I represent Social Security claimants so I have some knowledge of this subject as well as a self-interest which I acknowledge.
I suggest that the agency admit it lacks manpower to provide effective assistance to claimants. Since that is the case, it should enable third parties to make money providing those services. This may be a bitter pill for the agency to swallow but it is time to be honest about the situation.
The Social Security Act says that fees for representing claimants must be approved by the agency. 42 U.S.C. §406(a)(1). The agency has interpreted this provision broadly. Its position is that charging a fee just to help a claimant file a claim or an appeal must be approved by the agency. As a result no one is providing these services for a fee apart from those seeking contingent fees for much broader representation. This leaves a large number of people to seek services that the Social Security Administration is unable to supply. Social Security should announce that that merely helping a claimant file a claim or an appeal is not the sort of representation for which fee approval is required. This would allow attorneys and H.&R. Block and whoever else to provide these services for modest fees. As an alternative, if the agency still wants to control these fees, the Social Security Act provides authority for the Commissioner to simply approve a maximum fee. ("The Commissioner of Social Security may, by rule and regulation, prescribe the maximum fees which may be charged for services performed in connection with any claim ...) The Commissioner could announce that the maximum fee to help file a claim is, let's say, $250 and the maximum fee for helping to file an appeal is $100. Those providing these services would not have to submit a fee petition. I will concede that this suggestion helps those with some money more than it helps the destitute but one would hope that even the poor could come up with the modest fees I'm talking about. It would also free up agency personnel to provide more help for poor claimants. If Social Security cannot itself provide these services to all who need them, why stand in the way of others providing these services for modest fees?
We also need to have more disability claimants represented throughout the process.
When it's hard to make a living as a Social Security attorney, as it is now, the first thing you do is to be more careful about the cases you take on. This leaves more claimants with marginal cases without representation. This has the effect of discouraging them from pursuing claims. I'm sure that hearing offices notice that a significant percent of claimants never appear for their hearings. Do they notice that almost all of the no shows are unrepresented? Probably the biggest reason for the no shows is that the claimants have tried to find an attorney but became discouraged when they were turned down several times. Less obviously, potential claimants never file a claim to begin with because they couldn't find an attorney. However, cases that may appear weak when an attorney makes a quick decision on whether to take on a client may actually be much stronger than they appear.
How do we encourage attorneys to take on more cases? The incentives must be economic so, yes, my recommendations will be self-serving. Raising the fee cap and indexing it for inflation is the obvious start but that only gets us so far. Notice that SSI claimants are represented at a lower rate than Title II claimants. There are many reasons for this, including the fact that SSI claimants have less access to medical care, but the lower benefit rate for SSI claimants is a major factor, since that means a lower average fee. It would take legislation but the attorney fee in SSI cases could be changed to 1/3 of back benefits or there could be a minimum fee for SSI cases.
If you really want to encourage representation, extend the Equal Access to Justice Act (EAJA) to Social Security. EAJA shifts the fee burden to the agency when it loses. EAJA covers most adjudication at other agencies. Why except Social Security?
It would also be great if Legal Services had much higher funding so that its affiliates could once again represent claimants in a big way. That hasn't happened since the 1980s!
Aug 17, 2021
My Take On Encouraging Representation
I had posted a link earlier to Social Security's request for opinions about how to increase equity in Social Security's programs and services. One question they asked specifically is "Are there incentives or other changes you suggest for
encouraging attorney and non-attorney representation for claimants of
color and other underserved communities?" I addressed myself primarily to this issue since it's the one I know best. Below is a somewhat edited version of what I posted. Post your own opinions on Social Security's website.
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17 comments:
Sorry, Charles, but I disagree with most of your points. I operate in a large metro area and have a substantial amount of SSI clients. SSI claimants have no problem finding representation, if they have a valid claim. We assist many SSI claimants with their initial applications. I believe that experienced representatives working on a contingency basis serve a valuable role in the process by declining representation and discouraging filing of claims that likely do not meet the disability criteria.
Do you really want the H&R Blocks of the world filing applications for everyone who walks in the door to collect your proposed fee for filing applications? The system would be flooded with frivolous claims and only add the the enormous backlogs now forming at the initial and reconsideration levels. This would harm those with legitimate claims of disability.
Certainly the fee cap should be raised and indexed to inflation. Arcane resources rules for SSI eligibility should be revised. But keep the contingency fee arrangement for representation.
Again, we see the insulated bubble that is the life of the representative. Because the representative is focused on just getting the approval and the check, they are not aware of the services that take over after a Claimant is approved and the rep provides absolutely zero support for things like Medicare enrollment, Part D plan choice, LIS applications possible QMB, and other services and programs from LIHEAP to SNAP and beyond.
The places that are doing those are also in many instances also able to assist with an application. All ADRCs have the capacity to file and do assist, though not as many as we would like. Many many CILs provide assistance with the application process, or have an I&R person that can direct to a local source. Also these groups do NOT charge for filing a claim, not one cent.
So what you are suggesting in the third paragraph is already happening, has been happening and will continue to happen.
