What A Representative Firm Does | The Disability Benefits Podcast #38

In this episode, we explain what a representative actually is and how our firm represents and manages disability cases.

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Disability Consulting, LLC
(877) 204-8159

Disclaimer: We are a non-attorney firm. Our company specializes in representation for Social Security disability claims and is not a law office. The information provided in this video is for general informational purposes only and does not constitute legal advice. For legal guidance specific to your situation, please consult a licensed attorney.

Transcript

SPEAKER_00 0:00

Okay. Well this will likely be a shorter episode and I'm kind of just gonna let you take it away. But I want to talk a little bit about what we do as a representative firm in general and then also what a new client of ours can expect from the first time well the first time we talk to him is when I'm talking to him to get them signed and get all the information we need to start working on the case. But after that, once they get set up with their case manager and the representative, what they can expect from that point on. So yeah, like I said, I'll I'll probably intersect a couple of times, but I'll kind of just let you take this away. And um I I do want to I want to make sure I uh we answer what a representative does. Okay. So about our company in particular, but also just in general, what is it what is the role of a representative in a disability case? Um, and does it does a claimant actually need a representative? We'll get into that.

SPEAKER_01 0:53

Right. Yeah, generally, you know, statistically, you are far more likely to be approved with a representative than you are without. However, and we've said this before, not great for business, but it's the truth. You can go it alone. You can go it alone through the whole process, as a matter of fact. Um the initial level, um, you need to be mindful of filling out forms, you need to be mindful of keeping up with the deadlines, cooperating with them. Um if you don't have a rep, I think you can do that. Um if they deny you that's when things get a little bit fuzzy. Um do you have uh the capacity to research the law and to why you believe you're disabled? The worst argument that you can make is I'm just disabled. If anybody saw me, they'd know I'm disabled. Or mentally, if anybody talked to me, they'd know that I'm disabled.

unknown 2:01

Yeah.

