Social Security Disability Lawyer – SSDI and SSI Claims

Social Security & SSI Disability

The SSDI and the SSI Process Have Four Main Stages

Who qualifies

The Social Security Administration pays disability benefits under two programs. SSDI is insurance: you qualify by having worked and paid Social Security taxes long enough and recently enough — generally 20 of the last 40 quarters for a worker over 31. SSI is need-based and pays disabled adults and children with little income and few assets, whether or not they have worked. Both use the same definition of disability: a medically determinable impairment that has lasted or is expected to last at least twelve months or to result in death, and that prevents “substantial gainful activity” — in 2026, earnings above $1,690 a month for a non-blind claimant ($2,830 if blind).

How Social Security decides: the five steps

Every claim goes through the same sequence. (1) Are you working above the substantial-gainful-activity level? If so, the claim is denied. (2) Is your impairment severe — does it significantly limit basic work activities? (3) Does it meet or equal one of the impairments in Social Security’s Listing of Impairments? If yes, you are disabled without further inquiry. (4) If not, what is your residual functional capacity, and can you still do any of your past relevant work? (5) If you cannot, is there other work in the national economy you can do, considering your age, education and work experience?

Most cases are won or lost at steps four and five, and the rules at step five change at age 50 and again at 55. Under the Medical-Vocational Guidelines — the “grid rules” — a claimant 50 or older who is limited to sedentary work, with no transferable skills, is generally found disabled; at 55, the same result follows from a limitation to light work. A claimant who is 49 and a claimant who is 50 with identical medical records can receive opposite decisions. We know where those lines are and build the medical evidence to meet them.

Medical evidence wins hearings

Social Security does not decide claims on diagnoses; it decides them on functional limitations documented over time. A treating physician’s statement of what you can and cannot do — how long you can sit, stand and walk, how much you can lift, how often you would be off task or absent — is the single most useful piece of evidence in most cases, and it must be consistent with the treatment notes. Before your hearing we obtain the complete record, identify the gaps, and ask your doctors for the specific opinions the judge needs.

Veterans and Social Security

VA disability and Social Security disability are separate systems with separate definitions. A 100 percent VA rating does not guarantee SSDI, and an SSDI award does not create a VA rating. But they interact. Social Security expedites claims from veterans rated 100 percent permanent and total, and from wounded warriors injured on active duty after October 2001. VA treatment records are often the best-documented medical evidence a veteran has, and a VA examiner’s findings, while not binding on Social Security, must be considered. Many of our veteran clients pursue both claims at once; we coordinate the evidence so that what is said in one does not undercut the other.

Back pay, onset date and fees

SSDI pays retroactively for up to twelve months before the application date, after a five-month waiting period from the established onset of disability; SSI pays from the month after the application. The “onset date” the judge finds therefore controls thousands of dollars of back pay and is worth contesting when the evidence supports an earlier date. Attorney fees in Social Security cases are set by federal law: nothing unless you win, then a percentage of the back pay, currently 25 percent of past-due benefits or $9,200, whichever is less, paid directly by SSA out of the award. There is no fee on future monthly benefits.

Frequently asked questions

How long does it take? Initial decisions take several months; a hearing before an Administrative Law Judge is typically scheduled a year or more after the request. A claim that wins at the hearing level commonly takes two years from application to payment. Filing correctly the first time and not missing the 60-day appeal deadlines is the only way to shorten it.

Can I work while my claim is pending? You can work below the substantial-gainful-activity level, but any work is evidence the judge will weigh. Talk to us before taking a job.

I was denied twice. Should I file a new application or appeal? Appeal. A new application usually loses the earlier protective filing date and the back pay that goes with it, and the hearing stage — where most claims are won — is only reached by appealing.

Do I have to come to Gainesville? No. Hearings are held by telephone or video, and we represent Social Security claimants throughout Florida.

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