In this episode of Stress-Free IEP®, Frances Shefter speaks with Anjel Burgess, Managing Attorney at Burgess & Christensen, a firm solely dedicated to matters involving Social Security disability, veterans disability, and adult guardianship. For over a decade, Attorney Anjel Burgess has provided skilled representation to individuals and families inside and outside of the courtroom.
Tune in to the episode to hear about:
The difference between SSI and SSDI benefits and how to know which one is right for you
How the Social Security Benefit application process works
What to do if your application for benefits is denied
The benefits of hiring an attorney when seeking Social Security benefits
Learn more about Anjel Burgess and Burgess & Christensen:
Frances Shefter is an Education Attorney and Advocate who is committed to helping her clients have a Stress-Free IEP® experience. In each podcast, Frances interviews inspiring people to share information, educate you, empower you and help you get the knowledge you need.
VOICEOVER:(00:00:05): Welcome to Stress-Free IEP®. You do not need to do it all alone with your host, Frances Shefter, Principal of Shefter Law. You can get more details and catch prior episodes at www.shefterlaw.com. The Stress-Free IEP® video podcast is also posted on YouTube and LinkedIn and you can listen to episodes through Apple podcasts, Spotify, Google Podcasts, Stitcher and more. Now, here’s the host of Stress-Free IEP®. Frances Shefter.
Frances Shefter: (00:00:42): Hello, everyone and welcome to the show. Our first show of 2024. It’s a new year. Yay. And today’s topic which I’m really excited about is SSI and SSDI and I’m not gonna mess it up by saying it, but our guest Anjel Burgess with Burgess and Christiansen has been representing families in and out of the courtroom on SSI and SSDI claims for over a decade. So, Anjel please introduce yourself a little bit and tell us a little bit more about yourself.
Anjel Burgess: (00:01:14): Well, thank you. Thank you for having me. As you stated, my name is Anjel Burgess. I practice social security disability law which means that I help families to get approved for SSI and SSDI benefits. And I am able to help clients across the country because Social Security is a federal program. So that is what we do, that’s what we love to do and we’re excited to, you know, help out and I’m thrilled to be here to talk.
Frances Shefter: (00:01:52): Great. Awesome. Thank you. So, the first question I wanna ask cause I always mix it up and I never know what the difference is. SSI versus SSDI, what’s the difference? And how do you know which is right for you?
Anjel Burgess: (00:02:04): So SSDI is the program that’s traditionally known as like the workers program. So with that program, you are working, you’re paying into retirement, you’re paying into disability. So that in the event that you become disabled, you can draw benefits from that program, SSDI also comes with Medicare health insurance as opposed to SSI, which is also a disability program, but that is the program that is, it’s a needs based program. So of course you have to be disabled to get benefits but you have to meet income and asset requirements. So they’ve got really strict rules about how much money you can have to be eligible for SSI. So when you think SSI think money, I have to make sure that I don’t have too much money in order to qualify for SSI, you don’t have to work your way into eligibility for SSI you can get it if you’ve never worked before, children can get it as well. So it’s really a program that’s available to everyone as long as you meet this financial requirements.
Frances Shefter: (00:03:22): So interesting. So children can get it also. How would that, what does that look like?
Anjel Burgess: (00:03:27): So, for Children, when we’re talking about meeting the financial requirements, they look at the parents’ income. So they’re looking at the household income to make sure that the child qualifies for benefits, but as long as the financial requirements are met, so they’re looking at mom and dad’s income to make sure that they fall under the threshold for SSI but the child can certainly receive benefits, you know, on their own based off of the child’s disability.
Frances Shefter: (00:04:02): Interesting. OK, so that is cause I heard one time somebody was saying, oh, if your child has an IEP, you can qualify for SSI but that’s not totally true.
Anjel Burgess: (00:04:11): Not I mean you can, but it’s not based upon the IEP, the IEP is just kind of one tool that can be used to support the eligibility. So to support the claim.
Frances Shefter: (00:04:24): Got it the disability and I know I helped a client one time years ago. And it’s complicated like these, these applications, it’s not just I can’t work.
Anjel Burgess: (00:04:34): That’s right. It’s incredibly complicated. And so that, that’s why you know, you’ll hear people talking about disability all the time, like, you know, oh, nobody gets it. Everybody gets denied. It takes such a long time and, you know, many of those statements are true to some degree. But it is not just a program that most people simply just fill out one application for and they get approved. It is quite an in depth, process, , that social security uses to decide whether people are disabled. So it’s long, it’s confusing, it’s frustrating, it’s all of the above. But fortunately, there are attorneys such as myself whose, you know, job is to help and to help our clients to get approved for these benefits.
Frances Shefter: (00:05:30): And I, I mean, I have no idea if these statistics are right, but I heard at one point that only 25% of applications get approved on the first time. Does that sound about right?
Anjel Burgess: (00:05:40): So, pre-covid, I would say that was pretty spot on. We have seen since COVID that there has been a little bit of an improvement in that statistic. Now, I would say 25% to 33% of people are going to get approved at that initial application phase. But that’s still a lot of people that get denied. And so the the real challenge then becomes, you know, once there’s been a denial, continuing to go through the process to try to get an approval.
Frances Shefter: (00:06:16): And descend an appeal in. Yeah, that’s what I heard, which is so frustrating, I’m sure. But, I mean, I get it because it’s, the government’s, you know, they’re kind of like, they don’t want somebody to be able to fake their way into getting benefits.
Anjel Burgess: (00:06:30): Right. And, you know, you, bring up a really good point, because a lot of what we see, like, online and in the media is we see this like reports, there have been stories in the past about people like faking their disability and in actuality, the number of people that engage in fraud is extremely low, like 1% to 3% like it, it’s an extremely low number of people that are actually engaging in fraud. Contrary to what you see, most people have no desire to, you know, pretend to have a condition, you need documentation. So that’s really difficult to do, you know, you need documentation from your medical providers. So for someone to fake a condition really hard to do, there can be some questions about the severity but statistically speaking, the vast majority of people that receive disability benefits legitimately are disabled. There are just a very few numbers of people that you know, don’t need the benefits. And then there are also people that may need the benefits for a period of time they improve, they get, you know, the treatment that they need maybe medication, there’s been something new, something different that helps them. So they no longer need the benefits anymore. It is not a lifelong, it’s not intended to be a lifelong benefit.
