Key Takeaways: What Every Social Security Disability Victim Should Know
- Most initial applications are denied – the Social Security Administration denies the majority of first-time disability claims, with final award rates averaging 30 percent for claims filed from 2013 through 2022, making experienced legal representation crucial.
- You have 60 days to appeal – after receiving a denial letter, you must file a request for reconsideration within 60 days of the day after you receive the notice of determination or risk losing your claim.
- Total disability only – SSDI benefits require complete inability to work; the SSA assumes working families have other resources for partial disabilities like workers’ compensation.
- Medical documentation is critical – your claim must include proper documentation from medical professionals proving your condition meets SSA requirements.
- An Administrative Law Judge hears appeals – if your reconsideration is denied, the next step involves a formal hearing before an ALJ who works for the Social Security Administration.
Get help with your denied disability claim today. Contact our experienced Houston social security disability lawyers for a free consultation to discuss your case.
Why Choose Simmons & Fletcher After a Social Security Disability Denial in Houston?
When the Social Security Administration denies your disability benefits, you need experienced legal representation to navigate the complex appeals process. At Simmons & Fletcher, our Houston social security disability lawyers have been helping injured Texans since 1979, fighting for the disability benefits you deserve.
Our dedicated SSDI attorneys understand how overwhelming it can be to deal with disability claims while managing a serious catastrophic injury or medical condition. We handle all the paperwork and legal complexities so you can focus on your health.
If we take your social security disability case, our compassionate disability social security lawyers will:
- Review your denial letter and medical records for free;
- Gather additional medical evidence to strengthen your disability claims;
- Handle all communications with the Social Security Administration;
- Prepare you for hearings before an Administrative Law Judge;
- Fight for maximum disability benefits while you focus on your recovery;
- Work on a contingency basis – you pay nothing unless we win your case.
From our Houston office, we serve clients throughout Harris County, Fort Bend County, Montgomery County, and across Texas who need help with denied disability applications and appeals.
Don’t let a denial stop you from getting the benefits you need. Call (713) 932-0777 today to speak with a qualified SSDI attorney about your case.
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What is a Social Security Disability Denial Lawyer?
A Social Security Disability denial lawyer is a legal professional who specializes in helping clients appeal denied disability claims with the Social Security Administration (SSA). These attorneys focus specifically on SSDI and SSI cases, understanding the complex federal regulations that govern disability benefits.
When you apply for disability benefits, there is extensive red tape to navigate. You must file the correct paperwork with proper medical documentation, or your claim will be denied. Social security disability lawyers know exactly what evidence the SSA requires and how to present your case effectively.
Disability denials are more common than most people realize. The stress of dealing with complicated paperwork and legal procedures can add tremendous burden to someone already suffering from a serious medical condition or catastrophic injury.
Hiring an experienced SSDI lawyer can help you avoid common pitfalls that lead to denials and ensure your appeal has the best chance of success.
Need help with your denied disability claim? Contact our law firm for social security disability at (713) 932-0777 to be connected with a qualified disability denial attorney.
What is Social Security Disability Insurance (SSDI)?
Social Security Disability Insurance (SSDI) is a tax-funded federal insurance program that provides monthly cash benefits to disabled workers and their eligible family members. This disability insurance program is designed to replace income when you become disabled and cannot work before reaching retirement age.
Key features of SSDI include:
- Monthly cash payments from the Social Security Administration until you can return to regular work;
- Work incentives to help disabled individuals transition back to employment;
- Medicare eligibility after receiving SSDI benefits for 24 months;
- Family benefits for eligible spouses and children of disabled workers.
SSDI is just one form of recovery available to work injury victims. If you or a loved one has been severely injured, our social security attorneys can help you understand all available options for financial support during your recovery process.
The program requires that you have worked and paid into Social Security through payroll taxes for a sufficient period before becoming disabled. This “work credit” requirement ensures that benefits go to those who have contributed to the system.
What is the Definition of Disability?
According to the Social Security Administration, you are considered disabled under Social Security rules if you meet all of the following criteria:
- Cannot perform your previous work – you are unable to do the work you performed before your medical condition developed;
- Cannot adjust to other work – the SSA determines that you cannot adapt to other types of employment because of your medical condition;
- Long-term or fatal condition – your disability has lasted or is expected to last for at least one year or result in death.
This represents a strict definition of disability. The Social Security Administration assumes that working families have access to other resources during periods of partial disability, such as workers’ compensation benefits. Therefore, they only pay SSDI benefits for total disability.
The SSA uses the Listing of Impairments to determine which medical conditions automatically qualify someone as disabled. However, if your specific condition is not listed, you are not automatically disqualified from the process.
According to the SSA website, “the absence of a listing-level impairment… merely requires the adjudicator to move on to the next step of the process and apply other rules in order to resolve the issue of disability.”
Our experienced SSDI lawyers understand how to present medical evidence effectively, whether your condition is listed or requires additional evaluation through the disability determination process.
How Do I Qualify For Social Security Disability?
To qualify for Social Security Disability benefits, you must meet both work history and medical requirements established by the Social Security Administration.