I really liked that the poorest of the poor, the SSI you want to take 33% of the backpay. Because of course it makes perfect sense to take more money away from the poorest. Let us wring those turnips for all the blood we can. You spend a lot of time discussing that these claimants are lacking medical care, prescriptions, housing and food in this blog, yet:
"let's say, $250 and the maximum fee for helping to file an appeal is $100. Those providing these services would not have to submit a fee petition. I will concede that this suggestion helps those with some money more than it helps the destitute but one would hope that even the poor could come up with the modest fees I'm talking about." So which is it Charles are they naked and starving in the streets without a farthing or are they able to pay you $125/hour to file a claim?
More money for reps is not the answer. It is much more complex to resolve.
I too believe it would be great if Legal Services had much higher funding. It was not, however, a lack of funding which caused legal services programs to stop representing claimant's in a big way. In the late 1970s, there was a vast increase in the number of attorneys able, willing and anxious to provide contingent fee representation to denied disability applicants. Legal services programs have never desired to take on cases where other representation was readily available.
Just raise the cap of $6000. I am not sure what it should be but maybe $10,000. This would entice more representation. Here was my comment:
"I am not too concerned with the 25 percent cap. In California in workers compensation cases, the cap is 15 percent. Most personal injury claims can charge between 30-50 percent. I am not sure how the $6000 is calculate it is too low. Maybe increase it to at least $10,000 or just eliminate the cap to keep it at 25 percent."
As a representative you are basically doing the work for the agency. Reps are:
1. Doing claims
2. Processing appeals
3. Completing the record and paying for medical records
4. Helping clients with multiple forms
5. Answering daily/weekly status calls.
As a claims representative with SSA you were responsible for performing many of these actions. So, multiply 25 hours x $40 per hour (CR wages) and
If a judge doesn't like your case, you did all that work for free.
Then, you have to fight to get paid old fees, amended onset dates, and you pay the agency at FEE to even process your fee. No wonder many reps are moving on.
REPS SAVE THE AGENCY MONEY - 20 HOURS OR MORE ON MOST HEARING CASES. If you get involved early, you're basically an unpaid volunteer. Reps don't take certain kinds of cases because who wants to waste 20+ hours on a case the agency won't approve.
"As a representative you are basically doing the work for the agency."
I bet you are not paying your former retail workers turned office workers $40 an hour. Bet it isnt $15 either. Like reps are taking claims, C'mon man!
Wait…so Charles…one of your proposals is to take 1/3 of the SSI claimant’s back pay? Really? The poorest of the poor and you want more form them? Sounds backwards.
Most SSI claimants I deal with don’t like the 25% fee so I can imagine raising it to 33% would not drive more of them to seek representation.
"Like reps are taking claims, C'mon man!" 2:20 PM, August 17, 2021
Wrong. Attorneys at our firm talk to all prospective clients. Attorneys field calls from clients. Attorneys supervise staff and ensure all medical records are obtained and client is prepared for the hearing. Staff earns close to $40 hour with insurance, 401k, bonus (if possible), and vacation. All the while living under the risk of contingency agreements, competition, and unpaid costs. But we yes, we accept this risk, and hope we can help some people out.
So how is the weather up in your ivory tower?
one thing that would help on the post-eligiblity issues (CDRs, overpayments, etc.) is if SSA got better at ruling on fee petitions. It sucks to have the money sitting in trust for years.
SSA could also try a pilot where it pays reps a flat rate for representation if they are successful in adjusting the amount of an overpayment, obtaining a waiver or payment plan, showing that benefits should continue after a CDR, etc. Maybe try it with SSI recipients first?
They could also just send out info about representation to everyone who applies at the initial level rather than having OHO do it when people request hearings. Not everyone knows they can get a rep, or that it's contingent fees.
"Not everyone knows they can have a rep." I guess they have never watched television.
I will take ivory tower over needing a glass belly button every time.
10:46, Your non-attorney staff are making around $75K/yr with benefits, potential bonuses, and vacation? Are you hiring?
12.5 $6000 claims per employee, yeah that really doesnt sound right does it? That would be without the atty making a single cent, plus office space in the strip mall, utilities, internet, I believe there may be a little bit of hyperbole on that or as they say now, "alternative facts."
I'm not so sure about getting paid for filing claims and appeals. I would rather do the appeal on my cases than have SS do it. However, I would like something on cases lost, overpayments, and CDR's. Of course increased funding for Legal Services so they can do the over payments and the CDR's would be nice.
For lost claims 10:24 you get experience. Payment for lost claims would lead to even more frivolous filings. I know the argument will be that the reps will be responsible, but remember there were lawyers willing to file lawsuits about last election being stolen, so credibility is an issue.
I like how the discussions with the Teachers Unions is NEVER about what's best for students. Likewise, this site NEVER seems to be about the disabled. What's best for the agency or attorneys seems to be the ONLY concern. Want more representation? Want fewer "frivolous" claims? But, don't want to do it at the expense of claimants? Easy. Increase the fees, but make the government pay it. Take NO money from claimants. With no cost to claimants, they will get a representative... SSA will have an incentive to pay earlier, especially those cases they know they'll have to approve. To increase that incentive, SSA should have to pay from the legitimate claim of date of on-set when a claim is paid. No "new claim" after an ALJ denial. The only exceptions would be those who had SGA for consecutive quarters (maybe, a full year) AFTER a denial. I was unable to work for 6 years before getting approved by a 2nd ALJ. I only got 1 1/2 of back pay. Attorney got his $6000 out of that. I think that's unjust.
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