Frances Shefter: (00:08:11): So do you have to reapply every year?
Anjel Burgess: (00:08:14): You don’t reapply, but once you do get approved for benefits, there is what they call a continuing disability review. So they are going to review everyone that receives disability at some point in time. And that review time frame can range anywhere from like 1 to 7 plus years. And so when Social Security approves someone for disability, they will tell you you are going to be reviewed in X number of years. So they give you warning in advance. Hey, we’re gonna look at your case, let’s say in three years and we’ll contact you at that point and then they’ll start the review process and as long as they find that your disability continues, then there’s no interruption. But if they find that you’ve improved, then that’s when you have to start going through an appeal and getting back into the process, unfortunately.
Frances Shefter: (00:9:10): And have you noticed a difference? I mean, I don’t know if this is something you track or not, but do you notice a difference of applicants with an attorney versus applicants without an attorney on the approval rate?
Anjel Burgess: (00:9:22): So it’s not something that I track. but I will tell you that I do get a lot of clients who’ve gone through it on their own sometimes all the way through to a hearing on their own and, you know, received a denial and, part of the challenge with just the process in general is that if you don’t know the rules and regulations, then it’s hard to know what you’re trying to prove. What’s the end game? Do you know what these benefits are for? Do you, you know, do you meet the requirements? So it’s really helpful. I would encourage everyone to at least consult with an attorney. You don’t have to have an attorney if you don’t want to, but to at least consult with an attorney to get a professional opinion about, you know, are benefits likely, you know, are you likely to get approved for benefits are, what are the obstacles that may be standing in your way to an approval? What do the rules say? You know, just those types of things? It’s important to know before you decide to apply on your own because I mean, you can apply on your own if you’re not sure what the rules are or what you need to be doing, then that ultimately can affect your eligibility down the road and it can make it much more difficult for you to get approved later on.
Frances Shefter: (00:10:48): Which makes sense. I mean, it’s the same thing with IEPs. You don’t know what you don’t know. And how to prove what, you know, pull from the reports, what you need to prove, especially with the medical reports.
Anjel Burgess: (00:10:58): Yes.
Frances Shefter: (00:11:00): Yeah, like, you know, like obviously you don’t work, I don’t think you have a medical degree but not, but you know what in the reports are needed to be pulled to prove the disability.
Anjel Burgess: (00:11:13): Absolutely. And you know, just to, to kind of clear up some, another misconception that I hear a lot about disability people will say, oh, well, they just rubber stamp, everybody’s, you know, application. So all these people that are getting denied, it’s just a rubber stamp. It’s like an automatic denial and that is not the way that it works. There is indeed a process, a very detailed process that Social Security goes through with, you know, every application to see if that individual meets the requirements and that includes a medical review. So Social Security does have their own physicians and psychologists that are in house and it’s their job to read through the medical records and reports IEPs any and every piece of evidence that, that they obtain, it’s their job to read through review the medical and then give their opinions as to, you know what they think in terms of what your conditions are and how severe those conditions are. So, if you’ve received a denial from Social Security, you know, it’ll usually say something like, you know, we’ve reviewed your medical records and and our doctors have determined that you don’t meet the requirements. And, that’s legitimately true, they do have their own doctors who review the medical evidence and you know, give their opinions on disability.
Frances Shefter: (00:12:46): So on appeals, is it like so in the court as I’m sure, you know, you can appeal, but you can only work on the evidence that was presented. If you appeal on disability, can you put in new evidence, additional reports?
Anjel Burgess: (00:13:00): So the answer to that is it depends on what level you’re appealing. So if you filed an initial application and you get denied and you appeal that. Absolutely, you can submit new evidence. If you get denied again and you request a hearing, absolutely, you can submit new evidence. But if you get denied at a hearing and you want to file an appeal from that point, then you’re not allowed to submit new evidence that has, you know, anything that’s transpired after the decision, right? So if you get denied today on January 1st 2024 you’ve got or January 2nd 2024 you’ve got 60 days to file the appeal. So you can’t run to the doctor tomorrow and say, oh, I got denied. You know, let’s tell the judge about what’s going on for my appeal. So you can’t submit new evidence in that regard, but you can submit new evidence that maybe Social Security didn’t have for whatever reason that still relates to that time frame. So new evidence that would have been new to the judge at the time that the decision was made, you can submit after being denied at a hearing. So it just depends on what part of the process you’re in.
Frances Shefter: (00:14:23): So, I mean, here’s a question that if you get, I’m just thinking of somebody that decides to do this on their own. And they get denied and they miss the appeal time frame. Is there anything you can do to help? Can they reapply or are they done for a certain time period?
Anjel Burgess: (00:14:43): So in most cases, as long as you are still meeting the technical requirements or the non-medical requirements, they call them, then in most cases, you can just reapply. But the caveat with that is that if you are reapplying that denial that you received, that’s the final determination. So you are literally starting all over. And so whatever time it took to get that denial, so you could have been waiting for years. You didn’t, you were denied, you didn’t appeal, you were starting from now, even though you had previously waited two years. So it is really important that if you get a denial, to know that you’ve got 60 days to appeal that denial, do not let that 60 days run out. Even if you’re not entirely sure, well, you know, maybe I did it on my own. I don’t have, I didn’t have an attorney and I need to find one, find an attorney. If you need to request an extension, you can try to request an extension of time. It just depends on what stage of the process that you’re in. But if you know, if you’re not able to do that at least call social security and say to them, I want to appeal so that it will be noted that you are, you know, filing an appeal and they’ll walk you through it and that will preserve your claim and then you can try to find an attorney. If the time is running out on you, but it’s really important to try to keep that claim going for as long as you can.
Frances Shefter: (00:16:23): That makes sense cause and I guess that’s, that’s where it makes sense to bring in an attorney sooner rather than later. Because if you’re, if you’re in the case from the beginning and you get denied, you can help the client on the appeal automatically. They don’t have to think anymore.
