How to Win Social Security Disability Without a Lawyer

Although you don't need a lawyer to file for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), statistics show that you're much more likely to be approved if you have representation. Additionally, having a lawyer work on your claim and handle communications with Social Security can save you a great deal of time and effort.

That doesn't mean you can't win Social Security disability without a lawyer, however. If you choose to represent yourself, you should keep in mind several important factors that can determine whether you win your disability claim.

How to Win an SSDI or SSI Disability Claim Without a Lawyer

Most people don't win their disability claim after their initial application for benefits. Usually, it takes several levels of appeal before Social Security will decide that you're disabled. But you can improve your chances of winning your claim earlier by following some basic guidelines.

Provide Social Security With Complete Medical Records

One of the main reasons claimants are initially denied is because they don't submit all the necessary medical records. Although Social Security is supposed to get these records for you, you shouldn't rely on the agency to obtain them. Claims examiners are often overworked and understaffed, and record requests can get lost in the shuffle. This means that you should review your file to make sure all the relevant evidence is included.

You'll likely have to sign a release form allowing your medical providers to give your records to Social Security, but if you request the records for yourself, you might not need a release. Either way, you might have to pay to have your records copied. Some states have laws prohibiting doctors from charging a fee for the cost of duplicating medical records for a disability claim, while others allow doctors to charge but impose a maximum fee limit. Check your state's laws on medical records handling to see how much you might have to pay for your records.

Avoid submitting irrelevant medical records to Social Security. For example, if you're filing for disability due to back problems, don't give them records from your oral surgeon or your ophthalmologist. Depending on the nature of your impairment, the agency will be on the lookout for the following documentation:

• discharge and intake summaries from any hospital stays
• emergency room records
• lab reports
• X-rays, CT scans, and MRIs
• biopsy results
• surgical reports
• clinical notes from your doctors' visits containing your doctor's observations about your physical or mental condition
• medication lists with the dosage of the medication, the name of the doctor who prescribed the medication, and any side effects you have as a result
• treatment notes from your therapist or psychiatrist
• physical or occupational therapy records, and
• school records and I.Q. tests.

Make sure that Social Security has all of the contact information for your medical sources—the names, locations, and dates of service for the providers who've been treating you. That way, if the agency needs to reach out to your doctor for more information, they can do so without delay.

Get Your Doctors' Opinions Into Your Medical Record

Social Security values the opinions of your treating providers. Because claims examiners aren't doctors, they often rely on doctors' expertise to help them make sense of the medical record. If your doctor is willing to write a supportive statement to the agency, you'll have a much better chance of winning your case.

Doctors are busy, however, and you might need to schedule an appointment, separate from your usual visits, to discuss your disability claim. Bring a physical RFC or mental RFC form with you and ask your doctor to fill it out to the best of their knowledge. RFC stands for "residual functional capacity," Social Security's term for the most you're able to do, physically or mentally, in a work setting.

A physical RFC form assesses how your medical condition affects your ability to do certain exertional activities like sitting, standing, lifting, and walking. A mental RFC form assesses your ability to perform job tasks like remembering simple instructions, getting along with others, and being reliable. If your disability claim is based on a mental health condition (such as depression or anxiety), you should ask your treating psychiatrist or psychologist to complete a mental RFC form for you.

Become Familiar With the Listing of Impairments

Social Security considers certain medical conditions to be especially severe. These conditions are described in the "Blue Book," also known as the "listing of impairments" (or simply "the listings"). Each listing contains a set of criteria that the agency will look for in your medical records to determine if you "meet a listing." During Step 3 of the disability determination process, if the agency finds that you meet a listing, you'll win your disability claim automatically, with no further inquiry into whether you're able to work.

Many of the listings have complicated requirements, such as specific blood test results. Bring a copy of the listing requirements for the condition you might qualify under to your doctor, and ask them if they think you meet these requirements. If your doctor thinks that you meet a listing, get them to include their opinion in your doctor's notes, and provide Social Security with medical records showing how you meet each requirement.

For example, if your doctor thinks you meet the listing for chronic obstructive pulmonary disease (COPD), you'll need to provide your spirometry (breathing test) results. Additionally, because part of the COPD listing requirements includes having a specific type of breathing test done, you'll have to show that your spirometry was conducted by standards acceptable to the agency.

Know How Social Security Decides Disability Claims

You can still win your claim even if you don't meet the requirements of a listed impairment. In fact, most people who are awarded disability benefits aren't found disabled because they meet a listing, but because they don't have the RFC to do any full-time work.

