Denied Claims

If your claim for Social Security Disability (SSDI) or Supplemental Security Income (SSI) is denied, do not give up! Contact me right away at 503.620.3171 or at slgabin@pacifier.com. After listening to your situation, I will tell you whether you have a valid appeal to pursue and I will help you understand all of your options and how best to proceed. This is the time to have an experienced lawyer at your side. I have years of experience helping disabled people win their claims.

Time Limits

The time limit to appeal is ticking away. Do not lose valuable benefits by missing a deadline. Most notices contain a 60 day time limit from the date you receive the notice. You are presumed to have received the notice within five (5) days from the mailing date.

Valuable benefits may be lost because a claimant has missed a critical deadline. When you receive a notice denying your claim, at any time, DO NOT GIVE UP. Contact me immediately.

Reconsideration

This is the first level of appeal. It takes about two to six months. At reconsideration, most claims are denied again. Contact me right away to request Reconsideration.

Most claims are denied on reconsideration regardless of the merits of the claim. If you have requested reconsideration on your own and if your claim remains denied, contact me right away to appeal the “Notice of Reconsideration.” It is now time to request a Hearing.

The Hearing

The hearing is the level of appeal after reconsideration. It is time to request a hearing as soon as you receive a “Notice of Reconsideration” that continues to deny your claim. The hearing consists of your appearing personally before an administrative law judge where you testify under oath. You have the right to be represented by a lawyer. I have years of experience representing disabled clients at Social Security hearings. As your lawyer, I will develop the medical records as much as possible to show that you are disabled. At hearing, I will ask the questions that are necessary to show how your impairments affect you. Most claims that go to a hearing are won at the hearing. It takes about 18-24 months to get a hearing. Often I am able to shorten the wait (see below). Contact me right away.

Speeding up the Long Wait for a Hearing – On the Record Decisions

I realize that most claimants need their benefits “yesterday.” Unfortunately, in Oregon the wait for a hearing is running 18-24 months. I view all cases I accept as “winnable,” and many “winnable” cases I view as very strong cases. After I request a hearing, I order your medical evidence and if this evidence shows clearly that you are disabled, I am often able to shorten the long wait by asking an attorney advisor in the hearings office for a decision on the written medical record. Your claim may be resolved within about two to six months after you have requested your hearing without your ever having to attend a hearing.

But plan on the “long wait.” This is the “default” process and is what you should expect.

Appeals Council Review

Some claimants lose at hearing, in my experience about 10-15 percent. This is unfortunate and often involves a very good claim. When you lose your hearing, and if the medical evidence supports your being disabled, I keep on working for you. The next level of appeal is called Appeals Council Review before an Administrative Law Judge in Falls Church, Virginia, someone you will never meet. In my experience, over half the time the Appeals Council simply “passes” and affirms the unfavorable hearing decision with no more than a boilerplate letter “denying review.” However, when going to the Appeals Council, there is the opportunity to introduce new evidence that addresses your disabling condition and this evidence can be considered at the next level of appeal, Federal District Court Review. So, do not give up if you lose at hearing or at the Appeals Council. If you do not have lawyer, contact me. I have years of experiencing handling appeals post hearing.

Federal District Court Review

If you continue to lose at the Appeals Council, the next level of appeal is Federal District Court Review. This review takes place before a seated Federal Judge or Magistrate. In my experience, about 60-80 percent of cases that go to Federal Court are eventually won. If you have not yet hired a lawyer, contact me. I have years of experience representing disabled clients in Federal Court.

Attorney Fees

Attorney fees in SSDI and SSI claims are set by statute and are strictly contingent. That means I receive a fee ONLY if you receive benefits. That means you do not owe me a fee UNLESS you receive benefits.

• If you win at reconsideration or hearing and without going to Federal District Court

Fees are 25% of past due benefits with a maximum fee cap of $6,000.00 (or the statutory cap in effect on the date of the decision awarding benefits) if you win your case at anytime without proceeding to Federal District Court.

• If your case goes to Federal District Court

If your case goes to Federal District Court, and if you receive a remand for rehearing, I will request a fee for my Federal Court time to be paid by the government. If I win for you at a rehearing, your fee is 25% of past due benefits with a fee cap of $6,000 (or the statutory cap in effect on the date of the decision awarding benefits).

If you receive a remand for payment of your benefits, I will request a fee for my Federal Court time, to be paid by the government. I will also request a full 25% of your past due benefits without a cap, offset by any fee I receive from the government.

Costs

In nearly all cases, I will incur out–of–pocket costs. These are not attorney fees, but are fees for such things as medical record duplicating charges, attorney/doctor conferences and treating doctor medical reports.

I incur expenses only when necessary to prepare properly. I am bound to follow Oregon State Bar ethical rules that require the client to assume responsibility for these costs if the client is able to pay. Therefore, I will bill for these costs but will not expect payment unless you can afford to reimburse me.

Free Consultation

Contact me at 503 620-3171 or at slgabin@pacifier.com for a free in-person consultation about your denied claim for SSDI or SSI.