Anjel Burgess: (00:16:41): That’s right. That’s right. We can literally step in at that point and, , you know, take over for the client. One of the, the things that are really, that’s very important to me and to my office is that when we can, we would like to start our clients out from the very beginning. So let us file the application for you. And of course, we’ll have to get information, you’ll have to assist us to get the information that we need. But let us take care of social security, let us file for you. If you get denied and it’s time to appeal, then let us file the appeal. We know this process, we do it every day, many, many, many times a day. So we know all the ins and outs, we know how long things should take, you know, how the application should move. So it’s important to have someone that is an expert and is really familiar with the ins and outs of the process, right?
Frances Shefter: (00:17:42): Which is the same thing with an IEP. Like when should you bring an attorney the minute you’re thinking about bringing an attorney, like, don’t wait till it gets, you know, till due process hearing because there’s lots of stuff we could have done beforehand to set it up that we have less chances of needing due process to get what you wanted.
Anjel Burgess: (00:17:58): Absolutely. And, and my personal preference is while you’re just thinking about disability, you know, a lot of times I’ll get calls from people. They may still be working for example, and they are trying their best to hang on to the job, but things are just worsening for them health wise and they know that it’s just a matter of time. So I really appreciate it. When I get that call at that point in time so that I can just walk you through. This is what the process looks like. You know, have you thought about long term disability? You know, insurance? Are you eligible through your employer? Just some things to think about before you get to that point where you’re going to need to apply for disability.
Frances Shefter: (00:18:43): That makes sense to set it up. Right. And I mean, I’m sure people are like, yeah, whatever attorneys, they’re too expensive. I can’t afford it. If I’m trying to get disability, how am I gonna afford an attorney?
Anjel Burgess: (00:18:54): Right. So here’s the beauty of disability and the disability process. And one of the best things that I think the Social Security Administration does is they know that if you are disabled, that money is most likely going to be an issue for you. So, as attorneys, we are not paid in the traditional sense where if you want to hire an attorney, you need to pay a retainer, you have an hourly rate. We are paid on a contingency basis. And so what that means is that social security sets the rules, I can’t set my rate. Social security sets the rules in terms of how much I charge and it’s the same no matter who you go to for representation. So we have to win your case for you and we have to make sure that you are entitled to what they call past due benefits or back pay. And if both of those conditions are met, then we are paid attorney’s fees and the attorney’s fees are 25% of your back pay. And those attorneys have capped. So they’re capped at $7200. So let me give you an example if you hire me to represent you and I win for you, but you’re not entitled to any back pay. So social security says, yes, you’re disabled. Your disability started last month, then you’re not gonna be entitled to any back pay. So you do get disability benefits, you know, you win the case but there was no backpack. So you don’t have to pay me anything in attorney’s fees. If I do not win for you, you do not pay me anything in attorney’s fees. So it’s great because Social Security puts it on the attorney to say if you wanna get paid, you need to win your case for your client and you need to make sure that your client is entitled to back pay and then they pay us directly out of our clients back. So they win, win.
Frances Shefter: (00:21:01): But it does come out of the client’s pay.
Anjel Burgess: (00:21:03): It comes out of the client’s back pay. Yes.
Frances Shefter: (00:21:06): Ok. But not any future pay,
Anjel Burgess: (00:21:08): Correct. So it is a one time payment of attorney’s fees that comes out of the lump sum back pay.
Frances Shefter: (00:21:15): Got it. But I mean, I’m thinking about it. And like, it still makes sense because this is something that you’re getting moving forward and if it takes you six months, you know, to do it and you’ve wasted, I don’t want to say wasted, but you on your own and you’ve wasted it and then you bring in an attorney. Yes, those six months are back there, you’re not going to get it most likely if you don’t bring in an attorney.
Anjel Burgess: (00:21:39): Well,so we can, so, absolutely. I mean, we can come in and, you know, it’s not unusual for there maybe to have been some mistakes and, you know, using the right date, maybe even filing the right type of application. And so to the extent that we can correct those things, we’ll, we’ll go in and we’ll correct them but it’s just, you’re not losing anything by hiring an attorney. The attorney still has to win for you and get you back pay in order to be paid. So sometimes I’ll see, you know, some people prefer, well, let me just file it on my own first and see if I get approved and then if I get approved, then great, if I don’t get approved, then I’ll hire an attorney and that’s fine too. I mean, we can literally step in anytime. Some people just, you know, they, they look at things and they say, well, this, this should be a slam dunk. You know, this case should be a slam dunk. We should get approved right away. Sometimes it is, but most times it’s not.
Frances Shefter: (00:22:47): My brain is going but it doesn’t cost you anything. Why wouldn’t you just hire an attorney?
Anjel Burgess: (00:22:54): Well, I think the, the thought is that if there is any back pay and I get approved on my own, I don’t have to pay the attorney’s fees. So, and that’s true. I mean, if you do get approved on your own, then there are no attorney’s fees that need to be paid. So, you know, it’s something that you can weigh, but again, the beauty of it is that you can hire an attorney at any time, including I’ve got a hearing, you know, next week. Can you represent me? You know, we can be hired at any point in time, but you know, for your own peace of mind and, and just taking some of the stress off of you that the process is stressful, it is stressful to go through and it’s even more stressful when you don’t know what to expect and you don’t know what you’re doing and you know, what do they mean when they ask this question? , you know, all of those little details., It’s a long cumbersome process.
Frances Shefter: (00:23:57): It’s so funny because I’m just seeing like, it’s the same thing with the IEP process. Like, you know, it’s long and hard and can you do it on your own? Yeah. Are you gonna get everything you’re entitled to? Don’t know because if you don’t know what to ask for. And so consultations, like, do you charge for consultations or what does that look like?
Anjel Burgess: (00:24:18): So, no, we do not charge for consultations and quite frankly, I mean, social security does not allow us to. So it is really, they do a great job of making sure that, attorneys, you know, sometimes attorneys, we get a bad reputation, right. People say, oh, attorneys, they take all your money, they charge you for every second that they talk to you. But social security does a great job of making sure that they are literally putting things in our court. So if you wanna get paid, you’ve got to do all of this work and you’ve got to recover money for your clients.
Frances Shefter: (00:24:57): Got it. That makes sense. I just, yeah, I’m like, thinking, like, stop, I hate when people are like, oh, attorneys are expensive. Don’t like, don’t rule us out, you know. Yes. You know, but use our expertise, especially on something like this.
