The document provides a comprehensive guide for starting and managing a Social Security disability practice, detailing the attorney's background, goals, and resources available for legal aid. It outlines key components including case development, forms required, interviewing techniques, and defenses against common pitfalls such as non-compliance and fraud. Additionally, it emphasizes the importance of ethical standards, relevant legal codes, and client representation in the context of Social Security disability claims.

1. An Introduction to
Social Security Disability
Attorney Precious L. Vines, MSHS
Friday, March 20, 2015

2. Introduction
My history
O 2000-present
O Former Disability Examiner
O Worked with Private Attorneys, Law Firms,
and in Private Practice
O Pro Bono Service-Legal Aid of NC

3. Starting a Social Security
Disability Practice….
O Goals?
O Time Commitment?
O Knowledge and Understanding?
O Assistance?
O Additional Sources of Income?
O Client Relations?

4. Starting a Social Security
Disability Practice….
O Representative Learning Opportunity:
Pro Bono Service-Legal Aid
Representative Learning and Resources:
Disability Rights of NC
Client Resources:
www.disability.gov
Client Resources:
www.lawhelpnc.org

5. Statistics
O Does having a representative increase
chances of an allowance?
O Will a representative speed up the
process of processing a disability claim?

6. Toolkit
O Bluebook-SSA Disability Listings
O SSA website: Videos, Tutorials and
Handouts
O Forms Review
O Shadow a Disability Attorney

7. Case Development
O Adequate medical records documented
O Complete list of all medical providers
O Complete list of all alleged impairments
and dates
O Documentation of current activities of daily
living
O Documentation of past work and current
work, if applicable

8. Interviewing and Information Gathering
O Allow extra time for interviews/calls.
O Ask about client’s time to do interview.
O Quiet Environment.
O Break up complex questions.
O Ask clarifying questions.
O Use summarizing.
O Be aware of “Open Questions” and
“Closed Questions”.

9. Forms to Remember
O SSA 561-U2-Request for Reconsideration
O SSA 821-Work Activity Report
O SSA 827-Authorization to Disclose Info.
O SSA 1696-Appointment of Representative
O SSA 3368-Disability Report (Adult)
O SSA 3369-Work History Report
O SSA 3441-Disability Report-Appeal
O SSA 3820-Disability Report-Child

10. Medical Records
O Ensure time period covered
O Clear documentation of allegations
O Beware of inconsistencies
O A. medical diagnosis
O B. Claimant’s ADLs or continued work
O C. Substance abuse
OUnderstanding of abbreviations and terminology

11. Resource Links
O Disability Planner
O Disability Starter Kit (Adult)
O Disability Start Kit (Child)
O Online Application for Disability Benefits
O Representing Social Security Claimants
O Medical Abbreviations Dictionary

12. Client File
O Disability Determination and Transmittal
O Disability Determination Explanation
O Notice of any Disapproved Claims
O Representative Fee Agreements
O Appointment of Representative Forms
O Hearing Notices
O Earnings Queries
O Work History
O Disability Report
O Recent Medical Treatment
O Medications List
O Medical Records

13. Medical Summary/Brief
O Submission before hearing to ALJ
O Ensure no outstanding records
O Time period adequately covered
O Have client’s prior file
O File has been thoroughly reviewed

14. Organization of Medical
Summary/Brief
O Claimant’s identifying information
O Age at onset and current age
O Alleged onset date (AOD)
O Date Last Insured (DLI)
O Application Date
O Claim Type(s)
O Prior Claims and any ALJ denials
O Work History

15. Organization of Medical
Summary/Brief
O Education and Special Education
O Return to Work Attempts
O Physical and Mental Impairments
O If claimant meet or equals a listing
O Medical evidence of record

16. Organization of Medical
Summary/Brief
Medical Evidence of Record Reminders
O List all medical record synopsis in chronological
order
O All exhibits listed in the file, as provided by SSA
should be addressed unless duplicate or not
substantial
O Pull relevant information from records that support
claimant’s alleged impairments
O Address any discrepancies in file with client before
submission of medical brief, and before hearing

17. Meeting or Equaling a Listing
O 607. Medical Evidence as Basis for
Decision of “Disabled” -- Listing of
Impairments
O Meeting a listing?
O Equaling a listing?

18. “Red Flags”
O Substance abuse
O Cane usage
O Current work not addressed
O Malingering
O “Doctor shopping”

19. Defining Non-compliance
O What is non-compliance?
O Common types
O Relevancy to case

20. Mental Impairments:
Areas to Remember
O Special Education classes
O IQ=59 or less (12.05 B)
O IQ=60-70 and dual diagnosis (12.05 C)
O IQ=60-70 and marked deficiencies
(12.05D)
O Marked restrictions noted
a. (ADLs)
b. Social Functioning
c. Concentration, Persistence, and Pace

21. Global Assessment of
Functioning (GAF)
O Defining GAF
O Relevancy to mental impairments
O Relevancy to functioning and case
analysis

22. Mental Impairments:
Areas to Remember
O 12.04-Affective Disorders (Mood
Disorders)
a. Ex.-Major Depression, Bipolar Disorder
b. Extensive documentation and marked
decompensation
c. Inpatient hospitalization
d. Medical records supporting physical
symptoms resulting from affective disorder
e. Inability to function in basic areas

23. Substance Abuse
O 12.09-Subsance Addiction Disorders
O Not a “stand-alone” listing
O History and cessation is important
O Materiality of substance abuse-Code of
Federal Regulations Section 416.935

24. Application of Ethical Code
20 Code of Federal Regulations Section
404.1740:
Rules of Conduct and Standards of Responsibility for Representatives

25. Disclosure-NC State Bar
O Rules of Professional Responsibility-
Rule 4, Rule 7.2
O 98 Formal Ethics Opinion 1-Disclosure
of Adverse Evidence in a Social Security
Disability Hearing
O RPC 230-Disclosure of Adverse Medical
Reports in a Social Security Disability
Case

26. Client Fraud
O Cooperative Disability Investigations
O New York Social Security Disability Fraud
Scheme; Press Release
O Attorney Eric C. Conn-West Virginia

27. Marketing
O 2012 Formal Ethics Opinion 1
Use of Client Testimonials in Advertising
O Binder v. Disability Group Inc.
1. Trademark Infringement
2. False Representation
3. Unfair Competition)

28. Client Representation
O 2005 Formal Ethics Opinion 2
Representation of Nonlawyer for Social
Security Disability Claims
O 2003 Formal Ethics Opinion 10
Fee Sharing with Nonlawyer/Claimant’s
Representative in Social Security Case
O 2005 Formal Ethics Opinion 6
Compensation of Nonlawyer Employee Who
Represents Social Security Claimants

29. Client Competence
O RPC 157
Representing a Client of Questionable
Competence

30. Updates
O Administrative Updates
O Court and Administration Decisions

31. Resources
O National Organization of Social Security
Claimant’s Representatives
(www.nosscr.org)
O North Carolina State Bar: Rules of
Professional Responsibility
(www.ncbar.gov)
O Office of the Inspector General
(www.oig.ssa.gov)
O Social Security Administration
(www.ssa.gov)