SPEAKER_01 2:02

Well what's the law? What what what are you basing your claim for disability on? And so it all boils down to a representative has expertise. The good ones have excellent expertise, and the okay ones have okay expertise, and the bad ones, you know, don't mess with them. You know, they're they're they're gonna lead you down a wrong path. And there are bad reps, and there are great reps. There are great reps that compete with me, and I wish I could say that they're horrible, but they're they're they're really good. Um, so there are good ones, they're bad ones, they're you know, kind of middle of the road ones. But when you're denied, you really do have to have a reason to tell them you were wrong. You were wrong in the denial. Um, for example, you know, there's a lot of shop talk that Social Security is going to use. You know, they're gonna give you an RFC, and then you go, do you know what an RFC is? Well, you don't have that expertise. Well, an RFC is a residual functional capacity. And well, what does that mean? Well, then it means that you can do medium work or you can do light work or you can do sedentary work. Your past work was medium, light, sedentary, might have been heavy. Do you know what those definitions mean? And are you willing to do the research to take the time? And then when you get that knowledge, you know, do you have the expertise to make an argument that will make sense to Social Security? Um, okay, you said that I have a light RFC, but I don't believe that I can, you know, perform the work as that's defined. Um I believe that I'm limited to sedentary work at best, and I'm 50 something years old, and therefore you should find me disabled. Now you're citing law. Could you do that? Um so you need, you know, after the you've been denied, you know, personally I do believe that you need a representative. And then if you're denied again, this is where I believe that it borders on foolishness not to get a representative, and that is if you're denied at the reconsideration level and you appeal for a hearing, if you think that you can go to a hearing, and people do it all the time, if you think you can go to a hearing and argue your case with a judge and then cross-examine the vocational witness that the judge is gonna call, um good luck to you, because that is where a representative really will shine, if especially if they do their homework and they know what they're doing. Um they want to make an argument to the judge, and the judge they're supposed to be just kind of an impartial fact-finder, so they're they're not leaning one way. We know that they are, but they're not leaning one way or another, you know, when you walk through the door, um, and you're supposed to push them in the direction of this, you know, my client is disabled, and this is why. And you're gonna cite law and you're gonna cite medical records, and you're gonna cite how the medical records fit that law. And then the vocational witness might give some testimony that's damaging. Well, what would you do? If you're all by yourself and you're the vocational witness, the judge asks a question, you know, if an individual, you know, Mr. Smith, you know, Mr. Smith, I'm gonna ask some questions here. You know, just listen to the vocational witness testify. Um, if you know Mr. Smith here was able to lift 50 pounds occasionally, 25 pounds frequently, they'd be able to be on their feet all day long. They could sit or stand at however they want to. Posturally, they might have some frequent limitations, crawling and crouching. Um, could this individual perform any work in the national economy? Oh, yes, Your Honor, that person could do this, and here are three jobs, and here are the numbers of those jobs as they exist in the national economy. What do you do? You're a representative, you decided to go it alone, you're in a hearing, somebody's just testified that that individual that the judge asks a question on, it's you, by the way, um, that person can work. And are you going to challenge that? Um, you're gonna ask any questions? Well, what if that same individual, you know, had to take three unscheduled breaks and they're 15 minutes each? And this is unscheduled breaks. This is beyond the three breaks you normally get in an eight-hour workday. You know, what would be the impact then? Would you ask that question? Would you be, you know, prepared enough to ask that question? The the vocational witness says, you know, well, this you know, person could do, you know, forklift operator and da da da da da da da da. And there are 373,000 of those jobs in the national economy. How'd you come up with that 373,000 number? Where'd that come from? Are you prepared enough to answer that question and challenge them when they say, well, my education and experience, you know, and my, you know, I I use a software program. You you're you're getting your testimony from a commercially available software program, and yet you're coming into this hearing puffing out your chest with the term expert on your shirt, but you got your numbers from a software program. Okay, are you prepared to to give that kind of cross-examination to the vocational witness? Well, your rep will, because that's what we do. I mean, um, and we do it in a way that's non-confrontational. Um, there's not really there's no heated arguments in a hearing most of the time. Um so uh a rep is gonna know the law, they're gonna know procedures. For our firm, at the lower levels, the initial case, you know, after you guys in intake, take the case. We file the case for you. And and that might seem like, hey, no big deal, you know, file file a case. I am super speedy on those because I've been doing this for 35 years. I I can do one, but it takes me 30 minutes. I mean, I can't do one quicker than that. So we're right out of the gate, you know, we're gonna spend, you know, half an hour just just getting your case launched online. Um so that's one of the things that our firm does. We will file your application for you.

SPEAKER_00 8:24

Um and if you did it yourself, it would take significantly longer. Oh, yeah.

SPEAKER_01 8:28

Because we do a we do we do a gazillion of them.

SPEAKER_00 8:30

Yeah, if you did it yourself, you're not gonna take 30 minutes.

