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By Scott B. Elkind, Esq.

Many persons receiving long term disability benefits will be contacted by their insurers to encourage beneficiaries to apply for Social Security Disability and utilizing the company’s Social Security Disability vendor.  Some insurers will state that the representation will be done at no cost to the claimant.  There are several important facts that the disability insurers are not disclosing to you which may change your mind quickly, which include:

Claim #1: We provide a claim representative at no upfront cost to you.
Truth: Any attorney or representative representing a claimant before the Social Security Administration does so on a government-regulated contingency fee basis.  There should be no upfront costs, ever
Claim #2: We recommend the following vendor to assist you
Truth: Many vendors are paid directly by the insurer and not really working for you.  Their purpose is two-fold: (1) if your case is strong, the insurer will obtain an offset of benefits (reducing what they pay you by the amount of monthly SSD/SSI benefits paid by SSA) or (2) if your case is weak, to provide the insurer with medical evidence it can utilize to deny your claim.
Whereas, a private LTD counsel will not produce adverse evidence to the insurer and only works for your interest
Claim #3: A skilled representative will assist you
Truth: Most of the insurer vendors utilize claims “representatives” to represent you.  These people are not attorneys and most have not undertaken representation before the judge at your local Social Security hearings office more than a couple times at most.  A private Social Security attorney represents claimants before SSA on a routine basis and knows not only the local office “ropes,” but also has a full legal education and can represent claimants before a federal appellate court, if necessary. Whereas, the representative is not permitted to file an appeal to a federal court
Claim #4 A few insurers pay their vendors flat fees for representing you
Truth: These vendors have no “skin in the game” and make money whether you are successful in your claim or not. Therefore, they are not underwriting any risk and will not work as hard to win your case.  Further, they are owned by the insurer and can only survive by referrals from this source. For these reasons, these representatives are never on your side.

So, when you are contacted by a disability insurer, please take these factors into consideration when choosing a representative for your Social Security Disability case.

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