Social Security's Office of Inspector General (OIG) has issued an audit report on Claimant Representation at the Disability Determination Services Level. They reviewed 379 cases involving representation. Their findings were that in:
- 84, we found no evidence that the representative assisted with the claim;
- 154, the representative assisted with filing the claim, but did not assist the DDS with claim development in the disability determination; and
- 141, the representative assisted throughout the claims process
The report does not describe how it decided whether a representative had assisted with the claim or assisted DDS with claim development.
How would OIG know whether the attorney or representative had assisted the claimant with setting an appointment to file a claim or with completing claim paperwork?
Much of the time, the most important thing an attorney can do is simply to encourage the claimant to get on with it. Most claimants delay filing a claim because they keep hoping to get better. This may be appropriate for a few months but eventually it's just procrastination and the claimant needs encouragement. I don't see how OIG would know about this sort of encouragement which can be of considerable value to the claimant.
There's also the efforts that attorneys and other representatives make to prevent things from falling between the cracks at Social Security. It's not rare for a claim to be filed but go astray somewhere at Social Security. Without representation, nothing happens. Eventually, the claimant returns to Social Security some months later. The assumption is made that the problem happened because the claimant failed to complete the claim process and a new claim is taken. Sometimes it's the claimant's fault. Sometimes it's true that the claimant never completed the process but Social Security never warned the claimant that there was a problem. The process is complicated enough that it's not hard for someone who's sick to fail to do all that was expected of them even though they were trying. Sometimes the problem is wholly Social Security's fault. (Please, if you work at Social Security, don't tell me this never happens. I know better. Claims get sidetracked all the time. Sometimes they reappear months later. Sometimes they never re-emerge without external prodding.) A good attorney or representative straightens out these problems. Would OIG have been aware of this sort of work done by an attorney? I doubt it.
In terms of medical development at DDS, there's little point in the attorney or other representative duplicating DDS' effort. There's a role for the attorney or representative but in many cases, there's nothing the attorney or representative can do that helps the claimant -- and the point of representation is to help the claimant, not Social Security.
My view of representation at the initial and reconsideration level is that it usually doesn't involve that much work but the chance of getting a fee is low and the fee, if I do get one, is usually modest. It's a relatively low return for a relatively low effort. If OIG thinks that representation at the initial and reconsideration levels is so remunerative, why is it that most attorneys and representatives avoid this sort of representation?
