Category Archives: social security disability

Why Do So Many SSD Claims Get Denied the First Time?

You’ve worked hard your whole life, paid your taxes, and played by the rules. Then, you suffer a serious injury or illness. Suddenly, you can’t work anymore. So, you apply for Social Security Disability (SSD) benefits, which is a safety net you’ve earned. Then the letter comes: denied.

This is a frustrating and confusing situation. You did everything right. So, why were you turned down? If this sounds familiar, you’re not alone. Most people in New York get denied the first time they apply for SSD. But a denial doesn’t necessarily mean you don’t qualify. It just means the system is hard to navigate, and it’s not built with you in mind.

How does the SSD application process work in New York?

When you apply for disability benefits in New York, you’re actually dealing with both the Social Security Administration (SSA) and a state agency called Disability Determination Services (DDS). You can file online, by phone, or in person. Once your application is received, DDS reviews your medical records, work history, and other paperwork. They might even schedule a doctor’s exam for you.

This whole process usually takes a few months. However, it can drag on longer if there are delays, missing documents, or backlogs at the local office (which is common in New York).

What percentage of SSD claims are denied?

Around 65 to 70 percent of first-time SSD applications get denied across the country. New York is no exception, and in some years, the denial rate here has been even higher. That means most people hear “no” before they ever hear “yes.”

However, that initial denial doesn’t mean your claim is over. Many applicants win their benefits later through appeals, especially once they get help gathering evidence or working with someone who understands the system.

What are the most common reasons for SSD denial?

There are lots of ways an SSD claim can go sideways. Here are the most common pitfalls:

You didn’t provide enough medical evidence: The SSA needs more than just a diagnosis; they want to see how your condition affects your daily life. Can you sit, stand, lift, concentrate, follow instructions? If your records don’t paint that full picture, your claim might be denied.
You’re still working and earning too much: If you earn more than the Substantial Gainful Activity (SGA) limit, SSA considers you capable of working, even if your job is hanging on by a thread. In 2025, the SGA is $2,700 for blind individuals and $1,620 for non-blind individuals.
You didn’t follow your treatment plan: Maybe you didn’t go to physical therapy. Or you skipped appointments. If SSA sees that you’re not following medical advice, they might assume your condition isn’t that serious—even if that’s not true.
Your condition isn’t expected to last long enough: To qualify, your condition must last (or be expected to last) at least 12 months or result in death. Short-term disabilities don’t qualify, no matter how painful they are.
Your application had mistakes or missing info: It’s easy to make errors on the forms. Missing dates, incomplete job history, or forgetting to sign medical release forms can all lead to denials.
You didn’t respond to SSA’s requests: If you miss a phone call, skip a medical exam, or ignore a letter, SSA can deny your claim for “failure to cooperate.” It doesn’t always seem fair, but that’s how the system works.

Are there extra challenges to applying for SSD in New York?

New York has some unique roadblocks when it comes to applying for SSD. For example, New York, Buffalo, and other cities face backlogs at SSA offices due to the high volume of claims, which leads to delays and longer wait times for decisions.

On top of that, the state’s high cost of living forces many applicants to take on part-time work just to get by. Unfortunately, this can push their earnings above the SGA limit, which puts their eligibility for benefits at risk.

Additionally, many people in New York face limited access to consistent medical care. Without health insurance or the ability to see a doctor regularly, providing the thorough medical documentation SSA expects becomes harder.

How can you improve your chances of getting SSD in New York?

There are steps you can take to give your claim a better chance of approval, including:

Getting consistent medical treatment
Asking your doctor to describe your limitations
Staying under the SGA limit if you must work
Working with an experienced New York SSD lawyer.
Documenting your symptoms and the impact your injury has on your life.

What happens if my SSD claim is denied?

Again, an SSD claim denial isn’t necessarily the end; it’s just the beginning of the next phase. You have 60 days to appeal the denial. This starts with a Request for Reconsideration. If that’s denied (and many are), you can request a hearing before an Administrative Law Judge. This is where you can win, especially with a lawyer by your side.

