difficult to win your case.
In addition, having medical records that list various medical conditions or diagnosis doesn't always give you a "slam dunk" case either. Claimants also think that by taking 10+ different medications that they should have an "easy" case, but that isnt going to convince Social security that youre disabled. Many claimants believe that the more medical conditions they list to the attorney, the more likely they will get a lawyer to take their case. Although numerous medical diagnosis can help your claim, its important that you are currently treating for all these medical conditions. For example, if you claim you have carpal tunnel syndrome, but the last time you saw a doctor for that medical condition was 7 yrs ago, that diagnosis isnt going to help your case now. So its important that if you are alleging a certain diagnosis that you also have more recent medical treatment to back it up.
How Frequently You Are Seeing Your Doctor
Its important that you are seeking current medical treatment. If the last time you saw a doctor was a few years ago and you havent seen a doctor since, it will be tougher for an attorney to take your case. This is because Social Security relies heavily on current medical documentation in deciding whether a claimant qualifies for disability benefits.
Frequent monthly visits to your doctors will give you the best chances of prevailing. If you only see a doctor once every 6 months, it will make it more difficult to prevail as the less frequent your doctor visits the more likely SSA will assume that your condition isnt disabling.
Whether You Are Working or Not
If you are currently working full time, this is a red flag for any attorney. This because you cannot work full time, earn full time wages and also collect social security disability. When you are applying for social security disability benefits, you are representing to SSA that you cannot maintain a full time job due to your medical conditions. So if you are working full time and earning full time wages, its contradicting to the very essence of social security disability benefits.
If you are working part time, you may however, be able to file for disability benefits if your earnings are under the SGA limit. SGA stands for substantial gainful activity. For the year 2020, you can earn up to $1350 per month gross pay and still file for social security disability benefits.
Whether You Meet SSA's Nonmedical Requirements for SSDI or SSI
Social Security Disability is more than just proving you are medical disabled. The other component that is very important and will be considered is if you meet the nonmedical requirements. For Social Security Disability Insurance, also known as SSDI benefits, you have to had worked 5 of the last 10 years full time and your date last insured, also known as DLI, has to be current or a date into the future. For example, if your DLI ran out 5 years ago, an attorney will likely not take your case. But if your DLI will expire a year from now, then an attorney can likely still take your case. For Supplemental Security Income, also known as SSI benefits, if you have significant income or assets, a lawyer likely cannot take your case. An income and asset test will be determined by the lawyer. If you meet the requirements of that test, then you can file for SSI but if the attorney determines that you are considered over resourced, they will likely reject your case.
Whether There Is Alcohol or Drug Abuse
Most attorneys will not take a case if there is an ongoing problem with substance abuse. This is because SSA sees substance abuse as a contributing factor only making your medical conditions worse. However, if you can prove that even without the use of substances, you would still have severe and major problems and that those medical problems would still be severely disabling even if you quit using drugs or alcohol, then you may still have a viable claim. Its best that a claimant is no longer using drugs or alcohol before they decide to file a claim though. SSA does frown on substance abuse.
Your Current Age
Age is a huge factor in determining if an attorney will take a case or not. Most disability lawyers prefer taking clients who are at least 50 plus years of age. This is because the likelihood of winning those cases are a lot higher. It can be quite difficult for most disability claimants under 50 to get approved for benefits, unless you have a very very severe and extreme medical condition. This because SSA believes that if you are younger, you have a better chance and many years ahead of you to get better. There are also medical vocational allowance rules, also known as GRID rules, that grant disability benefits to almost any claimant over the age of 50 who is even limited to a sit down work or sedentary position.
In short, for an attorney to take on a claimant who is under the age of 50, their medical condition must be very severe and debilitating. Lawyers may ask how frequently youve been hospitalized, if you are using a cane or walker, how many recent surgeries have you had. So as you can see, the attorneys may be more lenient if you are over 50 as opposed to under 50. That doesnt mean that a lawyer wont take your case if you are under age 50, it just means you have to be ready to prove you suffer a severe and extreme medical diagnosis to convince the attorney to take your case.