Anjel Burgess: (00:25:13): Something where there is you’re not losing any money by hiring an attorney, which you are hopefully getting is benefits for as long as you need them and, and that’s the key. I mean, you know, you can receive disability benefits up until, you know, if you’re, if you’re a worker and you’re receiving SSDI for example, I mean, you can receive benefits if you need them up until the time that you reach retirement age. So right before you would reach your full retirement age, your benefits are going to convert over from disability to retirement. So for some people, I mean, that could be decades of time where they’re receiving benefits. So and health insurance we know is very expensive. You know, so there’s so many good benefits that come out of this program. So it’s important that if you are in need that you, work with someone that knows what they’re doing to help you out.
Frances Shefter: (00:26:19): And so what does the consultation look like? I mean, do the potential clients give you all of the information or do you just meet with them? What does that look like?
Anjel Burgess: (00:26:28): So, for our office, it looks i it’s a little bit more involved than, than probably for most offices. for us, we are really trying to talk with you and assess. Is this a viable claim? So, you know, there’s some places that you may be able to call and they’re just gonna take down your information and be like, oh yeah, sure, great. And then later on down the road, they may come back and say, well, you know, you don’t have a viable claim and so we don’t want to do that we want to make sure that from the outset, if we are deciding that we are going to work together, it’s because, you know, you feel that you are disabled and we feel that you are going to have the evidence that we can use to prove that you are disabled. So for us, you know, a consultation is going to, you know, be 20 minutes or more of us asking questions, getting information. Who do you treat with? What medications do you take? What are the conditions that you have? Why is it that you feel that you’re disabled? And sometimes explaining, ok, this is what it means to be disabled. Now, given this, do you feel like you can work? Have you looked for any other jobs? So we’re gonna ask all the tough questions at the outset, to try to figure out if this is a claim that we will be able to win for you.
Frances Shefter: (00:27:56): Which makes sense because if you take on a claim that’s not winnable, you’re doing work for nothing.
Anjel Burgess: (00:28:02): I mean, and it’s a waste of everyone’s time. It’s a waste of your time because you’re thinking I’m gonna be able to qualify for benefits and, and we don’t wanna do that, we don’t wanna give anybody any false sense of assurance that, oh yes, this is a good claim.
Frances Shefter: (00:28:19): That makes so much sense. I’m just like we need to get your name out there. To everybody, you know, and so are there. So it’s nationwide. So we know some people know that we have to be licensed in every bar we practice. Is there a special bar that you’re admitted to for Social security? What does that look like?
Anjel Burgess: (00:28:38): No. So what happens with social security is, it’s a federal program? And so because it’s a federal program, you can practice it, you can be barred or licensed in any state and practice federal law. So that’s what allows us to be able to represent clients anywhere in the United States. It doesn’t matter where you live, we can help you. So the rules are the same from state to state you know, there are judges, of course, but judges are following the rules and the regulations. So there is no variation in terms of the rules and what it means, what we have to prove. That’s the same no matter where you live in the United States.
Frances Shefter: (00:29:23): So you can work as an attorney in any state. Yes, because that’s the difference with us is that even though it’s federal law, IDEA is federal law, there’s state law. Each state has different laws too. So we have to technically be, well, we have to be licensed to practice law if we’re going to be a lawyer, but we are allowed to be an advocate in every state.
Anjel Burgess: (00:29:47): I see. Ok.
Frances Shefter: (00:29:47): So it’s a little bit different. But so with Social Security. It’s straight federal. That’s it.
Anjel Burgess: (00:29:52): That’s right. Straight federal law. That’s it. , and I mean, technically with social security there are, non attorney representatives, there are some, some individuals out there that are able to help plaintiffs and they’re not attorneys. So they have to go through their own, like, exam with social security, to be recognized as a non attorney representative. But again, and this is no, knock to non attorney representatives. You know, everybody would, you know, do what you need to do. But if you can hire an attorney, why wouldn’t you hire an attorney?
Frances Shefter: (00:30:35): Right. It’s just a big, yeah, there’s a big difference between an attorney and, and that’s the same thing we say is that there’s a big difference between an attorney and an advocate, you know. And not again, not knocking advocates. It’s, you know, there’s a place for everybody but, certain situations it’s, yeah, you need an attorney. And obviously, you know, the law better like that. Yes, an advocate might have to just take a little quiz or something, but they don’t, obviously they’re not trained on the law.
Anjel Burgess: (00:31:07): I mean, attorneys, we are advisors. Right. We’re giving advice.And if, if you’re not an attorney, I don’t know that legally, you can really advise anyone. You can provide some support, but I think that requires a little money in your offer.
Frances Shefter: (00:31:31): Right. I got it that makes sense. Yeah. I mean, it’s just like, I’m so glad I had this and I knew I was going to talk to you, because I, it’s been something I’ve considered adding to my practice because a lot of my clients, you know, with kids with disabilities and a lot of times my clients have disabilities also. It’s something, it’s something else. But the more I looked at it, the more I’m like, if you don’t do this on a daily basis, I don’t know how well you’re going to do. Right? I, I lost you. Are you there? I don’t know. I think she totally disconnected. All right. So it sounds like we lost our guest. I’m so disappointed, although I think we got a lot of great information out there.And Anjel about SSI and SSDI, and as we said, she practices nationwide. She is based in Georgia and they do free consultation. So if you think you might be eligible for SSI or SSDI, I strongly recommend that you reach out to Anjel or another attorney just to see, do you have a case? What do you need? Even if you choose not to engage, it’s costing you nothing. So, this was wonderful and I’m hoping I don’t see her logging back in. I don’t know if something happened with her internet or not. But thank you all for listening. And for joining us on the show and Anjel’s information will be in the show notes in the summary. And thank you all. Have a great day.
VOICEOVER: (00:33:18): You’ve been listening to Stress-Free IEP® with your host, Frances Shefter. Remember you do not need to do it all alone. You can reach Frances through www.Shefterlaw.com where prior episodes are also posted. Thank you for your positive reviews, comments and sharing the show with others through YouTube LinkedIn Apple podcasts, Spotify, Google Podcasts, Stitcher and more.
