What Disability Claims Is an Attorney Likely to Reject?

Disability lawyers and law firms only get paid if they win your case, so they may reject cases that are unlikely to end in an award for benefits.

By , Contributing Author
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Because disability lawyers get paid only if they win, they sometimes decline to represent a person if they believe there is little chance of success of winning or if they determine that if the disability applicant is approved, there will be very little backpay or retroactive benefits from which to be paid. (Disability lawyers are paid directly from the Social Security Administration (SSA) out of any backpay or retroactive benefits the disability applicant receives.)

Disability lawyers and their assistants who screen cases for them will assess a case before they agree to represent a disability applicant, and if they notice weaknesses in a case, they might reject it.

How a Disability Lawyer Spots a Weak Case

Sometimes there are red flags that indicate to a legal professional that there is either a weakness in the claimant's case or some other issue that makes winning the case unlikely or overly burdensome. Here are some examples, broken down into categories.

Weak argument for medical eligibility. A disability attorney or staff member may feel that your case will be a difficult one to win if any of the following are present:

  • lack of supportive objective medical evidence despite appropriate diagnostic tests
  • lack of consistent medical treatment
  • refusal by medical providers to provide supportive statements
  • the claimant (applicant) is under the age of 45
  • the claimant is collecting unemployment benefits
  • the claimant mentioned that other disability attorneys wouldn't take the case, or
  • the claimant is ineligible for SSI or SSDI.

Concerns about disability applicant. An attorney or law firm may decline to take a case if they feel the client may be troublesome or is not trustworthy, which may be evident if any of the following factors are present:

    • inconsistent statements from the claimant, or dishonesty
    • evidence that claimant is a malingerer (faking an illness or pretending the impairment is worse than it is)
    • failure to follow treatment prescribed by doctor
    • claimant has done "doctor shopping" (usually done to obtain pain medication)
    • evidence of untreated alcohol or substance abuse (unless claimant agrees to immediate treatment)
    • claimant was "fired" by another disability attorney
    • claimant expresses unrealistic expectations, or
    • combative or disrespectful behavior of claimant towards the attorney or staff.
    Logistical or financial reasons. Here are some other reasons that would make it difficult for an attorney to do a good job on your case or collect a good fee:
    • a claimant "fired" his or her original disability attorney
    • lack of sufficient time to prepare for a hearing (generally when the claimant calls last minute), or
    • potential for low-paying or non-paying SSI case (because the disability back payments would be low).

    Some, but not all, of these potential issues can be overcome if you discuss them openly with a legal professional. Some of the more common red flags are discussed in more detail below.

    Lack of Medical Evidence

    If there are legitimate reasons that a claimant has not had consistent medical treatment, an attorney or law firm could still decide to take the case. This usually happens when a claimant has not had access to health insurance or is ineligible for medical assistance. If the claimant has older supportive medical records that indicate a disability, an attorney or firm may decide to take the case and help the claimant get further testing either by requesting a consultative examination by the SSA or by helping the claimant find affordable community healthcare.

    If you haven't seen a doctor recently, be sure to explain to potential legal representatives the reason for any gaps in your medical records and express a willingness to do what is necessary to get the treatment you need. For more information, see our article on developing medical evidence when you haven't seen a doctor.

    Claimant's Dishonesty

    If an attorney or law firm feels the claimant has at any time been dishonest either with the attorney, a staff member, or a medical provider, it is highly unlikely that the firm will represent the client. This is especially true if any medical records suggest the claimant is exaggerating symptoms. For this reason, it is imperative that you are you are straightforward and honest with all medical providers and that you are forthright with a potential legal representative about embarrassing or unsupportive facts in your case.

    Claimant Is Under the Age of 45

    It's more difficult for a claimant to win approval if he or she is under the age of 45, unless it can be proven that the claimant has a serious illness such as advanced cancer or ALS, for example, or the claimant cannot do even sedentary work. If you are a younger claimant, make sure you have as much supportive medical evidence as possible when you first speak to a legal professional. This enables the legal professional to better review your case and hopefully alleviate any concerns regarding your age. (For more information, see our article on how your age impacts your disability case).