SPEAKER_01 8:33

Oh yeah. It's you gotta think about it. You're online, because that's the way you have to do it now, and let's say you have eight providers that you see. Eight. I got eight doctors, you know. Well, I got seven doctors and a therapist. You have to put in every one of their names, every one of their addresses, every one of their phone numbers, every one of their dates of treatment, and if it's a hospital, they want to know what dates you were there as an inpatient, da da da da da da da, what dates you were there as an outpatient, what dates you went there just for an x-ray or some ancillary study, da da da da da da da da da da da da da da. You gotta do that, you know, seven or eight times. You're gonna be, you know, an hour and a half, two hours into this process. Um, and we do it really, really quickly, um, but that's not really that quick if you think about it. You know, 30 minutes is about as quick as I think that we can do them. But that's just to launch your case. I think one of the things that a good representative firm, in fact, I think this is probably what separates the good ones from the bad ones. A good representative firm is gonna call you periodically, and they're gonna basically say, man, we we haven't heard anything, uh, but I wanted to get with you, just check in with you. We haven't forgotten about you. I want to once again verify your case is active, it is being processed by Social Security. They move at a snail's pace. Um, but I want to check in with you. How are you doing? You know, what kind of treatment have you had? You know, you are still going, right? I'm gonna be a cheerleader. I you know, you got that's that's the secret. The secret sauce to winning a disability case is persistence and ongoing treatment. You're in treatment. That's how we prove you're disabled, is by uh, you know, the medical records that your treatment generates and we get and submit to Social Security. So we'll be a cheerleader, we'll check in with you, um, hopefully give you some peace of mind that your government hasn't forgotten about you because they take forever to do these cases. Um but I'm not going to downplay the importance of a cheerleader. You know, you I say that and you might think of pom-poms and and a short miniskirt. What I mean by a cheerleader is we're gonna continue to encourage you through a time that you're gonna feel incredibly discouraged and you're gonna be incredibly, you're gonna feel like you've been forgotten. Um a rep serves an invaluable role in those kinds of cases where, yeah, they, you know, they're taking forever, but we've checked with them. Um, we've checked with them either electronically, and we can say that case is still going and it's still there, we're good to go. Um, or we've checked with them, hey, you know, Mr. Smith, you know, he's been waiting seven months. You guys gonna get a decision out anytime soon? Um and we do that all the time. Um so that's what reps do. So I don't want to downplay the role of a cheerleader, an encourager. I you know, I call them cheerleaders, but they're really just we're just encouraging you. Um because what's the secret sauce again? Persistence. You know, I I tell my clients, and I think I've said it in the podcast, my reputation as a representative within and without Social Security is I am I am highly persistent. You know, there are so many firms that do not take a case after they've lost at the hearing level. Why? Yeah. You thought your case was so good that you went out and you puffed out your chest in front of a judge. The judge said no, and therefore, uh, well, yeah, you must not be disabled. You believed in it, you know, several months ago, but now you don't believe in it, and they drop your case. And what do I do now? Well, you still have another level within Social Security. It's called the Appeals Council. And then if the appeals council denies you, you can sue Social Security in federal court. Does my firm do that? We partner with attorneys that absolutely do that. We partner with uh almost a dozen now attorneys all over the nation. You know, here's, you know, Mr. Smith's been denied. This is why I don't believe he should have been denied. And what happens is if they get a remand, and about 75% of the time they do, it comes back to us again. We know the case. You know, yes, come back to us, we're going back in front of the judge again. You know, the judge is gonna have to clean up his mess, and you know, we do that. I would say we're probably 5% of the firms that do that. Uh if you didn't you didn't win at the hearing level, you know, just start all over. Start a new claim. And we're not gonna help you. But if you get denied again, you know, we might help you again. Yeah. What the way you helped them by by dumping me after the hearing uh was denied. So I you know, I just don't want to downplay how important having a encouragerslash cheerleader is. You know, we you know, we if we took your case, unless there was just something that we didn't find out until later, or the medical record showed something completely different than what we expected. If we took your case, it's because we believed we can win the case, and unless that's changed, medical records, you went to work, you lied to us, unless that's changed, I'm gonna take your case as far as you let me take your case. And that's my reputation, and that's why I tell my clients, I don't see no or denied from Social Security as the final decision. I just see that I haven't convinced you yet. Yep. I'll convince you on the appeal.

SPEAKER_00 14:26

Yeah, and I I see a lot of a lot of examples of what it looks like to fail as a representative because I talk to clients that have already had a representative in the past. And the most common the number one most common thing I hear all the time is have you ever filed before? Yes. Okay, were you denied or is it still pending? I don't know, I haven't heard anything. Did you were you working with the representative? Yeah, they helped me file. I just haven't heard from them though. And so now this this client is in the dark, they've it's been, you know, six months, maybe twelve months, maybe three months, whatever it is, they haven't heard from their representative. They've called, they get some kind of call center, they text, and their representative doesn't use text. And so they just they have no idea what's happening with their case. They're thinking, do I even have a case pending? Do I need to hire someone else? Do I need to refile? That is an example of a representative failing to represent the claimant. Absolutely. You are failing to advocate for your clients if you're not even keeping in contact with them.