Unraveling Disability Benefits with Anjel Burgess Esq.
Stress-Free IEP® with Frances Shefter, Episode 43
In this episode of Stress-Free IEP®, Frances Shefter speaks with Anjel Burgess, Managing Attorney at Burgess & Christensen, a firm solely dedicated to matters involving Social Security disability, veterans disability, and adult guardianship. For over a decade, Attorney Anjel Burgess has provided skilled representation to individuals and families inside and outside of the courtroom.
Tune in to the episode to hear about:
Learn more about Anjel Burgess and Burgess & Christensen:
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Stress-Free IEP®:
Frances Shefter is an Education Attorney and Advocate who is committed to helping her clients have a Stress-Free IEP® experience. In each podcast, Frances interviews inspiring people to share information, educate you, empower you and help you get the knowledge you need.
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Connect and learn more from your host, Frances Shefter:
FULL TRANSCRIPT:
VOICEOVER:(00:00:05): Welcome to Stress-Free IEP®. You do not need to do it all alone with your host, Frances Shefter, Principal of Shefter Law. You can get more details and catch prior episodes at www.shefterlaw.com. The Stress-Free IEP® video podcast is also posted on YouTube and LinkedIn and you can listen to episodes through Apple podcasts, Spotify, Google Podcasts, Stitcher and more. Now, here’s the host of Stress-Free IEP®. Frances Shefter.
Frances Shefter: (00:00:42): Hello, everyone and welcome to the show. Our first show of 2024. It’s a new year. Yay. And today’s topic which I’m really excited about is SSI and SSDI and I’m not gonna mess it up by saying it, but our guest Anjel Burgess with Burgess and Christiansen has been representing families in and out of the courtroom on SSI and SSDI claims for over a decade. So, Anjel please introduce yourself a little bit and tell us a little bit more about yourself.
Anjel Burgess: (00:01:14): Well, thank you. Thank you for having me. As you stated, my name is Anjel Burgess. I practice social security disability law which means that I help families to get approved for SSI and SSDI benefits. And I am able to help clients across the country because Social Security is a federal program. So that is what we do, that’s what we love to do and we’re excited to, you know, help out and I’m thrilled to be here to talk.
Frances Shefter: (00:01:52): Great. Awesome. Thank you. So, the first question I wanna ask cause I always mix it up and I never know what the difference is. SSI versus SSDI, what’s the difference? And how do you know which is right for you?
Anjel Burgess: (00:02:04): So SSDI is the program that’s traditionally known as like the workers program. So with that program, you are working, you’re paying into retirement, you’re paying into disability. So that in the event that you become disabled, you can draw benefits from that program, SSDI also comes with Medicare health insurance as opposed to SSI, which is also a disability program, but that is the program that is, it’s a needs based program. So of course you have to be disabled to get benefits but you have to meet income and asset requirements. So they’ve got really strict rules about how much money you can have to be eligible for SSI. So when you think SSI think money, I have to make sure that I don’t have too much money in order to qualify for SSI, you don’t have to work your way into eligibility for SSI you can get it if you’ve never worked before, children can get it as well. So it’s really a program that’s available to everyone as long as you meet this financial requirements.
Frances Shefter: (00:03:22): So interesting. So children can get it also. How would that, what does that look like?
Anjel Burgess: (00:03:27): So, for Children, when we’re talking about meeting the financial requirements, they look at the parents’ income. So they’re looking at the household income to make sure that the child qualifies for benefits, but as long as the financial requirements are met, so they’re looking at mom and dad’s income to make sure that they fall under the threshold for SSI but the child can certainly receive benefits, you know, on their own based off of the child’s disability.
Frances Shefter: (00:04:02): Interesting. OK, so that is cause I heard one time somebody was saying, oh, if your child has an IEP, you can qualify for SSI but that’s not totally true.
Anjel Burgess: (00:04:11): Not I mean you can, but it’s not based upon the IEP, the IEP is just kind of one tool that can be used to support the eligibility. So to support the claim.
Frances Shefter: (00:04:24): Got it the disability and I know I helped a client one time years ago. And it’s complicated like these, these applications, it’s not just I can’t work.
Anjel Burgess: (00:04:34): That’s right. It’s incredibly complicated. And so that, that’s why you know, you’ll hear people talking about disability all the time, like, you know, oh, nobody gets it. Everybody gets denied. It takes such a long time and, you know, many of those statements are true to some degree. But it is not just a program that most people simply just fill out one application for and they get approved. It is quite an in depth, process, , that social security uses to decide whether people are disabled. So it’s long, it’s confusing, it’s frustrating, it’s all of the above. But fortunately, there are attorneys such as myself whose, you know, job is to help and to help our clients to get approved for these benefits.
Frances Shefter: (00:05:30): And I, I mean, I have no idea if these statistics are right, but I heard at one point that only 25% of applications get approved on the first time. Does that sound about right?
Anjel Burgess: (00:05:40): So, pre-covid, I would say that was pretty spot on. We have seen since COVID that there has been a little bit of an improvement in that statistic. Now, I would say 25% to 33% of people are going to get approved at that initial application phase. But that’s still a lot of people that get denied. And so the the real challenge then becomes, you know, once there’s been a denial, continuing to go through the process to try to get an approval.
Frances Shefter: (00:06:16): And descend an appeal in. Yeah, that’s what I heard, which is so frustrating, I’m sure. But, I mean, I get it because it’s, the government’s, you know, they’re kind of like, they don’t want somebody to be able to fake their way into getting benefits.
Anjel Burgess: (00:06:30): Right. And, you know, you, bring up a really good point, because a lot of what we see, like, online and in the media is we see this like reports, there have been stories in the past about people like faking their disability and in actuality, the number of people that engage in fraud is extremely low, like 1% to 3% like it, it’s an extremely low number of people that are actually engaging in fraud. Contrary to what you see, most people have no desire to, you know, pretend to have a condition, you need documentation. So that’s really difficult to do, you know, you need documentation from your medical providers. So for someone to fake a condition really hard to do, there can be some questions about the severity but statistically speaking, the vast majority of people that receive disability benefits legitimately are disabled. There are just a very few numbers of people that you know, don’t need the benefits. And then there are also people that may need the benefits for a period of time they improve, they get, you know, the treatment that they need maybe medication, there’s been something new, something different that helps them. So they no longer need the benefits anymore. It is not a lifelong, it’s not intended to be a lifelong benefit.