Your RFC typically plays a large role in the ultimate outcome of your disability claim. By knowing how Social Security uses your RFC, you can prepare better arguments as to why you're disabled. Here are some examples:

• Proving you can't do your past work. Step 4 of the disability determination process is whether you can do your "past relevant work." Having an RFC that shows you aren't capable of doing any job you've had in the past five years gets you to the final step of the process, where Social Security decides whether you can switch to other work.
• Showing that your exertional and non-exertional limitations rule out all work. Exertional limitations affect your ability to do basic strength-related physical tasks, such as carrying a package or sitting at a desk. Non-exertional limitations cover all other physical duties—like bending down to pick up a box or typing on a computer—as well as mental activities such as concentrating on your job tasks long enough to finish them. The more limitations you have in your RFC, the more likely you are to win your claim.
• Having multiple impairments reduce your RFC. Many people have more than one condition affecting their ability to work. Social Security must consider the combined impact of your conditions on your RFC. For example, chronic pain can cause depression and depression can exacerbate pain. The two impairments combined can be more restrictive than each would be separately, which can further reduce your RFC.
• Getting disability under medical-vocational grid rules. The "grids," as they're often called, are a series of tables that tell Social Security when a claimant must be found disabled. The grids take into consideration factors like your age, education, RFC, and skill set. They're only used when the agency determines that you can't do your past work, but can often make it easier for claimants 50 years of age or older to qualify for benefits.

Closely review your medical records for evidence that you can use to support the limitations in your RFC. If you think that a disability claims examiner overlooked one or more of the above factors—for example, they neglected to consider your non-exertional limitations when determining your RFC—you can raise that issue on appeal.

How Do I Apply for SSDI or SSI Benefits Myself?

Filing your initial application for SSDI or SSI is a fairly straightforward process, and most people are perfectly fine doing this step themselves. The easiest way to start is by filing your claim online using Social Security's web portal. All applications for SSDI, and certain applications for SSI, can be completed entirely online. Right now, only adults who have never been married and have never applied for SSI before can complete their SSI application entirely online, but the agency plans to expand access in the future.

Both SSDI and SSI applications are accepted over the phone by calling 800-772-1213 between the hours of 8 a.m. and 7 p.m., Monday through Friday, and speaking with a Social Security representative. Deaf or hard of hearing applicants can use the TTY number at 800-325-0778. If you'd prefer to file your claim in person, you can go to your local Social Security field office. Keep in mind that some offices require you to make an appointment, so it's best to call ahead and find out before you show up.

Winning Your First Appeal at Reconsideration Without a Lawyer

The majority of disability claimants don't get benefits on their first try ("initial application"). But the Social Security Administration has several appeal stages, and each stage presents you with another opportunity to win your case. If you're denied disability benefits after your initial application, you can ask the agency to review your claim again ("request reconsideration").

The important thing to be aware of when requesting reconsideration is the 60 day time frame in order to submit your appeal. The clock on a timely appeal starts running once you receive your initial notice of denial. If you miss the 60 day appeal deadline and you don't have a good reason why you missed it, you'll need to start over from square one by filing a new application.

Only about 15% of disability claims are approved at the reconsideration level, however. You can improve your chances at this stage by responding quickly to any notices from Social Security—such as a scheduled consultative exam—and making sure that you keep the agency updated on any new medical treatments or procedures you're undergoing. For example, if you recently had a nerve conduction study showing severe carpal tunnel syndrome, the agency may consider these new findings to be persuasive evidence of disability that they didn't have on first review, and can award you benefits on reconsideration.

Handling the Disability Hearing On Your Own

If you're denied a second time (a common occurrence), you can request a hearing in front of a disability judge. Your disability hearing is often your first opportunity to speak directly to the person who decides whether or not you qualify for benefits, and it's at this stage where most people who are ultimately awarded benefits win their case. Knowing that your hearing represents your best shot at getting disability benefits, you should make sure that you're familiar with the hearing procedure and are ready to handle it without legal help.

Prepare to Testify About Why You Can't Work

Disability hearings are held in front of an administrative law judge (ALJ) who listens to your arguments and reviews the medical evidence you have submitted. The ALJ will ask you questions about your medical conditions, your work history, and your activities of daily living. Be as specific as possible when you're describing what you can and can't do—for example, say "I can't lift anything heavier than five pounds," or "I can't stand to be around more than ten people," rather than saying "I can't carry much weight," or "I don't like crowds."

You should also be ready to discuss why you think you're unable to work at all. These reasons must be tied to your physical and mental health. Not wanting to do a specific job isn't a valid reason, nor is a lack of work available in your area. Broadly speaking, if you're younger than 50 years old, you'll need to explain why you can't do the simplest sit-down jobs full-time, while claimants 50 years of age or older will need to show that they can't make a switch to less physically demanding job from their past work (that they can't do anymore).

