Every month, we are contacted by potential clients all across the nation
asking if we can help them with their SSDI/SSI case. We strive to be as
selective as possible in taking only the strongest cases up to the federal
government. As a result, this means we cannot take every case and we unfortunately
have to turn down a large number of potential clients. This inevitably
raises a question: “why won’t you take my case?” In
this post, we want to discuss some of the more common issues we encounter
and give you an idea how we decide whether a case meets our standards
We first want to stress, however, that our callers are some of the most
sincere, deserving individuals, many of whom are suffering terminal and
lifelong illnesses that legitimately keep them from working. Unfortunately,
not every deserving case is possible to prove in court. As attorneys,
we are ethically bound to only take only the cases we reasonably believe
will be meritorious. We, therefore, are selective not only by choice,
but also by duty.
Also bear in mind that this post is intended only to address the most common
issues we see, and none of these factors may be relevant to your case.
Every SSDI/SSI case is unique, and deciding whether to take a case involves
a careful review of a constellation of different factors.
Here are some of the more common factors that can make a difference:
Eligibility: There are various types of disability benefits, including SSI benefits,
SSDI benefits, disabled widow’s benefits, and MQFE benefits, just
to name a few. Each of these programs has its own set of technical requirements,
and not everyone is eligible. For more information on these requirements,
see our section on
Qualifications for Social Security Disability.
Age, education, and work history: These factors are critical to determine whether or not you qualify under
the federal government’s definition of disabled. Some of this is
to be expected. For instance, we can all agree that returning to the workforce
becomes gradually more difficult with age, particularly if a person has
to learn how to perform a job he or she has never held in the past. Likewise,
your education makes a tremendous difference on whether you can work.
If you have highly marketable skills that give you a significant advantage
over unskilled workers, the government may conclude that you are not disabled.
In fact, even if you never sought higher education or vocational training,
you may possess highly marketable skills by virtue of learning them on
the job. If that is the case, we may decline representation because it
will be too difficult to prove you qualify under the government’s
definition of disability.
Your medical condition: The government’s definition of disability requires proof that you
cannot work “by reason of any medically determinable physical or
mental impairment…” What is particularly important here are
the words “medically determinable,” and some impairments are
inherently more difficult to prove than others. For instance, while a
broken bone may show up on an x-ray, a mental impairment does not necessarily
show up with conventional diagnostic testing. Fibromyalgia, in particular,
is extremely difficult to establish, and it is often diagnosed by excluding
other possible medical conditions. Consequently, it has been our experience
that proving disability due to fibromyalgia is extremely difficult, and
we sometimes have to decline representation for the simple reason that
we cannot show there is a “medically determinable” impairment.
Your treatment: Your treatment is just as important as the medical condition you suffer.
When a person has no medical treatment, we usually cannot take the case
because the government puts the burden of proving a disabling medical
impairment on the disability applicant. Moreover, the medical impairment
must be confirmed by an “acceptable medical source,” and not
every healthcare professional meets this definition.
- Another thing we consider is whether you are following your doctors’
orders. Unless there are unusual, compelling circumstances, the government
will not compensate you for a medical condition that is self-imposed.
Consequently, we sometimes have to refuse representation when a person
fails to take their medication, follow up with their physicians, or obtain
treatment that is reasonably necessary.
Other factors: Even when all of the factors above are favorable to a person applying
for disability, other factors can make the case very difficult to prove.
For instance, an otherwise outstanding case can be destroyed when the
person seeking disability is using illegal drugs or alcohol. We also see
instances where a person, often through no fault of their own, has become
addicted to narcotic pain medication, which can also make their case difficult
to win. A person’s limited work history or criminal record can also
occasionally be problematic. But, as you can imagine, there are any number
of factors that play a role in a disability case, and it is impossible
to list them all here. This only further demonstrates how unique each
case really is.
While this only scratches the surface of all the complexities we consider,
these are the most common factors we review when deciding whether to offer
legal representation. Again, no two cases are alike, and the decision
of whether to take a case depends on a careful weighing of these and other
factors. If you have questions about whether you qualify for disability
benefits, or if you are looking for legal representation,
please contact Coats & Todd.