While the Social Security Administration (SSA) is a federal agency, it does not make the initial decisions on who qualifies for a disability benefit. This determination is made by a state agency which is staffed by state employees.
In Alabama, this agency is the Disability Determination Service (DDS) in Birmingham. Getting a claim paid by the DDS is challenging. Here is basically the process:
- Review of Medical Evidence – DDS gathers your medical records from doctors, hospitals, and treatment facilities.
- Assessment of Functional Limitations – The agency evaluates whether your condition limits your ability to work.
- Consultative Examinations (CEs) – If your medical records are incomplete, DDS may request additional exams from an SSA-paid doctor.
- Determination of Disability – Based on the evidence, DDS decides whether you meet SSA’s definition of disability. In most cases, you will not.
- Case Return to SSA – If approved, your claim moves to the payment processing center.. If denied, you have the right to appeal within 60 days--a strict deadline.
Many
applicants receive denials at this stage because of insufficient
medical evidence or failure to meet SSA’s very strict criteria.
Around 75 percent of claims receive denials at the DDS because of insufficient medical evidence or failure to meet SSA’s strict criteria.Upon denial, it is very important to file an appeal. Most disability claims are won in the appeal stage, not in the application stage.
Your denied claim will probably need two separate appeals to be paid:
1. "Reconsideration" is the first appeal. While this stage has a very low approval rate, it is required. In Alabama, the denial rate at "Reconsideration": runs between 80 and 90 percent.
2. Hearing. Your second appeal takes you to a hearing before an Administrative Law Judge (ALJ). At this stage, you have the BEST chance of approval in the entire process.
Should you be represented by an attorney or experienced advocate at the hearing? Without representation, only 31 percent of claims get approved, according to a US government study. With expert representation 60 percent of claims get approved. So, yes, the odds dictate that you want an attorney or trained advocate to assist you at the hearing.
What Does it Cost to Get an Attorney?
Advocate / Attorney fees are governed by Social Security law. You may only be charged a legal fee if you win your appeal and collect past due payments (also called "back pay"). The fee approved by Social Security is the smaller of 25 percent of your past due benefits or a maximum fee set by the Social Security Administration. For example, if you collect $10,000 in past due benefits, your lawyer's fee would be $2,500. If you don't get any past due benefits there cannot be a fee.
The Forsythe Firm in Huntsville has more than 20 years experience in helping claimants win Social Security disability claims. You will be given face to face time with one of our experts who will answer your questions and give you a free consultation. If you decide to have us represent you, we will handle your case or appeal with no upfront fee. We never ask you for money. If you win and recover past due benefits, Social Security will pay us directly, using a small percentage of your past due benefit.
We are local professionals right here in Huntsville that you can sit down and talk to.
Call The Forsythe Firm in Huntsville today. (256) 799-0297. or (256) 503-8151.
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