Kay Tracy, Professional Representation for Social Security Claimants

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The process of getting disability benefits from the government can be so overwhelming that disabled people freeze like a deer in the headlights. It can be paralyzing.
There is relentless physical and mental pain. On top of that, there is the very real fear that financial disaster is just around the corner. One day, a person is fine – the next day they are unable to care for themselves or their families. There is often shame at the thought of having to ask for a “hand out” from friends and family – or worse, welfare. Suddenly, they have no health insurance.
Then, there’s the federal government.
I have helped hundreds of people go through this process. I can help you.
Kay E. Tracy, Esq.

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FAQ:
1. Do I need a lawyer?
2. Why hire a lawyer?
3. Who Qualifies and What are the Benefits?
4. What are the chances of winning?
5. Why do claims get denied?
6. What does this cost?
7. Why hire Kay Tracy?

Helpful Links:
Social Security Administration FAQ (external link)
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1. Do I need a lawyer?
No. You can do this on your own. You can have a friend or family member help you.
There are non-lawyers who do this kind of thing on a professional full time basis.
The Government does not require that a representative be a lawyer.

Social Security Disability law is not something that law schools typically teach. It isn’t like contracts, personal injury or criminal law which are required law school subjects in ABA accredited schools.

To really learn this, you need to have a “mentor” who has done it a long time: someone who can show you first where to find the law and then how to use it. You also need to keep up with current developments through organizations like the National Association of Social Security Claimants (“NOSSCR” www.nosscr.org) that hold two, three-day seminars a year that draw thousands of practitioners from all over the country.

Hiring a lawyer who has no experience is like hiring Aunt Bea – she will probably mean well, but may not know much more than you can learn yourself simply from reading www.ssa.gov. Unlike Aunt Bea, however, the lawyer will charge you a fee.

If you can read, you really can do this on your own – just like you could write your own will; do your own taxes; build a back yard BBQ or wire your new family room.
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2. Why hire a lawyer?

1) An experienced Social Security Claimant’s Representative – lawyer or not – will dramatically improve your chances for success, in my opinion.

2) A lawyer will stand between you and the grinding government machine. It takes the weight off your shoulders so you can focus on your health.

This can be a long, long process – typically 18 – 24 months. Yet, approvals at the initial level can take as few as three months.

Four real client examples from my practice:

ONE: One 32 year old man had been in a wheel chair for a year before he lost his leg. He had been a very successful journeyman building scaffolding for bridges. He filed a month before the amputation and was denied at the Initial level. He gave up and did not file an appeal. (Way too many people do that.) Two years later, after he lost everything, he came back and was approved with my help in 6 months – and, he got those two years of past benefits.

While there are no guarantees in any of this, it is obvious that his case should have been approved initially – since later, they gave him the two years of back benefits.

TWO: A well-educated medical professional came to me having just been diagnosed with an aggressive form of lung cancer. She had the capacity to deal with this on her own. However, she chose to have me help her so she could focus on her health. It took three months.

THREE: A 35 year old man who needed a double lung transplant could barely breathe – obviously enough. It was a strange disease and he was denied at the Initial level having already filed on his own. I helped him file the appeal and it was approved in four months. (He eventually got involved in a clinical trial at UCSF and so far has not needed the transplant.)

FOUR: A 38 year old man had uncontrolled diabetes. He could lift 50 pounds without any problem; but, he couldn’t keep a job because he kept getting sick. Then he lost his medical care and had no insurance to buy the medication.

Diabetes impairs the body’s ability to heal. Even minor infections can turn deadly in uncontrolled diabetics. He filed on his own, and was denied. He filed the Reconsideration appeal, and was denied. He went to a hearing before the Judge and the Judge told him that he had a right to a lawyer and if he wanted one, the Judge would give him time to do so.

Eight months later, the Judge approved his claim. He had been dealing with the process for roughly 30 months.
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3. Who Qualifies and What are the Benefits?

Financial 1
There are two basic Social Security programs: Social Security Disability Insurance (SSDI) which is what it says: Insurance - If you qualify, so do minor children you support.

A typical benefit is $1,100 per month, and additional amounts for minor children in your household who you support. If you win, you can get benefits as far back as a year before the date you first filed. But, every case is different.

Whether you qualify for SSDI or not depends upon how long you worked and when. You can ask your local Social Security Field Office – but be skeptical of their answer.

You need to know what your “Date Last Insured” is.

Just like with car insurance, when you stop paying the premium, your coverage will stop.

Say your coverage ended in January, but you had an accident in November of the preceding year. You could still go to your insurance company about the claim even if you are no longer covered.

The same is true in SSDI cases.

Say you were employed full time, and got hurt in 2004 and stopped working. But, you didn’t file a claim until 2013. You would not be covered in 2013 – but, you probably would have been covered up to December 31, 2010.

So you would be covered, if Social Security Agency finds your disability started any time before December 31, 2010 – but not after.

This happens all the time in Workers Compensation cases when people live off of their WC payments and so aren’t working. When that money is gone, they decide to file for SSDI. The Social Security Field Office could very well tell you when you call that you are not eligible. That is true – but only if your condition happened after December 31, 2010.

So, you need to know 1) Were you ever covered; and, 2) When did coverage stop.

Financial 2:

Supplemental Security Income (SSI) provides a very small amount of money (less than $850 per month) to people who live at or below the poverty level. If you win, you do get paid for the time you have been waiting to get your case heard, but not for any time prior to that.