SPEAKER_01 15:25

There is that's a great point, and you're uh sadly you're absolutely correct. There is Social Security law, and it is the responsibilities of a representative, and one of those is to maintain good communication. I think that's a quote: maintain good communication with your client. Um when I worked for disability, and we would call a law office, very, very few non-attorney reps, advocates like me, very few of those um existed at this time. That's how long ago it was. But um nine out of ten times we wouldn't get an answer, and sadly, nine out of ten times we wouldn't get a call back. You know, I'd leave a message with a receptionist or leave a voicemail. Um, yeah, I'm calling about your client, I'm processing his disability claim, I need to know this, da da da da da da nothing, we didn't get anything. So when I went when I jumped ship and went out on my own, I was absolutely determined not to be that rep. And for every single day that I've been in business, and it'll be 22 years in about a month. As a rep, when I jump shipped from Social Security, became a rep 22 years ago, I made it a mandate that every at that time, 45 days, we do about 45 now, um, sometimes 60, but usually 45 days. Every 45 days, if you haven't heard from this client, you're calling them. Oh, wait, wait a minute, that's that's gonna mean a lot of phone work for us, especially if we have you know a few hundred clients, it does mean a lot of phone work for you, and you're going to do it. Because if I was a client going through the Social Security disability process, which is completely confusing, it's daunting. There are people from my government that are saying, you know, threatening that I'm not disabled, da da da uh if I was going through that, I'd want to know that the person that I have asked to be my advocate, that's us, that they're interested in hearing from me periodically, that they care enough about my claim that they'll call me and tell me, hey man, we're still working on it. Uh, you know, I wish I could call you and give you an update. We've asked Social Security for an update, and they say the case is still being processed. But I'm still gonna call you, and I'm still gonna tell you, you know, I wish I had some news, I don't. Social Security says it's still being processed. But I did want to check in with you. How are you doing? You know, you have any any treatment? So that was my mandate when I when I jumped ship 22 years ago and started disability consulting. That the number one thing that I will never change is calling my client periodically. Because you are exactly right. I knew from when I worked for Social Security that rep firms were really bad about communication, which blows me away. But they were, most of them were really, really bad. And then just doing this for you know a few weeks, it's the same thing was going on. I realized that, you know, I'm calling uh, you know, doctors' offices and they're not calling back, and you know, it's just it's just a lot of from every direction the claimant is getting nothing. Not getting a call, not getting a call, not getting information, stuck out there, don't know what's going on, haven't heard anything for months at a time. No, no, I'm I'm not gonna be that firm. And so we do to this day, and we don't have um hundreds of cases anymore. We have you know a lot more than that. Do we still do that? Do we still is that still a mandate, Carl? Yes, it absolutely is. I tell my case managers, absolutely you have to, well, man, you know, do I have to call this? Yeah, you do. That's that's a mandate, not optional. In my firm, you want to work in my firm, you're gonna call our clients, you know, and so so we do. So that's um that's a kind of a long answer to your short question about you know why reps are needed. Um, but I think you know expertise is the obvious thing. You know, they they know the law, they know, you know, cross-examination questions in a hearing. But I just I can't underestimate how important it is to have somebody who's gonna call you up and encourage you. And secret, the the absolute secret to disability claim is persistence. Persistence, persistence, persistence. They tell you no, all that means is we haven't convinced them yet. It doesn't mean no. It means we haven't convinced them yet, and we'll just keep on pushing. And that's the reputation that I have, and I don't shy away from that. I like that reputation.

SPEAKER_00 20:23

Right. Okay, so yeah, that's more yeah, I like where you took that. That's more general for representation and kind of how we have structured the firm. Um now let's get more narrow for say I sign a client, we file the case online, and now we're working on it. What are the what are the first few things that the client can expect from us?

