Hire a Pro When Filing a Disability Claim

EDITOR'S NOTE: This article was originally published in the February 2010 issue of Kiplinger's Retirement Report. To subscribe, click here.

Olga Lombardi enjoyed her job as chair of the foreign language department at Ursuline College, outside of Cleveland, and intended to work until age 65 or longer. But a breast cancer diagnosis at 61 in March 2008 derailed her plans. She took what was supposed to be a six-month disability leave. After several surgeries and radiation, she is still home because her medication causes body aches, migraines and nausea. "I became very ill. The doctor said,'‘You're in no shape to return to work,' " says Lombardi.

Nor was Lombardi in shape to pursue a Social Security disability claim. Marcia Margolius, a Cleveland lawyer who specializes in pursuing such claims, took on Lombardi's case in October 2008. "She collected the medical records and asked the doctors to give their opinions of my physical and mental health," Lombardi says.

From just $107.88 $24.99 for Kiplinger Personal Finance

Become a smarter, better informed investor. Subscribe from just $107.88 $24.99, plus get up to 4 Special Issues

CLICK FOR FREE ISSUE

Sign up for Kiplinger’s Free Newsletters

Profit and prosper with the best of expert advice on investing, taxes, retirement, personal finance and more - straight to your e-mail.

Profit and prosper with the best of expert advice - straight to your e-mail.

Sign up

Her claim was denied twice, and Margolius filed appeals twice. Lombardi was approved for a disability benefit in October 2009. She is using the $1,414 a month from Social Security to pay her mortgage.

If you have an illness or injury that prevents you from working before you are eligible for a Social Security retirement benefit, you could be entitled to a disability benefit. You can go through the claims process on your own, but it could be a smart move to hire an authorized representative. Such an advocate could be a lawyer or non-lawyer who's trained to handle disability claims. "It is a very complex process," says Mark Lassiter, a Social Security Administration spokesman. "People like to have someone navigate that process, gather documentation and present their case."

To be eligible for a benefit, you must be unable to work for 12 months at any job for which you could qualify. A claimant could go through five layers of consideration, starting with the state agency that makes disability decisions for the Social Security Administration up to the U.S. District Court. More than half of claims are denied at the first two levels.

Finding a Qualified Advocate

A representative collects medical records, gets information from your Social Security file, talks to your doctors and communicates with agency officials. "If there's a hearing, they will be there with you. They can bring witnesses to testify on your behalf," says Lassiter.

Your local Social Security office has a list of organizations that can help you find a representative. After you appoint one, you must file Form SSA-1696-U4, Appointment of a Representative, available at www.socialsecurity.gov or by calling 800-772-1213.

The representative must get approval from the agency before charging you a fee. The agency usually approves fees of no more than 25% of past-due benefits, or $6,000, whichever is less. In many cases, representatives only get paid if the claim is approved. Claimants get benefits dating back to five months after the date that they're deemed to have become disabled.

The representative you choose should have substantial experience in representing disability claimants, says Charles Martin, a lawyer who specializes in Social Security cases in Decatur, Ga. He says that you should ask prospective representatives how many years they've been representing claimants and the number of cases they've handled at each level of the process.

Margolius says that Lombardi's claim would probably not have been approved until October 2011 because three years is the average length it takes for disability cases to be resolved in Ohio. Margolius asked the federal administrative-law judge to make an exception for Lombardi. "To wait another two years would have been financially and emotionally harmful to her," she says. "I was able to bring the strength of her case to the judge's attention."

You can find a representative through the National Association of Social Security Claimants' Representatives (www.nosscr.org; 800-431-2804) and the National Association of Disability Representatives (www.nadr.org; 800-747-6131). You could also seek help from Allsup (www.allsup.com), a Belleville, Ill., company with non-attorney representatives.

For more authoritative guidance on retirement investing, slashing taxes and getting the best health care, click here for a FREE sample issue of Kiplinger’s Retirement Report.