There will be a video of the presentation available to watch, if you belong to the PDXFibro/CFS Ning community.  Cheryl also provides printable versions of her materials on her website, including the brochure she handed out at the meeting, and welcomes any questions here on the blog or to her directly.

There are two big concerns that sometimes become walls blocking us from considering applying for disability .  One worry is “How much will it cost me?” and the other is “Who should I get to represent me?“  Sometimes, these two questions can play off of each other, with the question of cost determining our decision about representation.  Local attorney, Cheryl Coon, offers us a quick summary targeting both of these questions.

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How do Social Security Representatives (Attorneys and non-Attorneys) get Paid?

When clients come to see me about their case, the first question is usually “Do I have a good case?”  The second question is “What will you charge to help me?”

The easiest question is, of course, the second one.  (Evaluating the strength of a case is a complex process that includes a claimant’s age, education, past work, and general credibility (which includes alcohol and drug use, criminal record).  Then there are the factors beyond the claimant himself – which judge is assigned to hear the case.)  Today’s column explores the myths about how representatives (reps), both attorney and non-attorney get paid.

Myth #1:  Only some attorneys and non-attorney reps offer to represent you for free until or unless you win.

Under the Social Security law and regulations, no-one can charge you for helping you with your case without first getting their fee approved by the Social Security Administration.

Myth #2:  Even if I lose, my attorney/non-attorney rep can charge me a lot of money.

What you pay depends on the agreement you made with your attorney/non-attorney rep.  Although it is widely believed that you can only be charged if you lose, in fact, neither the Social Security law nor the regulations say this.  As a practical matter, I do not know any attorneys who charge if they are unsuccessful in winning your case.  You can and will be asked to pay out-of-pocket expenses such as postage or the costs of a medical consultation, regardless of the outcome.

Myth #3:  Attorneys and non-Attorney reps get paid 25% of back benefits.

Attorneys and non-Attorney reps do get paid out of back benefits, but it’s the lesser of 25% or $6000.  The cap of $6000 always applies.  In a typical case, the fee is usually closer to $3000 or less.  In an SSI case, where the monthly amount is currently $674, a year of back benefits will result in a fee of $2000.

Myth #4:  Non-attorney reps charge less than Attorneys.

The law allows both attorneys and non-attorneys to charge the same amount.

Myth #5:  Anyone can be a non-attorney representative.

In order to insure the best possible representation, the Social Security Administration recently changed its rules for direct payment of non-attorney reps (a person can represent another without getting direct payment but it’s a powerful inducement to comply with the rules).

The law requires that non-attorney reps must:

• possess a bachelor’s degree from an accredited institution or possess equivalent qualifications;
• pass a written examination administered by the Social Security Administration, which tests knowledge of the relevant provisions of the Social Security Act and the most recent developments in agency and court decisions;
• obtain professional liability insurance sufficient to protect claimants in case of malpractice;
• pass a criminal background check; and
• complete continuing education courses.   (Effective August 29, 2011)

Myth #6:  You don’t need to understand how to do a federal court appeal in order to represent a social security disability claimant.

The Social Security disability process has multiple levels of administrative appeals, culminating in a hearing.  If you don’t win at hearing, all is not lost.  There is one more level of appeal, known as the Appeals Council.  After that, a claimant still has the option of going to federal district court to appeal.

Social security disability appeals to federal district court are common.  Many claimants succeed here who did not get favorable results at hearing.  Only attorneys are allowed to handle federal district court appeals.

A successful federal district court appeal depends upon the record that was created during the other levels of appeal, including: evidence submitted, examination of the claimant, cross-examination of the medical and vocational experts, and briefs.  So, while you don’t have to understand how to do a federal court appeal, it helps to have a representative who does, because he or she will approach the hearing record with that in mind right from the beginning.  Moreover, many attorneys will not bring district court appeals for claimants whom they did not represent during the hearings process, so it can be hard to find an attorney at that stage of the process.

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Cheryl Coon exclusively focuses her law practice on social security disability at all stages of the process, representing clients from Eugene, Oregon to Vancouver, Washington. She can be reached at ccoon@stc-law.com. Her law firm, Swanson Thomas and Coon, can be found at www.stc-law.com.  Cheryl’s blog offers case studies called “Can This Case Be Won” and I encourage you to read more about how this challenging process evolves.

Another resource Cheryl invites you to check into is the Ticket To Work Program , which works with the disability program incorporating employment opportunities without adversely affecting your disability rights.

Have you ever wondered how a lawyer analyzes a social security disability case and figures out whether a case can be won ?  How do the facts in a particular case add up — or not — to a winning case? 

I decided to create a column dedicated to sharing an inside look at how a lawyer takes the facts of an individual case and works with them to shape a winning argument for disability benefits.  In my column, I draw on my own cases with names and other facts changed to protect privacy to help explain how it works.  I call my column “Can This Case be Won?” because I believe that stories, especially those based on a true case, are the best way to help non-lawyers understand the legal process.  Let me know what you think!  And check it out at my social security disability blog .