SPEAKER_01 20:45

Right. So after the intake, which will be a phone interview, um you probably won't hear from us because when we put the case online, I mean it doesn't do anything, it just tells us, you know, we get the confirmation so we can tell approved to Social Security. Yeah, we did put it online. Um but you probably will get a letter, it's called the attestation letter. Um it's like it's uh several pages, but you only have to sign one of them. And the attestation is basically yes, I want to apply for disability. I noticed that disability consulting made my application for me. Yes, we're in the process. We have launched. Um, so you attest to that, just means, yeah, I agree with that. Um I think some some of them have, you know, I've appointed, you know, disability consulting. It might have our rep's name. There's we've got four reps in our in our firm that handle these cases, um, me and three others. Um and it might have my name. You know, Carl, see the Carl, you've appointed Carl Groves to be your representative, and you attest to that, yeah. You initial it or sign your name. That's it. But you got to send that back to Social Security because that's what officially launches your case. Yeah, we've got the we've got it online, but if you attack when you attest it, now the case launches. What happens after that from our standpoint? Point is we've assigned you a rep and a case manager. And in disability consulting, you will always have a rep and a case manager. Now the rep will stay the same from the very first time that you know we make application for you, the rep will always be the same. The case manager might change because we have case manager ones and they're the ones who handle the initial and reconsideration cases. But when your case moves to a hearing or above, hearing the appeals counsel, federal district court, we use case manager, we call them case manager twos. They're more experienced and they handle those kinds of cases. But your rep is going to stay the same. And the rep is behind the scenes guiding them. I need you to call the cell. So I need this kind of information. These are the arguments that I need to make, but I can't make them unless we get this. And you and you and the rep will tell the case manager, you know, you get this. Your case manager is probably the engine, especially early on, initial and reconsideration, is is in disability consulting, they're the engine that that moves the train. Um because they do so much, they are the front line with you, even though we do have um, you know, our our client services people, uh represent uh receptionists, we have several of those. But the case managers are the ones who will call you periodically to you know encourage you. Hey, you know, they're the ones who who contact the lower levels and try to keep your get your case moving, keep the case moving. Um, and then when we get to the hearing level, the case manager twos, they're the ones who will request medical records. Um, you know, we pay for medical records at that level because we're responsible for building your case at that level. The lower levels, the state will usually buy the records and uh and and populate your case record. Um but case manager twos, the CM2s at uh in disability consulting, they're they're handling hearing and above levels. Um they'll do the same thing though, they'll be contacting you. Um and your case gets um it gets I guess the word is denser. I mean, uh early on we're basically just trying to push Social Security, make a decision, you know. Just this is this is this is the law that we believe applies to this case. These are the medical records that we've you know we see in his case file. This is why the case should be approved. Lower levels, we're doing a lot of that, we're doing a lot of pushing. Um, but as the case progresses through the system, you get denied at initial, well, we appeal that. You don't have to handle that, we handle that, our case managers do that. If you get appealed or you get denied at the reconsideration level, we appeal that, our case managers handle that. Um now you're at the hearing level, our case managers are going to handle, you know, making sure that all the medical records you told Social Security you have, and yet for some reason they didn't get them, we'll clean up that mess. Um, new medical records, we we we order those and pay for those, and we submit them to Social Security. Um but the case gets more dense. It just as you're progressing towards a hearing, um, you're gonna you're gonna hear from your case manager a lot more. Um and the rep the whole time is like, I need these records, and this is the this is our theory of the case, this is the law we believe applies here. I believe that these records are gonna show this, you know, blah, blah, blah. So the case manager too and the rep are really starting to work very closely on your case, the closer your hearing comes. And then before the hearing, that's when the rep will actually give you a buzz and say, listen, you know, I you know, I know you've been talking with so-and-so or my case manager. Um, I'm the one who's gonna be at the hearing with you, either on the phone or in person. I had an in-person hearing last week, is the first one in quite a while. But um, you know, and I'm the one that's gonna be asking questions, and I'm the one that that's been guiding your case managers since you first applied. Um, and so you you you get a little bit, you know, more activity going on, especially before the hearing. A couple weeks before the hearing, a week before the hearing is when um your rep will give you a call and prep you for the hearing. Um, I like prepping my clients to let them know not only what the hearing's like, and I literally will walk through the whole mechanics of it. You're gonna get a phone call, these are the people that are gonna be on the hearing. This is, you know, da-da-da. This is this is what I uh the way that you want to answer. I'm never gonna tell you what to say, but I am gonna tell you the way to answer. You know, if it's a yes or no question, answer yes or no. Um, and these are the questions I know I'm gonna ask you because I get to ask you questions in a hearing. This is how it's gonna go, this is how long it's gonna last. I you know, I give them all that. So they're not so nervous. Once again, you've hired somebody, and then you'll hear me in the in the hearing, I will give my theory of the case, what law I believe supports it. You will hear me cross-examine a vocational witness, and um that's you know, that is the process. And of course, if you know, if you're denied at a hearing, if I believed you were disabled before the hearing and during the hearing, unless something has ridiculously changed, I still believe you're disabled even though the judge said no, and I will talk to you about, hey, you know, we can go further on this. You know, this the hearing is not the the end of the road. A lot of firms treat it like it is the end of the road. Well, I didn't I didn't win at the hearing level. I'm just gonna, you know, drop your case. You know, you'll have to start all over, sorry.