    Alcohol and Substance Abuse

    If you abuse alcohol or illegal substances, you need to tell the prospective attorney or firm. This is especially important if you are not receiving treatment. Many attorneys and firms will take a claim despite substance abuse problems if the claimant is getting help. The claimant must also be able to provide a statement from his or her healthcare provider that says the disability would exist even if he or she were clean and sober. For more information, see our article on how drug and alcohol use affects disability.

    Lack of Preparation Time

    Even if a case appears good on paper, some attorneys and law firms will decline to take a case if the hearing is scheduled for less than a month away from the date the claimant calls the attorney or firm. This is because there is not enough time for an attorney to get all the evidence needed to argue the case, to write a legal brief, and to properly prepare for the hearing. Also, the SSA is generally unwilling to reschedule hearings unless the claimant can demonstrate a good reason to do so (such as illness). Therefore, you should contact potential legal representatives as soon as you receive your denial letter.

    Disrespectful Behavior

    The disability process is stressful and attorneys and their staff members well understand this. However, attorneys will not tolerate abusive or disrespectful language directed at themselves or their staff no matter how good the case. Therefore, if you have behaved inappropriately towards an attorney or firm staff member, you should apologize directly to the attorney or staff member and provide a written letter of apology. Remember, though, that an attorney can cease to represent you if there is a relapse in your behavior.

    Issues with Previous Attorneys

    Claimants who have been represented in the past on a disability case may have difficulty finding a new attorney. This is partly due to professional courtesy. It is also because clients who have had issues with a previous firm or advocate are more likely to have the same issues even with a new attorney. In addition, the new attorney might have to file a special fee petition with Social Security to divide the fee with the former attorney or firm. If you were previously represented, you must tell your new attorney immediately and explain the reason the relationship ended. Do not speak badly about your previous attorney or advocate.

    Financial or Legal Ineligibility for SSDI or SSI

    Unfortunately, not everyone is eligible for SSI or SSDI even though they are clearly disabled. This usually happens when a person doesn't have enough work credits to qualify for SSDI but has too much income or other assets to qualify for SSI. For more information see our articles on SSI eligibility and SSDI eligibility.

    SSI Cases

    A disability representative gets paid only if he or she wins, and the fee is 25%, up to $6,000, of any retroactive or back-payments the claimant is entitled to. A claimant who is approved for SSI can receive back-payments only from the date he or she was approved going back to one month after the application was filed, even if the SSA determined the applicant became disabled long before the application date. Therefore, fees in SSI cases are usually small and, occasionally, an attorney is awarded no fees at all for an SSI case. In addition, monthly payments for SSI are usually smaller than payments for SSDI, so the percentage the attorney gets is smaller. (In a recent survey, our readers responded that the average attorneys' fee for SSI cases was $2,900.) Therefore, if a legal representative reviews an SSI claim and feels it isn't a sure thing that the claimant will be found disabled, the representative may choose not to represent the client.

    Collecting Unemployment Benefits

    Many disability lawyers and law firms recommend against collecting unemployment benefits when applying for disability benefits, but in certain situations, it may not work against you (either in hiring a lawyer or getting disability benefits). For more information, see our article on unemployment and disability.

    What Do I Do if I Can't Get a Disability Attorney?

    If an attorney or firm doesn't think you have a case, or declines to take your case for other reasons, it is important that you ask the attorney or firm to explain why they won't represent you. This will allow you to address any issues so that you can strengthen your case, either to convince the attorney or firm to take your case or have a stronger case for the next legal representative you interview. To contact other disability attorneys and firms in your area, you can use our disability attorney locator tool.

    You can also learn how to represent yourself at a disability hearing by reading Nolo's Guide to Social Security Disability, by David Morton, M.D., a former medical consultant for Social Security disability.

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