Social Security Disability frequently asked questions

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SSDI Applications and Appeals

SSI Applications and Appeals

Social Security Disability legal fees

SSDI Applications and Appeals

Disability is defined by Social Security law as “the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.

While it is true that the Social Security Administration (SSA) denies many of the claims submitted, it is also true that you can win your case the first time you apply. The best way to achieve success the first time is to know exactly what you are doing, or retain a Social Security Disability attorney who does. LaPorte Law Firm has disability lawyers with decades of experience who can fill this role. We handle hundreds of disability claims each year, and most of them are successful the first time we try.

Many people under the age of 50 mistakenly believe that it is impossible for them to win a Social Security Disability claim. However, if you have a severe physical or mental condition that prevents you from performing basic work activities for one year or longer, you may be eligible for benefits regardless of your age.
You may be able to file for disability benefits if you are still working, but only if your monthly gross earned income is below the annual substantial gainful activity (SGA) level for that year. For example, in 2021, the SGA level was US$1,310 in gross monthly earnings, so a person earning less than this amount per month that year could have applied for benefits. It should be noted that the SGA level is US$1,350 gross earnings for 2022.

When your benefits begin, the SSA will inform you of your duty to report future work income, as it could have an effect on your benefits. As a disability beneficiary, you are entitled to a Trial Work Period where you can test your ability to work while receiving disability benefits. The amount of income you earn during your Trial Work Period and the length of your work may impact your benefit. Read our blog post on the Trial Work Period for more information.

SSDI benefits are not based on financial need, so your assets and passive, unearned income do not impact eligibility. As long as you have earned the minimum number of quarters required and the SSA determines that you are totally disabled, you are eligible.
No, SSDI can be seen as a safety net. It will pay monthly benefits to you based on the amount of money that you have already paid into the system through employment taxes.
If your claim is approved upon the first attempt, the process should take just a few months. However, it should be noted that only approximately one-third of claims are approved on the first filing. As such, most applicants need to go through the appeal process to secure their benefits. If your claim is then approved after an appeal to the Office of Disability Adjudication and Review, delays of a year or more before benefit payment commences are also common.

Attorney’s fees are 25% of the first retroactive payment to you by the SSA; however, the fee is capped at US$7,200 regardless of the amount of money you are owed by the SSA. After November 30, 2024, the maximum attorney’s fees are capped at $9,200. There is no ongoing fee after you win your case. Because the SSA can take several years to adjudicate a disability claim, disability claimants are often entitled to a large check for retroactive benefits for the period in which they were waiting for their claim to be decided. Our fees automatically come out of that first retroactive check, so our clients never have to pay us directly.

If your application is rejected on your first attempt, as is the case for many first-time applicants, you should seek legal counsel as soon as possible. An appeal must be filed using the proper forms within 60 days of the date of the denial decision. Your chances of winning an appeal are greatly enhanced by retaining a firm that specializes in Social Security law.
Medical reports are critical in proving your disability. While you can ask that the SSA provide doctors for “consultative exams,” these are a poor substitute for the reports of a treating physician. If you cannot afford a doctor, you may be able to obtain treatment through a hospital clinic or county health services. If you do not know how to find these services in your area, contact us and we will try to assist in any way we can.
Your doctor’s support is not required for a disability claim, and you may still be eligible for disability benefits even if your doctor will not support your case.
You generally have 60 days to submit an appeal after receiving a denial notice. The SSA assumes five extra days for mailing time, so the actual deadline is 65 days from the date of your decision. Under certain circumstances, however, the SSA will accept a late appeal if you have a good cause. Some reasons the SSA may consider a good cause for filing a late appeal include diminished mental capacity, hospitalization, lost mail, an incorrect address, etc. However, filing a good-cause statement for failing to meet a deadline can lead to delays in the processing of your claim. Therefore, it is important not to delay filing your appeal.
If the SSA denies your claim on the basis that you failed to meet a deadline, you have a right to file a new application. In some circumstances, you can ask the SSA to reopen a previously denied application.

The monthly amount you will receive depends on factors such as age, past earnings, and type of benefit. The law allows retroactive pay up to 12 months prior to the month of a disability application. To get a better idea of your situation, it is advisable to consult the SSA’s benefit calculator.