unknown 28:02

Okay.

SPEAKER_01 28:02

Well, we're not like that. Um, I'll discuss with you. You know, here's what the appeals council is, and here's the the wait time usually. Um do you want to do this? You can start all over, but do you want to do this? Um appeal it if you do, we handle that. We we take care of that. That's one of the things that the the actual appeals counsel appeal brief is always by the rep. It's you know it's not the case managers do the other appeals, but um I always brief my own uh appeals counsel uh briefs.

SPEAKER_00 28:36

One of the things one of the things that I tell uh clients is the case manager is more of the day-to-day stuff, handles all the day-to-day operations. And then you can think of the representative as the strategist behind the case that's proving that you're disabled according to social security law. So they're working on the theory of the case and doing everything behind the scenes. Is that pretty accurate?

SPEAKER_01 28:58

Oh yeah, absolutely. It's you know, you got to think about some things, you know, we the the case management software that we use is real time. So I mean, if if somebody at the front desk, you know, receives a call um from a a claimant who's you know really needing to report something, um if what they'll do is they'll just transfer the call to the case manager, and the case manager can document that and we the rep sees it immediately. I mean it literally is in real time. Um so when I say that the case managers are really the engines that that run the the train, um especially at the lower levels, and then the the case manager twos um who handle um hearing and above cases, they're getting, you know, they're doing day-to-day stuff, and day-to-day stuff is not just talking to you as the claimant, it's talking to your doctors. And you wouldn't believe, or maybe you would, but you wouldn't believe how problematic it is to get your doctor to send us 25 pages that we've paid $55 for. You wouldn't believe how many times we have to call them. We requested these records two weeks ago and we haven't gotten them yet. You know, we sometimes we've prepaid for them. Oh yeah, we're you know, we're working on that. So you wouldn't believe how you know those kinds of phone calls um are necessary in the claim. Now multiply that times a few hundred and you get an idea of what the CMs, the case managers do all day long. Uh so it's not just talking to you, it's talking to um hospitals, doctors, the social security administration, you know, c case managers. Um they're on the phone pretty much all day long. Um and sadly, if you call Social Security these days, um you get really, really bad music while you're on hold, and you're on hold for you know 45, 55, 85 minutes. It's yeah, it's ridiculous. Yeah. But it's gotta be done. Somebody's gotta do it, and that's what you've uh appointed us to do, and that you know, we're by gosh, we're gonna do that.

SPEAKER_00 31:17

Okay. Well, that's good info. I think that's a good place to wrap it up.

SPEAKER_01 31:20

Cool.

SPEAKER_00 31:24

If you have a question about your disability case, drop it in the comment section below and we will do our best to answer it in the next episode.