Prior Claims: How far back the government will pay you could depend on whether you filed prior claims – too complicated to explain here.

Medical: Once you know your financial status, there are five steps to a determination.

Step 1. Are you working? You don't have to be bed-ridden to qualify. This is why so many people who get Social Security benefits may not look like they should qualify if you see them on the street. Only you know how you feel and what you can do. Don't give up hope just because someone else doesn't believe you.

Step 2. Do you have a medical impairment? Basically this means a diagnosis of something that limits your ability to work. Here, unlike Workers Compensation cases, they don't look at just one injury, illness or consequence. Everything counts. Does pain or pain medication limit your ability to concentrate? Are unscheduled breaks necessary for you? Are you out of breath or fatigued because you can't sleep? It is the combination of things and what a medical professional says about them that matter.

Step 3 Listed Impairments: There are special rules for some conditions (blindness, some cancer, some heart conditions, etc.). These cases may be processed more quickly. There is a long list of these conditions. Every case is different.

Step 4: Past Work. Can you do the easiest job you have done in the past 15 years? They don't just look at the most recent job you have had. If you have had a sit-down job in the past 15 years, it is legally significant even if you have done heavy labor for the past 10 years.

Step 5: Other Work If you can't do your past job, other factors (age, education, job skills and difficulty with English) will make it harder for you to go back into the work force. It does not matter whether you could actually find a job. It is your "vocational profile" and what the medical professionals say your maximum physical capacity that count.

CASE EXAMPLE: The young man with diabetes I mentioned earlier. He could easily lift 50 pounds. He could sit, stand and walk on an unlimited basis. So, why was he disabled? He was denied at the first two levels because the decision makers at that point did not look at the ravages of the disease.

He was approved by the Judge because we proved he could not do those things on a competitive and sustained basis long enough to maintain full time employment. In his case, the Agency will do a medical review in about a year. Hopefully, he will get the right medication and be better enough that he can go back to work – which he really wants to do. His benefits will end at that point.
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4. What are the chances of winning?

Obviously, this depends upon your medical conditions.

There are three levels in the application process. 1) The Initial Application; if that is denied; 2) An appeal called “Reconsideration;” if that is denied, 3) an appeal to an Administrative Law Judge. (There are appeals after that – but, it’s too complicated for this discussion.)

At the Initial Application Level, the approval rate in 2010 was 35%. Remember that this 35% includes people who have terminal illnesses; organ transplants; have lost limbs and are blind. The statistics for a “typical case” (low back problems; purely mental illnesses; cancer in remission etc.) are unknown. I’d guess 10 – 15%, but that’s just a guess.

At the next stage, Reconsideration, only 10% of the people who did appeal were approved. Remember here, that many people just give up after the first denial – particularly if they’ve tried to do it themselves. They are either too tired to go on, or they figure that the “government knows what it’s doing” and wouldn’t deny a good claim.

At the Administrative Law Judge Stage, about 70% of those who appeal go on to have their claims approved – this varies greatly region to region. One third to one half of that 70% are not represented.

You can find out about your region, and specific judges at the Social Security Official Website:
http://www.socialsecurity.gov/appeals/DataSets/03_ALJ_Disposition_Data.html

As a general rule, the younger you are, the less likely your chances of winning.
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5. Why do claims get denied?

All denial letters start the same way: “Based upon the evidence we have. . .” you are either 1) not medically disabled, or 2) even though you cannot do your past work, there is other work you can do.

That sums up the entire decision making analysis.

Note the phrase “medical evidence we have.” That does not mean that they have everything they needed.

Similarly, they may not have understood what your past work was; or, how your age, education and experience will affect what other work you could do.
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6. What does this cost?

There is no consultation fee either over the phone or in person to decide what is right for you.

If possible, I may advance whatever costs are needed to get copies of medical records and reports. You would agree to re-pay the costs advanced whether you win or lose, but there is no attorney fee unless you are successful.

I may ask for a retainer to cover costs – about $100 so the money is there to pay for the records. It depends upon your financial circumstances.

If you are successful, the fee is a maximum of 25% of your back benefit – but there is a cap of $6000. The back benefit is different for each person so there is no set fee.
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7. Why hire Kay Tracy?

1. To me, you are a person – not a file. I actually care about my clients.

2. I know what I am doing.
Before going solo, I worked for years as a Legal Aid lawyer; then with a very experienced Social Security Attorney; then, with a firm that hired me specifically because of my experience and their desire to develop a Social Security division as part of their successful Workers Compensation and Family Law practice.

3. I will always return your calls, tell you what to expect and help you through the process.
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*Licensed by the State of Nebraska and 8th Federal Circuit Court of Appeals: 1985;
U.S. Supreme Court: 1987
Social Security Law Experience since 2006; Social Security Law Exclusively since 2009
Not Licensed by the State of California - No other legal advice given.
The foregoing is an advertisement.
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Copyright ©  by Kay Tracy, Esq. All rights reserved. ~ 707-439-3346 ~ ktracy@socialsecurityprofessional.com


 
FAQ ~ Social Security Disability Representation, Kay Tracy Esq., Vacaville Fairfield Vallejo Napa Suisun Solano County CA, free consultation, Medi-Cal benefits, Medicare benefits, Supplemental Security Income, Social Security Claims, Social Security Lawyer, 707-439-3346