Although you are not required to hire a lawyer to apply for Social Security Disability, it has been statistically proven that hiring a lawyer can improve your chances of success. With the support of a legal representative who can help you navigate the complex system by helping you file your application or appeal, gathering relevant records and documentation, and preparing you for your hearing, you are more likely to be successful on your first attempt.
The hearing is usually attended by you and your legal representative, the Administrative Law Judge, a court reporter, a vocational expert, and occasionally a medical expert. You will be sworn in to testify, and your medical evidence will be presented and documented as a written record in your case file. A medical doctor or expert is also sometimes required to testify at the hearing in addition to other witnesses that may be asked to testify on your behalf to provide evidence of certain medical conditions.
No, a permanent disability is not a requirement. In fact, being disabled or expecting to be disabled for a minimum of a year or having a condition that is expected to result in death means you qualify for benefits.
Unfavorable facts refer to information from medical providers that claim that you are not complying with medical recommendations and treatments, or are engaging in acts that may negatively impact your recovery (not taking medication, not attending medical appointments, abusing alcohol or drugs). Any incorrect statements you provide that are viewed as purposely misleading to Social Security are also considered unfavorable facts.

Social Security Disability applicants are typically denied for the following reasons:

  • Criminal convictions: Although prior convictions do not generally affect your ability to obtain Social Security benefits, a convicted criminal will not be able obtain benefits if their disability is a direct result of an action that took place during the commission of a crime, if the disability stems from time spent in a correctional facility, they intentionally became an orphan or widow to receive benefits, or parole or probation has been violated.
  • Alcohol- or drug dependence-related disability: If a drug or alcohol addiction is determined to have led to your disability, you will not be eligible for benefits.
  • Lack of cooperation: The SSA requires applicants to submit their treating doctors’ medical records. Failure to comply with SSA requirements, such as not submitting your treating doctor’s medical records, leads to Social Security Disability claims being denied. If you do not have a treating doctor, you may be required to undergo an examination with one of the SSA’s doctors; failing to do so may result in your claim being denied.
  • Fraud: Lying on an application may lead to benefits being denied as well as prosecution for fraud. 
  • Length of disability: A short-term disability does not meet the requirement for receiving Social Security Benefits, as the SSA requires the disability to last for at least a year or likely to result in death, with the exception being blind applicants. 

SSI Applications and Appeals

SSDI is a disability insurance program financed by your Social Security paycheck deductions. Unless prohibited by your age, you must have worked a total of 10 years (40 quarters), 5 of which must be within the last 10 years (20 of the last 40 quarters). In order to be eligible for SSDI benefits, you must have earned FICA-taxed wages during this work period.

For Supplemental Security Income (SSI) benefits, no work time is required at all. There are, however, limits to eligibility based on how much property you own or money you have in the bank, as the SSI program is aimed at individuals who lack income or resources and are disabled. Benefits are paid as a flat rate, and the amount may be reduced if you receive any money or assistance from any source.

With both SSI and SSDI, you must be found disabled. The SSA oversees both programs and defines disability as being unable to perform any “substantial gainful activity.”
Funded by general tax revenues as opposed to Social Security taxes, SSI provides monthly financial support covering eligible people’s basic needs. Those eligible for SSI are typically disabled, blind, or 65 and older with limited income and assets. As the monthly amount received is subject to a person’s financial resources, such as accommodation and income, extensive documentation related to these resources are to be submitted when applying for SSI. When attempting to receive SSI due to a disability, evidence of medical history must be provided.
It is possible to qualify for SSI if you are a US citizen or lawful resident who is 65 or older, or blind or disabled, and have limited income and resources. However, the following exceptions should be noted:
  • States that do not offer supplemental SSI payments are Arizona, Mississippi, North Dakota and West Virginia.
  • Residents of Puerto Rico, the US Virgin Islands, American Samoa, and Guam are not eligible for SSI. For more information on this, read our article on the Supreme Court ruling.
  • Although residents of the Northern Mariana Islands are eligible for SSI, federal payments are not supplemented in the territory.
When filing for SSI, applicants are usually required to work with a Social Security representative, who will conduct an interview either in person or over the phone. However, in certain cases, SSI applicants can complete the application process online without having to be interviewed by a Social Security representative. This applies to applicants who are:
  • Aged 16 to 65
  • US citizens living in one of the 50 states, the District of Columbia, or the Northern Mariana Islands
  • Single and have not been married before
  • First-time SSI applicants
Yes, if you have a work history as well as limited income and resources, it is possible to qualify for SSI and SSDI. However, it should be noted that you can only collect whichever benefit is a higher amount.
Yes, income is considered by Social Security when determining whether an applicant is eligible for SSI as well as how much they will be paid. In general, the SSI benefit depends on the amount of countable income you have — the higher your countable income is, the less your SSI benefit will be. If your countable income is over the stipulated limit allowed by Social Security, then you will not be able to receive SSI benefits.
There are certain types of income that are not counted by the SSA, such as the first US$20 of income you receive in a month (regardless of whether it is earned or unearned income) and the first US$65 of earned income, and half of all earned income over US$65 each month. It should be noted that there are various other types of payments and services that are not counted as income, such as food stamps, income tax refunds, etc. To ensure that your income is calculated correctly, it’s advised to reach out to a reputable law firm that specializes in Social Security Law, as this is a well-known source of confusion for many SSI applicants.
A resource is considered something you own or an item that can be turned into cash money, which can be used to purchase essential items, such as food and shelter. Although an SSI applicant’s resources are taken into account when SSI benefit payment is calculated, not all resources are counted by the SSA. Your home’s value, one vehicle, etc. are, for example, not counted what the SSA determined eligibility and benefit amounts. For an in-depth resource list, it’s advised to consult Social Security’s SSI resources page.

