If your client doesn’t qualify for our SOAR Project, and other legal services aren’t a fit for whatever reason, a good case manager can make a great deal of difference in the outcome of a SSD/I case. See below for some general guidance on how you can help.
Disclaimer: the following is cursory in nature, and by no means exhaustive. It is only an overview for case managers and social workers.
Know when to file a claim
Social Security defines disability as “the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”
You know your client better than Social Security does. If you can say in good faith, “my client is unable to earn substantial gainful activity ($1,690/month in 2025) due to their medical condition or mental illness, and I know there’s an established record of medical evidence of that condition or illness,” then you have the bones of a theory of disability. It might be time to file.
Optional: Enter into non-attorney representation
You don’t have to be an attorney to formally represent your client. If you complete this simple SSA-1696 with your client, you will be able to directly advocate on their behalf, even without their presence. Otherwise, you will need your client present and consenting to take any direct action on their behalf.
Updated guidance! If you have never registered as an authorized representative with SSA before, you will need to do so in order to enter into representation by filing a SSA-1699. Simply fax the form to 877-268-3827, and you should receive a notice with your representative ID number in the mail within a week or two.
Avoid a technical denial at the field office
The vast majority of initial Disability claims are denied for technical reasons–very often missing paperwork. Once you enter into representation, Social Security is required to copy you on all mailed correspondence (although, fair warning: with Social Security, what’s supposed to happen and what happens isn’t always the same thing).
Now you can make sure all components of a disability claim are completed and submitted to the field office per SSA’s guidance. Those components include:
- SSA-16: Social Security Disability Application (online)
- Signature page for SSA-16 (PDF)
- SSA-8000: SSI Application (PDF)
- SSA-827: Authorization to release information to SSA (PDF)
A claims representative from the field office will be in touch in case anything else is needed or needing amending. One of the best things you can do for your client at this stage and throughout is follow one simple rule: always be reachable.
Avoid a medical denial at the Disability Determination Services
Once the claim is processed by the field office, it will be assigned an adjudicator at the DDS . This is the person responsible for collecting and evaluating the evidence of disability. Note: final decisions are made by doctors at the DDS, who you will not have access to. Still, the adjudicator plays a pivotal role, and there are three main ways you can work with them to help provide the fairest outcome for the claim.
1. Steward the medical evidence
Make sure the adjudicator is aware of ALL relevant treatment providers. When you begin to receive correspondence from the adjudicator, look for the bar code–there should be a phone number there. It’s good practice to call, introduce yourself as the non-attorney representative, and make sure they are aware of any place your client has received treatment for their disabling condition(s). You can also make sure they are successful in actually obtaining all evidence. Call providers, and ask them to please comply with the records request the adjudicators will be sending out.
Note: YOU are a treatment provider! You can use the fax cover sheet to submit all your case notes and any evals or treatment docs you have on file. For an extra push, write a letter of support.
2. Help with the reports
The adjudicator will send one or two reports out for the client to complete, a work history report, if applicable, and an adult function report. You can either help them complete the reports or complete them on your client’s behalf. They can be faxed back to the adjudicator using the same fax cover sheet.
3. Help Complete the Consultative Evaluation
Very often, the adjudicator will order a consultative evaluation through a third party. Help your client schedule this and attend. You can make sure your client is as thorough as possible during the evaluation. In fact, you presence alone will make a difference to the evaluator.
Support your client through the decision
In the home stretch of a claim, as in any other time, the earliest advice we gave is still critical: always be reachable! The field office will reach out either via phone or mail, and you don’t want to miss it.
If your client is awarded a favorable decision, amazing. Congratulations! Help them complete the PERC appointment with the field office and finally get into much-needed, deserved pay. This appointment is required to finalize financial details; make sure your client has their current address, any rental agreement, and bank information on hand for the PERC. Important: if too much time passes from the time of the decision, and they still have not completed this important step, the claim can be reversed on a technical basis.
If your client’s claim for disability is denied, don’t lose heart. These are complicated processes, with very high bars to clear. Still, it’s understandably disappointing, and your client will likely need support in thinking about next steps. You’ll have 60 days to file a request for reconsideration, which would be the quickest recourse, usually resolved within a month or two. If the reconsideration is denied as well, you can file a full appeal. This will be a long, complicated process, though, and it might be advisable to reconsider bringing an attorney into the picture and transferring representation. We recommend first trying a free legal services program that serves your area–a simple google search will usually yield something.