Warm regards,

Cheryl

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Cheryl Coon exclusively focuses her law practice on social security disability at all stages of the process, representing clients from Eugene, Oregon to Vancouver, Washington. She can be reached at ccoon@stc-law.com. Her law firm, Swanson Thomas and Coon, can be found at www.stc-law.com.

(a) elderly

(b) undeserving

(c) disabled for life; and/or

(d) taking advantage of the system

Our social security disability clients are young and old, wealthy and homeless. And their “impairments” – the word that Social Security uses – include: Fibromyalgia, Parkinson’s, anxiety and depression, ischemic heart disease, degenerative disc disease, Lupus, cancer, asthma, chronic pulmonary obstructive disease, schizophrenia, bipolar disorder, traumatic brain injury, HIV/AIDS and interstitial cystitis, to name just a few.

I’ve never met a client who would rather receive disability benefits than feel healthy and be able to work ! Many of my clients could and probably will do some kind of part-time work eventually. Very few of my clients could be described as elderly.

But unfortunately, the labels I described above discourage many people from even applying for disability benefits and that’s a shame. It’s a shame because disability benefits can serve as a bridge to carry a person from one phase of his or her life to the next phase. If you’ve been diagnosed with a chronic illness and it’s reached a stage where you cannot work at your occupation right now, at least not on a full-time basis, disability benefits can help you through to another phase you may well reach – a time when you discover other interests and skills that fit better with the reality of your illness and allow you to return to work.

If you’ve been injured and it’s lasted more than a year and shows no sign of getting better soon, disability benefits can help you through difficult times until you’re able to resume your past or new work. And yes, in some cases, when you are not likely to ever return to work, disability benefits are your right.

Consider this – President Harry Truman, no bleeding-heart liberal, said of Social Security disability:

“It has long been recognized as an inescapable obligation of a democratic society to provide for every individual some measure of basic protection from hardship and want caused by factors beyond his control.”

If you are eligible for Title II, the Social Security Disability Insurance program, it’s because you’ve worked consistently and, by the way, you’ve paid into the system every time you’ve received a paycheck. If the benefits you’re eligible for are under Title XVI, Supplemental Security Income, there’s no shame in that. You’re in good company with people who, for various reasons, don’t have enough of a work history for the Title II program. Maybe they are mothers who have raised kids rather than been in the workforce. Maybe they are too young to have amassed the necessary work history. Maybe they are veterans who suffered an injury in service and haven’t worked since then.

Probably you’ve heard that it’s a long and frustrating process. There’s some truth to that but not enough that you should fail to exercise your right to access these funds. The first step is to contact the Social Security Administration and apply. The Social Security Administration (SSA) offers three ways for you to apply for Social Security disability benefits: by telephone (1-800-772-1213), in person at a local Social Security office, or online at www.socialsecurity.gov/applyfordisability/.

If you get turned down the first time (and nearly two-thirds of applicants do), don’t give up. File an appeal within the time period allowed. Get a lawyer to help you. Keep trying until you get to the hearing stage because this is the stage when many folks finally get a positive decision. And keep seeing your doctor – the evidence of your regular visits and the relationship you are building with your doctor will prove invaluable when your hearing date finally arrives.

Remember that the Social Security disability program was set up for the situation you are facing. President Clinton said it best:

“Social Security. . . reflects some of our deepest values–the duties we owe to our parents, the duties we owe to each other when we’re differently situated in life, the duties we owe to our children and our grandchildren. Indeed, it reflects our determination to move forward across generations and across the income divides in our country, as one America.”– William J. Clinton, February 9, 1998

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Cheryl Coon exclusively focuses her law practice on social security disability at all stages of the process, representing clients from Eugene, Oregon to Vancouver, Washington. She can be reached at ccoon@stc-law.com. Her law firm, Swanson Thomas and Coon, can be found at www.stc-law.com.

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As this network’s coordinator, I work at making connections with local professionals who focus on topics and issues I hear about most frequently from the MLWT community.  Recently, I received a comment recommending that I enlist the expertise of an attorney to contribute posts here regarding disability benefits.  I have met with Cheryl personally, as I do with many of the local professionals I have as guests, and must say that between her professional experience in this arena and her personal experience getting through the health care maze and building a supportive community for parents before social media, I believe she will be a great resource here.  As with any of my guests, please recognize that everyone must be their own best advocate and my guests are merely the people I wish to introduce to you~ not necessarily to endorse.

Healthcare.gov is coordinating this insurance plan that has been offered to all 50 states as a means of meeting some of the immediate needs until the entire 2014 health care reform law will take effect.   Some states opted out of using the allocation funds due to their concerns about receiving enough funding to cover the insurmountable health care costs facing their high-risk residents.  Oregon is one of the states that opted in to using the funds for this new insurance plan and you can find out more about what  the program might offer you by going to this Healthcare.gov link. 

I know that there are plenty of people in this high-risk category and that it would be impossible (on many levels) to create a plan that offers something for everyone.  Although my situation meets the criteria to pursue this option, the fact is that I would end up paying more per month than I do now and I simply can’t afford it.  That isn’t by choice, mind you. 