Frances Shefter: (00:08:11): So do you have to reapply every year?
Anjel Burgess: (00:08:14): You don’t reapply, but once you do get approved for benefits, there is what they call a continuing disability review. So they are going to review everyone that receives disability at some point in time. And that review time frame can range anywhere from like 1 to 7 plus years. And so when Social Security approves someone for disability, they will tell you you are going to be reviewed in X number of years. So they give you warning in advance. Hey, we’re gonna look at your case, let’s say in three years and we’ll contact you at that point and then they’ll start the review process and as long as they find that your disability continues, then there’s no interruption. But if they find that you’ve improved, then that’s when you have to start going through an appeal and getting back into the process, unfortunately.
Frances Shefter: (00:9:10): And have you noticed a difference? I mean, I don’t know if this is something you track or not, but do you notice a difference of applicants with an attorney versus applicants without an attorney on the approval rate?
Anjel Burgess: (00:9:22): So it’s not something that I track. but I will tell you that I do get a lot of clients who’ve gone through it on their own sometimes all the way through to a hearing on their own and, you know, received a denial and, part of the challenge with just the process in general is that if you don’t know the rules and regulations, then it’s hard to know what you’re trying to prove. What’s the end game? Do you know what these benefits are for? Do you, you know, do you meet the requirements? So it’s really helpful. I would encourage everyone to at least consult with an attorney. You don’t have to have an attorney if you don’t want to, but to at least consult with an attorney to get a professional opinion about, you know, are benefits likely, you know, are you likely to get approved for benefits are, what are the obstacles that may be standing in your way to an approval? What do the rules say? You know, just those types of things? It’s important to know before you decide to apply on your own because I mean, you can apply on your own if you’re not sure what the rules are or what you need to be doing, then that ultimately can affect your eligibility down the road and it can make it much more difficult for you to get approved later on.
Frances Shefter: (00:10:48): Which makes sense. I mean, it’s the same thing with IEPs. You don’t know what you don’t know. And how to prove what, you know, pull from the reports, what you need to prove, especially with the medical reports.
Anjel Burgess: (00:10:58): Yes.
Frances Shefter: (00:11:00): Yeah, like, you know, like obviously you don’t work, I don’t think you have a medical degree but not, but you know what in the reports are needed to be pulled to prove the disability.
Anjel Burgess: (00:11:13): Absolutely. And you know, just to, to kind of clear up some, another misconception that I hear a lot about disability people will say, oh, well, they just rubber stamp, everybody’s, you know, application. So all these people that are getting denied, it’s just a rubber stamp. It’s like an automatic denial and that is not the way that it works. There is indeed a process, a very detailed process that Social Security goes through with, you know, every application to see if that individual meets the requirements and that includes a medical review. So Social Security does have their own physicians and psychologists that are in house and it’s their job to read through the medical records and reports IEPs any and every piece of evidence that, that they obtain, it’s their job to read through review the medical and then give their opinions as to, you know what they think in terms of what your conditions are and how severe those conditions are. So, if you’ve received a denial from Social Security, you know, it’ll usually say something like, you know, we’ve reviewed your medical records and and our doctors have determined that you don’t meet the requirements. And, that’s legitimately true, they do have their own doctors who review the medical evidence and you know, give their opinions on disability.
Frances Shefter: (00:12:46): So on appeals, is it like so in the court as I’m sure, you know, you can appeal, but you can only work on the evidence that was presented. If you appeal on disability, can you put in new evidence, additional reports?
Anjel Burgess: (00:13:00): So the answer to that is it depends on what level you’re appealing. So if you filed an initial application and you get denied and you appeal that. Absolutely, you can submit new evidence. If you get denied again and you request a hearing, absolutely, you can submit new evidence. But if you get denied at a hearing and you want to file an appeal from that point, then you’re not allowed to submit new evidence that has, you know, anything that’s transpired after the decision, right? So if you get denied today on January 1st 2024 you’ve got or January 2nd 2024 you’ve got 60 days to file the appeal. So you can’t run to the doctor tomorrow and say, oh, I got denied. You know, let’s tell the judge about what’s going on for my appeal. So you can’t submit new evidence in that regard, but you can submit new evidence that maybe Social Security didn’t have for whatever reason that still relates to that time frame. So new evidence that would have been new to the judge at the time that the decision was made, you can submit after being denied at a hearing. So it just depends on what part of the process you’re in.
Frances Shefter: (00:14:23): So, I mean, here’s a question that if you get, I’m just thinking of somebody that decides to do this on their own. And they get denied and they miss the appeal time frame. Is there anything you can do to help? Can they reapply or are they done for a certain time period?
Anjel Burgess: (00:14:43): So in most cases, as long as you are still meeting the technical requirements or the non-medical requirements, they call them, then in most cases, you can just reapply. But the caveat with that is that if you are reapplying that denial that you received, that’s the final determination. So you are literally starting all over. And so whatever time it took to get that denial, so you could have been waiting for years. You didn’t, you were denied, you didn’t appeal, you were starting from now, even though you had previously waited two years. So it is really important that if you get a denial, to know that you’ve got 60 days to appeal that denial, do not let that 60 days run out. Even if you’re not entirely sure, well, you know, maybe I did it on my own. I don’t have, I didn’t have an attorney and I need to find one, find an attorney. If you need to request an extension, you can try to request an extension of time. It just depends on what stage of the process that you’re in. But if you know, if you’re not able to do that at least call social security and say to them, I want to appeal so that it will be noted that you are, you know, filing an appeal and they’ll walk you through it and that will preserve your claim and then you can try to find an attorney. If the time is running out on you, but it’s really important to try to keep that claim going for as long as you can.
Frances Shefter: (00:16:23): That makes sense cause and I guess that’s, that’s where it makes sense to bring in an attorney sooner rather than later. Because if you’re, if you’re in the case from the beginning and you get denied, you can help the client on the appeal automatically. They don’t have to think anymore.
