Social Security Disability and US Court?

Question

I've been denied my SSD benefits for the 3rd time. My attorney and my doctors want me to pursue this in federal court, but it will cost me $350 to file it.

My questions are these...
1) What are the chances of finally being granted my disability if I take it to this level?
2) Since my attorney doesn't work federal courts, he's sending me to one who does......will I have to pay 2 fees if I do win?
3) Has anyone here ever had to go to these lengths to finally get SSD?
4) Is it worth the cost to do this, or am I just throwing away money?

OK, a bit more info here.....

It was initially denied (like 90% of claims), and we went to the Law Judge hearing. He denied it, but did so using faulty evidence (he was saying my GAF score was a BMI, even though 3 different doctors said that I was severely depressed with a GAF score of 45 or higher.....I AM overweight, but this claim wasn't for that).

My attorney asked for a review, and sent in additional copies of the proof that the judge made a huge mistake in his decision, but were denied a review. Now, he wants me to go to Federal Court to fight it.

My original claim is for extreme pain (I was in a truck wreck in 2001, and haven't worked since) and severe depression. According to SSD rules, anyone getting a repeated GAF score of 42 or higher is considered totally disabled (mine were 45, 49, and 48 respectively over a 3 year period). Treatment has NOT alleviated the problems, despite medications and physical therapy for the last several years.

Answer 1

First, answering your specific questions.
1) Statistically, Federal court is a 50/50 shot while the Appeals Council in Virginia is a 25/75 shot. You have a better chance in Federal Court. Even if the Magistrate recommends no action (ie you lose) your attorney can appeal it within the Federal court system.
2) No, not usually. Typically, an attorney representing a claimant in Federal court who wins will request EAJA fees (Equal Access to Justice) which will be paid by the government. However, due to current IRS and Office General Council actions, fewer and fewer attorneys are willing to take claims to federal court without a claimant pre-paying attorney fees ($4,000 to $6,000 in most cases). It is a different matter, you have your attorney who did your ADMINISTRATIVE hearing who represents you before the SSA and another attorney representing you in federal court system.
3) Yes, many people have to go this far. It is not uncommon even though it should be. I have seen many Judges read medical evidence wrong which leads to denials which should not be (but also seen approvals where should have been denials for the same reasons but claimant's don't complain about those.).
4) Yes. Failure to pursue makes the Judges decision FINAL that you are NOT disabled. You will never again be able to allege you were disabled any date prior to that Judge's decision. This could cost you your benefits permanently.

Now to clarify something, you indicated, "According to SSD rules, anyone getting a repeated GAF score of 42 or higher is considered totally disabled..." No this is not correct. It is a good way to shortcut to an answer, but ALJ decisions are considered appellate decisions and the answer must be well reasoned. An ALJ can discount every GAF score IF that ALJ can justify so doing, but an ALJ may NOT ignore such evidence.

Additionally, most ALJ's apply the incorrect pain standard and most ALJ's seem to ignore the compounded problems obesity can have upon someone in chronic pain. But then again, the ALJ's do not write the decisions....

Answer 2

1

Answer 3

To take your last question first....only you know whether this worth it...it depends on what your SSDI payment would be which is based on your earnings in past years...this amount SHOULD be on any SS earnings reports you have...or you can find out what your payment would be by contacting the Soc. Sec. Administration. That is if by Soc. Sec Disability you mean Social Security Disability Insurance. SSDI is an INSURANCE

IF you meant SSI [supplemental security income] which is a BENEFIT program that provides payment to those who do not have enough quarters in Soc. Security and meet income requirements - that benefit payment is usually rather low....as low as $400 month.

Depending on what the reason was for your denial, it may not be worth it....if the reason was that your disabling condition does not meet the criteria set forth, then more adequate medical documentation would be needed...often after that is done persons win their case.

Answer 4

Your chances depends on the nature of your claim, and the legal and factual issues involved -- that's impossible for us to analyze without full details -- but your lawyer (old or new) can do so.

Whether you have to pay your current attorney if the other attorney helps you -- that's up to the fee agreement you have with your current attorney. It's negotiable.

As to whether it is worth the cost -- that depends on whether you are likely to win, and how much you would win if you did -- see the first part of teh answer.

Answer 5

IF you do get it , it will be about 2+ more years..u just dont apply and poof recieve a check..they have to have a ton of doctors test you, docotrs repoerts, medical records etc for a minimum of 18 months, then they make a decision, and you could very well work from home....I believe many of those "problems" are easily fixed, but you dont want to. I think you need a real dose of reality , but dont want to , so u wanna suck the government dry like a parasite....THere are MANY folks out there who are way worse and manage...buck up and be responsible,

Answer 6

As the other man said, it is hard to determine not knowing more. I do know that it took me 4 years to get mine (at one point they got my medical records mixed up with another lady with the same last name) and it went into appeals court. Finally, I went back and I was approved.
I wish I had a perfect answer for you.

Answer 7

"IF" your doctor will certify that your are 100% work disabled, then Yes, seek court intervention, other wise you will loose again.

Answer 8

I too have the same question