The Social Security Disability Program in Massachusetts: a Non-Adversarial System

The Social Security disability program, a federal program that provides for disability benefits to those who remain long-term disabled from working, is administered through a set of rules and regulations that are promulgated as part of the Federal Social Security Act and is set up as a non-adversarial process for deciding whether an individual is entitled to disability benefits.  That is to say, when one is applying for disability benefits before the Social Security Administration, there is no need to be concerned that there is a party on the other side that is fighting against them.  Rather, the system is set up in such a way that the Social Security Administration, as an agency, is called upon to make a decision as a neutral party to the process.  Unless and until you go through the entire agency process (that is to say, an initial determination and a resulting denial, a reconsideration determination and denial, an administrative law judge determination and denial, and an appeals council determination and denial), and then appeals to Federal District Court, there will be no attorney on the other side arguing against you.   Unless and until you get denied throughout the Agency determination processes, and have to appeal the Agency to the Federal District Court, you will not be faced with a lawyer representing the Government and a position adverse to yours.

With the process meant to be a neutral one, the process is in essence a neutral fact finding process meant to find fairly and openly whether one is “disabled” as that term is defined under Social Security’s rules and regulations.  Both lawyers and claimants are expected to be open an honest with the Social Security Administration when providing information and there ares significant penalties for providing false information.   The Social Security regulations provide for both criminal penalties (including potential incarceration and fines) and civil penalties depending on the nature of the fraud committed.   Likewise, recent regulations promulgated in March, 2015 provide that attorneys have an obligation to provide all relevant evidence even if that evidence is adverse to the claimant.  Thus, the traditional notion of an attorney in the justice system as an advocate has been clarified to require that attorney adhere to their role as officers of the court to ensure that all relevant evidence is made available for review.

And so it’s important to understand when completing the various forms, whether it be with respect to the initial on line application form or the subsequent disability report forms, that one provides an honest and complete indication of all treatment providers that have been seen, for whatever medical conditions that might have been addressed (whether one feels it’s related to their disabling condition or not).  Likewise, if one has undertaken work for pay or barter, whether it’s above the table or under the table, it’s important that one disclose this work.   The failure to disclose that one has been working would constitute a serious misstatement of a material fact and could 1) prove fatal to one’s claim and 2) prove to be a basis for criminal and/or civil penalties.  The Social Security regulations likewise provide that your attorney has an ethical obligation at the Administrative Law Judge (ALJ) hearing process to ensure that they do not mislead the ALJ or allow their claimant to mislead the ALJ on any material fact.  20 C.F. R. §404.1740(c)(3).

Thus, to ensure there is no issue with one’s ethical obligations throughout the disability determination process, it’s important to obtain a Massachusetts SSDI attorney schooled and experienced with the ethical requirements of the Social Security regulations as soon as possible in the application process so they can help you complete the various forms accurately.   This is especially important as you prepare for a hearing before an ALJ so that you have an understanding of the types of questions that will be asked of you at hearing and so you’re prepared to answer these questions accurately and efficiently.  The ALJ’s determination of your honesty and credibility at hearing is essential to ensuring not only compliance with Social Security’s regulations referenced above but also receipt of a favorable determination from the ALJ hearing your case.