Anjel Burgess: (00:16:41): That’s right. That’s right. We can literally step in at that point and, , you know, take over for the client. One of the, the things that are really, that’s very important to me and to my office is that when we can, we would like to start our clients out from the very beginning. So let us file the application for you. And of course, we’ll have to get information, you’ll have to assist us to get the information that we need. But let us take care of social security, let us file for you. If you get denied and it’s time to appeal, then let us file the appeal. We know this process, we do it every day, many, many, many times a day. So we know all the ins and outs, we know how long things should take, you know, how the application should move. So it’s important to have someone that is an expert and is really familiar with the ins and outs of the process, right?
Frances Shefter: (00:17:42): Which is the same thing with an IEP. Like when should you bring an attorney the minute you’re thinking about bringing an attorney, like, don’t wait till it gets, you know, till due process hearing because there’s lots of stuff we could have done beforehand to set it up that we have less chances of needing due process to get what you wanted.
Anjel Burgess: (00:17:58): Absolutely. And, and my personal preference is while you’re just thinking about disability, you know, a lot of times I’ll get calls from people. They may still be working for example, and they are trying their best to hang on to the job, but things are just worsening for them health wise and they know that it’s just a matter of time. So I really appreciate it. When I get that call at that point in time so that I can just walk you through. This is what the process looks like. You know, have you thought about long term disability? You know, insurance? Are you eligible through your employer? Just some things to think about before you get to that point where you’re going to need to apply for disability.
Frances Shefter: (00:18:43): That makes sense to set it up. Right. And I mean, I’m sure people are like, yeah, whatever attorneys, they’re too expensive. I can’t afford it. If I’m trying to get disability, how am I gonna afford an attorney?
Anjel Burgess: (00:18:54): Right. So here’s the beauty of disability and the disability process. And one of the best things that I think the Social Security Administration does is they know that if you are disabled, that money is most likely going to be an issue for you. So, as attorneys, we are not paid in the traditional sense where if you want to hire an attorney, you need to pay a retainer, you have an hourly rate. We are paid on a contingency basis. And so what that means is that social security sets the rules, I can’t set my rate. Social security sets the rules in terms of how much I charge and it’s the same no matter who you go to for representation. So we have to win your case for you and we have to make sure that you are entitled to what they call past due benefits or back pay. And if both of those conditions are met, then we are paid attorney’s fees and the attorney’s fees are 25% of your back pay. And those attorneys have capped. So they’re capped at $7200. So let me give you an example if you hire me to represent you and I win for you, but you’re not entitled to any back pay. So social security says, yes, you’re disabled. Your disability started last month, then you’re not gonna be entitled to any back pay. So you do get disability benefits, you know, you win the case but there was no backpack. So you don’t have to pay me anything in attorney’s fees. If I do not win for you, you do not pay me anything in attorney’s fees. So it’s great because Social Security puts it on the attorney to say if you wanna get paid, you need to win your case for your client and you need to make sure that your client is entitled to back pay and then they pay us directly out of our clients back. So they win, win.
Frances Shefter: (00:21:01): But it does come out of the client’s pay.
Anjel Burgess: (00:21:03): It comes out of the client’s back pay. Yes.
Frances Shefter: (00:21:06): Ok. But not any future pay,
Anjel Burgess: (00:21:08): Correct. So it is a one time payment of attorney’s fees that comes out of the lump sum back pay.
Frances Shefter: (00:21:15): Got it. But I mean, I’m thinking about it. And like, it still makes sense because this is something that you’re getting moving forward and if it takes you six months, you know, to do it and you’ve wasted, I don’t want to say wasted, but you on your own and you’ve wasted it and then you bring in an attorney. Yes, those six months are back there, you’re not going to get it most likely if you don’t bring in an attorney.
Anjel Burgess: (00:21:39): Well,so we can, so, absolutely. I mean, we can come in and, you know, it’s not unusual for there maybe to have been some mistakes and, you know, using the right date, maybe even filing the right type of application. And so to the extent that we can correct those things, we’ll, we’ll go in and we’ll correct them but it’s just, you’re not losing anything by hiring an attorney. The attorney still has to win for you and get you back pay in order to be paid. So sometimes I’ll see, you know, some people prefer, well, let me just file it on my own first and see if I get approved and then if I get approved, then great, if I don’t get approved, then I’ll hire an attorney and that’s fine too. I mean, we can literally step in anytime. Some people just, you know, they, they look at things and they say, well, this, this should be a slam dunk. You know, this case should be a slam dunk. We should get approved right away. Sometimes it is, but most times it’s not.
Frances Shefter: (00:22:47): My brain is going but it doesn’t cost you anything. Why wouldn’t you just hire an attorney?
Anjel Burgess: (00:22:54): Well, I think the, the thought is that if there is any back pay and I get approved on my own, I don’t have to pay the attorney’s fees. So, and that’s true. I mean, if you do get approved on your own, then there are no attorney’s fees that need to be paid. So, you know, it’s something that you can weigh, but again, the beauty of it is that you can hire an attorney at any time, including I’ve got a hearing, you know, next week. Can you represent me? You know, we can be hired at any point in time, but you know, for your own peace of mind and, and just taking some of the stress off of you that the process is stressful, it is stressful to go through and it’s even more stressful when you don’t know what to expect and you don’t know what you’re doing and you know, what do they mean when they ask this question? , you know, all of those little details., It’s a long cumbersome process.
Frances Shefter: (00:23:57): It’s so funny because I’m just seeing like, it’s the same thing with the IEP process. Like, you know, it’s long and hard and can you do it on your own? Yeah. Are you gonna get everything you’re entitled to? Don’t know because if you don’t know what to ask for. And so consultations, like, do you charge for consultations or what does that look like?
Anjel Burgess: (00:24:18): So, no, we do not charge for consultations and quite frankly, I mean, social security does not allow us to. So it is really, they do a great job of making sure that, attorneys, you know, sometimes attorneys, we get a bad reputation, right. People say, oh, attorneys, they take all your money, they charge you for every second that they talk to you. But social security does a great job of making sure that they are literally putting things in our court. So if you wanna get paid, you’ve got to do all of this work and you’ve got to recover money for your clients.
Frances Shefter: (00:24:57): Got it. That makes sense. I just, yeah, I’m like, thinking, like, stop, I hate when people are like, oh, attorneys are expensive. Don’t like, don’t rule us out, you know. Yes. You know, but use our expertise, especially on something like this.