Address any inconsistencies in your medical records. ALJs will notice them, so don't just hope the judge won't ask you any questions about a weakness in your claim. But ALJs will also give you the opportunity to explain any unfavorable facts, such as gaps in medical treatment. For example, if you haven't received any treatment for diabetes and you're alleging that your symptoms are keeping you from working, you can explain to the judge that the price of insulin is too high for you to afford.

Understand the Role of Expert Witnesses

A vocational expert (VE) is also likely to be present at your hearing. Judges often use VEs to get a sense of the types of jobs somebody with your limitations might be able to do. The VE will also classify your past jobs according to how physically and mentally demanding the work is, and give the judge their opinion on whether you could still do that work despite your limitations.

You're allowed to cross-examine the VE as well. Pay close attention to what the VE says about your past work history and other jobs you might be able to do. If the VE doesn't classify your past work correctly, the judge might mistakenly think that you can return to that job and deny your claim. Or if the VE says that you can do a sit-down job that requires a lot of typing—but you have osteoarthritis that restricts how long you can use your hands—ask if that job could still be performed with only occasional typing. If the VE says no, then you've ruled out that job (and increased the chances that you'll win your claim).

Occasionally, a medical expert (ME) might testify at your hearing. MEs are sometimes requested when the judge thinks that you may meet or equal the requirements of a listing and wants to get a doctor's opinion to find out for sure. MEs are harder to successfully cross-examine than VEs are, mainly because you'll need to be familiar with technical medical terms. But if you think that the ME didn't review a crucial medical record that supports your claim, ask them if they reviewed the relevant evidence. An ME who says that your back condition isn't that bad without reviewing an MRI showing severe lumbar degeneration will likely not be taken very seriously by the judge.

The Appeals Council and Federal Appeals

If the ALJ issues an unfavorable decision, you can ask the Appeals Council to look at the ALJ's decision to see if the judge made a mistake, but the council doesn't have to review the decision if it doesn't think it's necessary. If the Appeals Council declines to review your claim (or denies it outright), you can appeal again—this time to the federal district court. Social Security won't help you with a federal appeal, and you have to follow the court rules carefully or your complaint will be dismissed.

Do I Really Need a Lawyer to Get Disability?

You can go through the entire disability process—and successfully win your claim—without a lawyer at any stage. People who have exceptionally solid medical records without any gaps in treatment, a robust work history, favorable doctors' letters, and no "bad facts" (like inconsistent evidence) have the best chance of winning their claim without legal representation.

But few claimants have such "open and shut" cases when they file for disability, and are often denied at first. The appeals process can take several years, during which time your health might improve or get worse. Having an attorney on your side to help you tell your story in a way that fits Social Security's definition of disability can be a big advantage for almost everyone.

Special Cases Where You Probably Don't Need a Lawyer

Applicants with a condition on the Compassionate Allowances list probably don't need a lawyer's help to get disability. Compassionate Allowance conditions are exceptionally severe (and often rare) disorders that Social Security has decided can meet a listing with only minimal objective evidence. In some very rare circumstances—including several types of cancers and Lou Gehrig's disease—the agency can award benefits as a Compassionate Allowance based solely on a medical diagnosis of the impairment.

Claimants with terminal illnesses also aren't likely to benefit from a lawyer. Social Security will even flag such applications as "TERI" cases and expedite payment of benefits. Expedited processing means that you can start receiving SSDI or SSI payments in as little as a few weeks from initial application, instead of having to wait several years.

Finding a Pro Bono or Reduced Cost Disability Lawyer

If you're hesitant to get an attorney because you're worried about the cost, it may help you to learn that disability lawyers work on contingency, so they don't get paid unless you win your claim. And if you do win, your representative will likely get paid from your back due benefits, meaning you won't have to pay much (if anything) out of pocket.

Knowing that, you may still want to explore lawyers who work completely for free ("pro bono") or on a reduced cost or sliding scale basis ("low bono"). Some legal aid organizations and nonprofit groups can help disability claimants with their SSDI or SSI applications and provide representation at hearings. Many disability rights organizations are focused on broader advocacy issues and don't usually do individual representation, but can usually point you in the right direction if you're looking for a lawyer before your disability hearing.

Check out our articles on when to talk to and how to find a good disability lawyer if you're still on the fence. When you're ready to apply—with or without representation—you can find state-specific resources at our topic page on filing for Social Security disability benefits.