Answers to Common Disability Questions

There is no single answer. A claim can move quickly or take many months, and if it goes to a hearing it can take longer still. What you can control is how carefully the claim is prepared from the start.

This is one reason to involve an attorney early. Working with you from the beginning means the person representing you understands your condition in depth, which matters most if your case eventually reaches a hearing.

It also helps with the forms. When you complete the Adult Function Report, small wording choices matter. Judges sometimes read everyday activities, like caring for children or grocery shopping, as evidence you can work full time. It is important to explain whether you get help, work through pain, or face other limits while doing those things.

Consulting us costs nothing, so start there. But be clear about what an attorney does. Much of the process is Social Security reviewing your claim, and there can be long stretches where little seems to happen. That quiet does not mean nothing is being done.

First, an attorney helps you avoid mistakes that can hurt your case now or later at a hearing. Second, working with you throughout a long process means we understand your situation far better than someone brought in only at the end. Third, we help you complete the Adult Function Report accurately, so it does not undercut your own claim.

Finally, if you run into issues with work credits, onset dates, or working while you claim disability, we can help you address them as they come up.

SSDI stands for Social Security Disability Insurance. SSI stands for Supplemental Security Income.

SSDI works like an insurance policy you paid into through payroll taxes while you worked. It may be awarded when you are found medically disabled and you have earned enough recent work credits for your age. Those credits can expire, so it is important not to wait too long to file. In most cases you can lose eligibility about five years after you stop working. After two years of receiving SSDI, you also become eligible for Medicare.

SSI is different. You still have to meet the medical requirements, but there is no work-credit requirement. Instead, SSI is based on financial need: your monthly income and countable assets must stay under set limits. Rather than waiting for Medicare, an approved SSI recipient can usually qualify for Medicaid right away.

After you file (filing online is a good option), your local Social Security office confirms your intent to seek benefits and starts the process.

Your case is then sent to a Disability Determination Services office in your state, where a claims examiner reviews your medical records and decides your case. If your records are not enough to decide, you may be sent to a consultative examination with a doctor Social Security chooses and pays for. Along the way you will complete a Function Report and a Work History Report, which help the examiner understand how your limits affect your ability to work.

If your initial application is denied, you can ask for reconsideration, where a new examiner reviews the file. If that is denied, you can request a hearing before an Administrative Law Judge. Most cases are resolved at the hearing stage. Beyond that, a claim can go to the Appeals Council and, in rare cases, to federal court.

We take cases on a contingency basis. If you do not receive a favorable decision, you owe no attorney fee.

Attorney fees in Social Security cases are set by federal law and must be approved by Social Security. The fee is 25 percent of your past-due benefits (back pay), capped at a maximum set by Social Security. You keep the rest of your back pay and all of your ongoing monthly benefits. This fee is separate from any government fees.

We also do not charge you to review your case or to consult with us. In Texas, doctors and hospitals cannot charge for the medical records needed for a Social Security disability case, so record costs are rarely an issue.

This can get complicated, but the short answer is that you cannot be doing what Social Security calls substantial gainful activity and still qualify. There is a monthly earnings limit that changes each year, and going over it can disqualify you.

Work is considered substantial when it takes significant physical or mental effort, and it counts against you when it is both substantial and gainful. The key point is to know the current earnings limit and to talk with us before you assume any work is safe, because the rules have exceptions worth understanding.

It is normal to feel anxious about a hearing. These hearings are meant to be non-adversarial, and there is no opposing lawyer arguing against you.

Every judge runs a hearing a little differently. Usually the judge opens the case, your attorney may offer a theory of your case, and the judge asks about the medical issues affecting your ability to work. A vocational or medical expert is often present to help the judge. The expert answers hypothetical questions about someone with your limitations, and your attorney can question the expert as well.

The goal is to establish that there are no jobs in the national economy you could realistically perform. Most hearings last 30 to 45 minutes, and you can usually expect the judge’s written decision within one to four months.

Only Social Security can decide whether you are disabled for benefit purposes, and it is more involved than a doctor saying you cannot work. Social Security uses a five-step process and its own definition: you are disabled if a medically verifiable physical or mental impairment keeps you from substantial gainful activity and is expected to last at least 12 months or result in death.

The five steps ask, in order: Are you working above the earnings limit? Is your condition severe? Does it meet a listed impairment? Can you do any work you did in the past? And can you adjust to other work given your age, education, and experience? A "no" at the wrong step ends the claim, which is why how your case is presented matters so much.