Anjel Burgess: (00:25:13): Something where there is you’re not losing any money by hiring an attorney, which you are hopefully getting is benefits for as long as you need them and, and that’s the key. I mean, you know, you can receive disability benefits up until, you know, if you’re, if you’re a worker and you’re receiving SSDI for example, I mean, you can receive benefits if you need them up until the time that you reach retirement age. So right before you would reach your full retirement age, your benefits are going to convert over from disability to retirement. So for some people, I mean, that could be decades of time where they’re receiving benefits. So and health insurance we know is very expensive. You know, so there’s so many good benefits that come out of this program. So it’s important that if you are in need that you, work with someone that knows what they’re doing to help you out.
Frances Shefter: (00:26:19): And so what does the consultation look like? I mean, do the potential clients give you all of the information or do you just meet with them? What does that look like?
Anjel Burgess: (00:26:28): So, for our office, it looks i it’s a little bit more involved than, than probably for most offices. for us, we are really trying to talk with you and assess. Is this a viable claim? So, you know, there’s some places that you may be able to call and they’re just gonna take down your information and be like, oh yeah, sure, great. And then later on down the road, they may come back and say, well, you know, you don’t have a viable claim and so we don’t want to do that we want to make sure that from the outset, if we are deciding that we are going to work together, it’s because, you know, you feel that you are disabled and we feel that you are going to have the evidence that we can use to prove that you are disabled. So for us, you know, a consultation is going to, you know, be 20 minutes or more of us asking questions, getting information. Who do you treat with? What medications do you take? What are the conditions that you have? Why is it that you feel that you’re disabled? And sometimes explaining, ok, this is what it means to be disabled. Now, given this, do you feel like you can work? Have you looked for any other jobs? So we’re gonna ask all the tough questions at the outset, to try to figure out if this is a claim that we will be able to win for you.
Frances Shefter: (00:27:56): Which makes sense because if you take on a claim that’s not winnable, you’re doing work for nothing.
Anjel Burgess: (00:28:02): I mean, and it’s a waste of everyone’s time. It’s a waste of your time because you’re thinking I’m gonna be able to qualify for benefits and, and we don’t wanna do that, we don’t wanna give anybody any false sense of assurance that, oh yes, this is a good claim.
Frances Shefter: (00:28:19): That makes so much sense. I’m just like we need to get your name out there. To everybody, you know, and so are there. So it’s nationwide. So we know some people know that we have to be licensed in every bar we practice. Is there a special bar that you’re admitted to for Social security? What does that look like?
Anjel Burgess: (00:28:38): No. So what happens with social security is, it’s a federal program? And so because it’s a federal program, you can practice it, you can be barred or licensed in any state and practice federal law. So that’s what allows us to be able to represent clients anywhere in the United States. It doesn’t matter where you live, we can help you. So the rules are the same from state to state you know, there are judges, of course, but judges are following the rules and the regulations. So there is no variation in terms of the rules and what it means, what we have to prove. That’s the same no matter where you live in the United States.
Frances Shefter: (00:29:23): So you can work as an attorney in any state. Yes, because that’s the difference with us is that even though it’s federal law, IDEA is federal law, there’s state law. Each state has different laws too. So we have to technically be, well, we have to be licensed to practice law if we’re going to be a lawyer, but we are allowed to be an advocate in every state.
Anjel Burgess: (00:29:47): I see. Ok.
Frances Shefter: (00:29:47): So it’s a little bit different. But so with Social Security. It’s straight federal. That’s it.
Anjel Burgess: (00:29:52): That’s right. Straight federal law. That’s it. , and I mean, technically with social security there are, non attorney representatives, there are some, some individuals out there that are able to help plaintiffs and they’re not attorneys. So they have to go through their own, like, exam with social security, to be recognized as a non attorney representative. But again, and this is no, knock to non attorney representatives. You know, everybody would, you know, do what you need to do. But if you can hire an attorney, why wouldn’t you hire an attorney?
Frances Shefter: (00:30:35): Right. It’s just a big, yeah, there’s a big difference between an attorney and, and that’s the same thing we say is that there’s a big difference between an attorney and an advocate, you know. And not again, not knocking advocates. It’s, you know, there’s a place for everybody but, certain situations it’s, yeah, you need an attorney. And obviously, you know, the law better like that. Yes, an advocate might have to just take a little quiz or something, but they don’t, obviously they’re not trained on the law.
Anjel Burgess: (00:31:07): I mean, attorneys, we are advisors. Right. We’re giving advice.And if, if you’re not an attorney, I don’t know that legally, you can really advise anyone. You can provide some support, but I think that requires a little money in your offer.
Frances Shefter: (00:31:31): Right. I got it that makes sense. Yeah. I mean, it’s just like, I’m so glad I had this and I knew I was going to talk to you, because I, it’s been something I’ve considered adding to my practice because a lot of my clients, you know, with kids with disabilities and a lot of times my clients have disabilities also. It’s something, it’s something else. But the more I looked at it, the more I’m like, if you don’t do this on a daily basis, I don’t know how well you’re going to do. Right? I, I lost you. Are you there? I don’t know. I think she totally disconnected. All right. So it sounds like we lost our guest. I’m so disappointed, although I think we got a lot of great information out there.And Anjel about SSI and SSDI, and as we said, she practices nationwide. She is based in Georgia and they do free consultation. So if you think you might be eligible for SSI or SSDI, I strongly recommend that you reach out to Anjel or another attorney just to see, do you have a case? What do you need? Even if you choose not to engage, it’s costing you nothing. So, this was wonderful and I’m hoping I don’t see her logging back in. I don’t know if something happened with her internet or not. But thank you all for listening. And for joining us on the show and Anjel’s information will be in the show notes in the summary. And thank you all. Have a great day.
VOICEOVER: (00:33:18): You’ve been listening to Stress-Free IEP® with your host, Frances Shefter. Remember you do not need to do it all alone. You can reach Frances through www.Shefterlaw.com where prior episodes are also posted. Thank you for your positive reviews, comments and sharing the show with others through YouTube LinkedIn Apple podcasts, Spotify, Google Podcasts, Stitcher and more.
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