The whole idea behind insurance is that we put money into a bucket per month that is supposed to insure us from future medical expenses and I get that.  Paying something each month to know that I will have some help paying for appointments, procedures and (heaven forbid) emergency situations is a wise investment.  Here’s the catch, however.  I paid for years when lupus hadn’t even arrived yet into a large insurer’s pocket and rarely needed any medical services.  I was young, healthy and taking the best care to make sure I stayed that way, yet I still paid them for this unused care through my employers totaling several thousands of dollars.  Decades later, and without warning, my health took a turn and I needed that coverage.  Although my employers and plans had changed, this company had my name and track record on file.  In spite of the money I paid and with little cost to them from their profits via my investments, they threw me to the curb.  Actually, they threw me to the curb AND sued me for $10, 000 claiming I knew I was sick before I signed up for my health plan.  Hello, …my doctors didn’t even know what was going on until my kidneys shut down.  But, that’s a nightmare best left in the past. 

It is the past, however, that has put me where I am today.  I cannot get insurance, even if I could afford it.  There are many things about the new Affordable Care Act taking effect in 2014 that has me worried.  As wonderful as it feels to think that I will have coverage, even with my health history, I still don’t know how I will be able to afford it.  Having options is one thing, but the question about who foots the bill—our government or myself—is what haunts me.  I agree that we need to develop a healthier country and providing more health care options is a great step forward.  The health care costs are still way too high, though.

Do I want to, once again, put what cash I have into my health care bucket only to have an insurer avoid returning my investment when I need it?  Will they hike the expenses and/or claim that I did something that disqualifies my right to the care I invested into?  Worse yet, as this news segment points out, what if I put into this plan and they run out of money before I need it?  Let’s face it, insurance may be profitable, but managing my own health care is not. There’s something really wrong with that.

As I wait for the industry to be seriously overhauled, I focus as much as I can in making the best choices I can every day to avoid future health woes.  There’s no guarantee either way, whether I pay an insurer or myself to put into a savings account, that I will have the care I need when I need it.  I can’t control what the insurance companies do, what the government will or won’t provide or how my lupus will progress.  There are a few things I can eat, move, try, think and prepare for that might cost me less down the road.  Even that sometimes costs me a pretty penny, but well worth the effort. 

The gal in this news segment, Ms. Eaton, who is living with the heart condition represents many of the people I work with every day.  She also represents my situation very closely.  Many of us aren’t disabled, are still working, take care of ourselves and are willing to pay what we can.  We understand that health care will never be free and that preventing illness would be ideal.  We also know that we don’t ask for diseases like lupus, genetic or congenital conditions, see ourselves as victims or live to frustrate the medial establishment.  We are simply going to have to do what we can with what we have until “health” is as valued as “profit”.

Where are you in all of this?

• Have you lost your health coverage through loss of employment or cutting costs at work?
•  How well can you manage your illness without care?
•  What are some of the things you let go in order to manage your health?
• How do you expect to handle the 2014 shift?

 After taking a look at the news segment link and learn more about what the preexisting insurance plan offers, I would be interested in hearing what you think.  Share your story, too~  you’re not alone.

“I appreciate the opportunity to share some of my background with your members who may need representation for matters concerning Social Security Disability (SSDI) and/or Supplemental Security Income (SSI). 

 As a certified rehabilitation counselor for over 27 years, I have been engaged in private practice in Oregon and Washington since 1980.  I am also a licensed professional counselor with the state of Oregon, as well as a certified disability management specialist.  I have extensive experience as a Vocational Expert with the Social Security Administration (SSA) and am certified by the Department of Labor to provide vocational services to federal employees.

In 1995,  I became a Vocational Expert with the Office of Disability Adjudication and Review (ODAR) with SSA.  In that role, I gained valuable experience providing testimony to assist the Administrative Law Judge (ALJ) with determining whether folks were able to work, under SSA regulations.  After over 13 years as a VE for SSA, I followed the counsel of several ALJs who recommended that I begin representing clients in their applications for SSDI/SSI. 

Most all of my clients are reassured to have access to an actual counselor who is well acquainted with the process upon which the disability determination in SSA is based:  ability to work.

I have extensive experience working closely with clients whose diagnoses include lupus and fibromyalgia, conditions that require the expertise of a professional who understands how the resulting symptoms so often prevent many people from sustaining work.  For many of my clients who suffer from these diagnoses, the real challenge is not found in getting a job, but in keeping the job. 

I have just completed my coursework for my doctorate in Human Rehabilitation, and look forward to concluding the dissertation requirement for my PhD in about a year.  While this credential certainly isn’t necessary or required for my work as a representative, many ALJs recognize the degree of proficiency afforded by years of such study.  It will be a powerful and respected credential for my clients who deserve the best representation available.

I serve clients throughout Oregon, Washington and Idaho and may be reached toll free at 1 (888) 355-5539 or by email at kheatherly@1hcc.net “