Population Health

Research Seminar with Nicole Maestas, PhD

Legal Representation in Disability Claims
Open to Penn Affiliates

12:00p.m. – 1:00p.m. ET October 25, 2022 In-Person Event

Colonial Penn Center Auditorium, 3641 Locust Walk

Legal representatives play a prominent role in the Social Security Disability Insurance adjudication process, earning fees totaling $1.2 billion in 2019. Long ubiquitous in appellate hearings, disability representatives—including attorneys and non-attorneys—have begun appearing more frequently at the beginning of cases, during the initial review. This development has raised questions about the motives of disability law firms, who are sometimes perceived to prioritize their own interests in response to incentives in the fee structure set by the Social Security Administration. At the same time, these concerns have revealed just how little is understood about the value of legal representation for claimants in disability cases. We provide the first estimates of the causal impact of legal representation on case outcomes when representatives are engaged from the initial stage. Our analysis is made possible by new administrative data identifying representatives appointed to disability claims at the initial and appellate levels. To address selection into representation, we instrument for initial representation using geographic and temporal variation in disability law firm market shares in the closely related but distinct appellate market. Among applicants on the margin of obtaining representation at the initial level, representation improves case outcomes and administrative efficiency across several metrics. Legal representation increases the probability of initial award by 23 percentage points, reduces the probability of appeal by 45 points, and induces no detectable change in the ultimate probability of award (including appeals). This pattern indicates that legal representation in the initial stage leads to earlier disability awards to individuals who would otherwise be awarded benefits only on appeal. Furthermore, by securing earlier awards and discouraging unsupported appeals, representation reduces total case processing time by nearly one year. Our analysis explores several mechanisms.

Co-hosted with the Health Care Management Department at The Wharton School.

Please note: In-person attendance at this event is preferred. Virtual access will be provided to registrants who are unable to be on campus.


Nicole Maestas

Nicole Maestas, PhD

Associate Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School

Nicole Maestas, PhD is an Associate Professor of Health Care Policy at Harvard Medical School and a Research Associate of the National Bureau of Economic Research (NBER), where she directs the NBER’s Retirement and Disability Research Center. She studies the economics of disability insurance, labor markets, health care systems, and population aging. Her research studies how the health and disability insurance systems affect individual economic behaviors, such as labor supply and the use of medical care. Dr. Maestas’ research has shown how the federal disability insurance system discourages employment by people with disabilities. In other work she is examining how population aging affects economic growth and how working conditions affect individuals’ ability and desire to sustain employment at older ages.

In current work, Dr. Maestas is investigating the causes of the opioid epidemic and its impact on employment and participation in the federal disability programs, as well as the effects of state Medicaid policies on the health care and well-being of people receiving Supplemental Security Income (SSI) benefits. Dr. Maestas has published widely in the leading journals of economics, policy and medicine. She received her MPP in Public Policy from the Goldman School of Public Policy at UC Berkeley, and her PhD in Economics also from UC Berkeley.