Work Credit Requirements
You must have worked in employment covered by Social Security and contributed to the Federal Insurance Contributions Act (FICA) for a significant period. The specific requirements include:
- Recent work test – you must have worked a certain number of years out of the 10 years before becoming disabled;
- Duration of work test – you need a total number of work credits based on your age when you became disabled;
- Covered employment – your work must have been in jobs where you paid Social Security taxes.
Medical Requirements
Your medical condition must meet the SSA’s strict definition of disability:
- Prevent you from performing substantial gainful activity;
- Be expected to last at least 12 months or result in death;
- Be supported by objective medical evidence from treating physicians.
The Social Security Administration can provide specific information about whether you qualify based on your work history and medical condition. Our security disability attorneys can also review your situation and help determine your eligibility for benefits.
Find out if you qualify for disability benefits. Contact our Houston office today for a free evaluation of your potential SSDI claim.
What Can You Do When You Are Denied Disability?
When you are denied disability benefits, you have several appeal options available, but you must act quickly to preserve your rights. The Social Security Administration provides a structured appeals process with specific deadlines that must be followed.
Request for Reconsideration
If your initial application is denied, you have the right to file a request for reconsideration within 60 days of receiving your denial letter. This involves:
- Submitting Form SSA-561 (Request for Reconsideration);
- Providing any new medical evidence that supports your claim;
- Having your case reviewed by a different disability examiner;
- Potentially undergoing additional medical examinations.
Administrative Law Judge Hearing
If your reconsideration is also denied, you can request a hearing before an Administrative Law Judge who works for the SSA. This hearing allows you to:
- Present testimony about how your condition affects your ability to work;
- Have your attorney question medical experts and vocational experts;
- Submit additional medical evidence and witness testimony;
- Cross-examine any experts who testify for the SSA.
Why Most Initial Applications Are Denied
The SSA denies the vast majority of first-time applications for social security benefits. According to SSA data, the final award rate for disabled-worker applicants averaged 30 percent for claims filed from 2013 through 2022. Common reasons for denial include:
- Insufficient medical documentation;
- Failure to follow prescribed treatment;
- Earning too much income during the application process;
- Not meeting the duration requirement for disability.
While you are allowed to represent yourself throughout the SSDI application and appeals process, the U.S. Government Accountability Office found that claimants who had legal representatives at the hearing level were allowed benefits at a rate nearly three times higher than those without representatives. According to the GAO study, approximately 80% of claimants at the administrative law judge hearing level have legal representation. Our disability attorneys understand exactly what documentation the SSA requires and how to present your case effectively.
Don’t navigate the appeals process alone. Contact our experienced social security disability lawyers for help with your denied claim.
Related Resources
- Houston Spinal Cord Injury Lawyer: Learn how spinal cord injuries can impact your ability to work and qualify for disability benefits.
- Houston Brain Injury Lawyer: Understand how traumatic brain injuries can result in long-term disabilities requiring SSDI benefits.
- Houston Work Injury Lawyer: Explore your legal options when workplace injuries leave you unable to work.
- Houston Construction Accident Lawyer: Learn about disability claims arising from serious construction site injuries.
- Houston Industrial Accident Lawyer: Discover how industrial accidents can lead to permanent disabilities requiring long-term benefits.
- Medical Malpractice: Find out how medical errors can result in disabilities that qualify for Social Security benefits.
- Defective Hip Implant: Learn about how defective medical devices can cause disabling complications.
- Wrong Medication or Prescription: Understand how medication errors can result in permanent disabilities.
- How to Prove Pain and Suffering: Discover strategies for documenting the impact of your disability on daily life.
- Mental Anguish: Learn about the emotional impact of disabilities and how it affects your claim.
FAQs About Social Security Disability
What is the Social Security disability?
Social Security disability refers to federal benefit programs that provide financial assistance to people who cannot work due to a severe medical condition. The main programs are Social Security Disability Insurance (SSDI) for workers who have paid into the system, and Supplemental Security Income (SSI) for individuals with limited income and resources.
What is the difference between SSI disability and SSDI?
SSDI is based on your work history and the Social Security taxes you’ve paid, while SSI is a need-based program for people with limited income and resources. SSDI has no income limits beyond substantial gainful activity, but SSI has strict financial eligibility requirements. SSDI recipients can receive Medicare after 24 months, while SSI recipients may qualify for Medicaid immediately.
In 2024, you can generally earn up to $1,550 per month ($2,590 if you’re blind) and still be considered disabled under Social Security rules. This amount is called “substantial gainful activity” (SGA). Earning more than the SGA limit may result in termination of your disability benefits, though work incentive programs may allow higher earnings in certain situations.
What is the average cost of a Social Security Disability lawyer?
Social Security Disability lawyers typically work on a contingency fee basis, meaning you pay nothing unless we win your case. There are no upfront costs, and our attorneys cannot charge hourly fees for most SSDI representation.
Should I get a lawyer to apply for Social Security Disability?
While you can apply for disability benefits without an attorney, having legal representation significantly increases your chances of approval, especially if your case goes to appeal. Given that most initial applications are denied, having an experienced disability attorney can save time and improve your outcome.