Social Security Disability legal fees

No, there is no upfront fee, as Social Security Disability attorneys work on a contingency basis. This means they only get paid when you win your case.
When hiring a disability attorney, a fee agreement is usually signed on a contingency basis, placing a limit on the attorney’s fee and allowing the SSA to pay the attorney if the case is approved.
While being represented by an attorney, there are often costs involved relating to documentation that needs to be requested, such as medical, work, and other required records. Certain legal representatives require their clients to pay for these costs in addition to the fee they will receive from the client’s back pay, and sometimes require the costs to be paid upfront. However, it is more common for attorneys to front these costs for their clients and then bill them for these costs once the case has been closed.

At LaPorte Law Firm, for the vast majority of cases, we pay upfront for any additional costs and bill clients at the end of the case once they get their award, ensuring no out-of-pocket expenses will be required from clients during the claim process.

When hiring legal representation for a Social Security Disability claim, it’s important to clarify whether you will be responsible for out-of-pocket expenses on top of the attorney’s fee and what types of expenses will be included.
Attorney’s fees automatically come out of the first retroactive payment of a disability award received by a client.

As mandated by the SSA, attorney’s fees are capped at US$7,200.

The amount of back pay owed to clients differs for SSDI and SSI. For SSDI, back pay includes retroactive benefits owed to the client from the date their benefits were approved up to the date their disability began (limited to 12 months prior to the application date), as determined by the SSA. However, for SSI, benefits are calculated from the date of approval of benefits to the month after applying for benefits.
No, there are no ongoing fees after your case has been approved. Once the attorney has received their portion of the back pay benefits, no additional fees are required.

No, your attorney will not be able to charge a fee unless your case is successful, as Social Security requires disability cases to be done on a contingency basis.

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My spouse was entering into the scary world of disability and we needed guidance. Kevin LaPorte and Sylvia Marichalar were patient, understanding, and helped us through the red tape of Social Security the first time around when most are denied. No stress, no fuss, just straightforward professionals with a heart.

Ben C.

I was Lucky to find Kevin LaPorte for my Social Security needs. I knew I would not be able to continue working with my health issues, so I made an appointment with him. He is a very nice guy, honest and straight to the point. I would recommend him to anyone needing help and can’t work any longer. Kevin is the guy to go to, because he is an honest, standup guy who will fight for you.

Bill R.

Terry LaPorte is the best. When I was looking for a referral, every knowledgeable attorney referred me to Terry (and only Terry). He worked hard for me, was an excellent advocate, and I completely trust his judgment. He is a kind and decent man, too. I’m grateful I found him.

Sam H.

Kevin LaPorte and Terry LaPorte helped my wife through what had previously been a challenging disability appeal that spanned years. Our only regret is not calling them sooner!

The Pages M.

Downtown, San Jose, CA

Attorney Kevin LaPorte represented me on my SSDI case. He was generous with his time, professional, and he and his staff always kept me informed through each step in the process.

Phil H.

Pleasanton, CA

I was very down on my luck and got an appointment set up in Oakland ca. I guess he was expecting me. He was a straight shooter.

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Emeryville, CA

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Everything You Need To Know About
The Social Security Disability application process