Our New York SSD attorneys can help you get the benefits you deserve

If you’re struggling to get approved for SSD benefits or dealing with a frustrating denial, it’s time to talk to someone who truly understands the system. The New York SSD attorneys at Pasternack, Tilker, Ziegler, Walsh, Stanton & Romano LLP have been standing up for injured and disabled workers for decades.

We know how confusing and frustrating the process can be, and we’re here to help you through every step. When you work with our legal team, you get more than just paperwork help. You get a dedicated lawyer who knows the ins and outs of New York’s SSD system, including how to avoid common application mistakes that lead to delays and denials.

If your SSD application has been denied, or you need help getting started with a claim, contact us today to schedule your free consultation. There are no obligations, and you pay nothing unless we win your case.

“I had to use them on 4 different occasions (cases), and they never disappointed me. Very professional and reliable. Highly recommend.” – M.T., ⭐⭐⭐⭐⭐

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Creative Legal Argument Leads To An Award of Lifetime Diability Benefits

Good lawyering requires both creativity and a deep knowledge of the law. Last week I obtained a ruling of Permanent Total Disability for a client. The ruling entitles her to much-deserved lifetime weekly compensation benefits. This is especially important because in 2007 the Workers Compensation Law was changed to put limits on the time period for which you can receive benefits. There is now a 10-year limit on benefit duration unless you had a 100% Medicial Disability or a 100% Loss of Wage Earning Capacity (ability to work and earn money).

My client is a 55 year-old woman with a severe back condition. All of the doctors she consulted with conculded that she has a 60% medical disability. Most attorneys would have accepted that rating as is, entitling her to just 350 weeks of compensation benefits. But that would have been the wrong outcome.

Because of my client’s educational level and work experience, I knew that she was entitled to more. She only has a high school education and does not know how to use a computer. My client has never worked in any other position other than house cleaning.

All of the doctors who testified conceded that my client’s injury prevented her from doing her job – the work of a house cleaner. In fact, they all conceded that she could not do any type of physical labor. I then took my client’s testimony and established her lack of transferrable skills, focusing on her education and work experience. In essence I showed that there was no other work that she could successfully perform.

The judge agreed with my argument — my client has only a 60% Medical Disability, but has a 100% loss of her Wage Earning Capacity. The judge awarded my client Total Disability benefits, which allowed an award of a lifetime of benefits, not just a 10-year benefit period. This was a huge, and much-deserved, victory for my client.

When representing clients it is important to know your client and to know their background. This is how we practice. We strive to obtain the best outcome for out clients by knowing them, knowing the law and knowing how to obtain the maximum benefits for them.

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How Do Social Security Disability And Workers’ Compensation Benefits Work Together?

As a practitioner in the workers’ compensation field for almost 25 years, I have represented thousands of injured workers. A large percentage of those injured workers are also entitled to Social Security Disability (SSD) benefits which are benefits based upon disability and not age. My Partner, Barbara Tilker has practiced in the area of social security disability for over 35 years and she has provided me with important information regarding SSD. But what exactly are these benefits and who is entitled to them? In order to qualify you must have the requisite work credits. The number of work credits you need depends on your age. Generally speaking you need at least five years of work (20 credits). You will often hear people say you need to have worked five of the last ten years. You also must have substantial gainful employment – having minimum earnings of $1070 per month. The maximum SSD rates are based on individual income and FICA tax paid. They are running around $2500 per person max and $4000+ if there is a dependent family

Filing for SSD can be a lengthy process. Every case is different, and some are processed faster than others. However, we’ve found that it takes the Social Security Administration (SSA) between four (4) to six (6) months to make an initial decision. If that decision is unfavorable (and about 70% of initial decisions are denials), it can take between eight (8) to twelve (12) months to have a hearing before an Administrative Law Judge (ALJ) scheduled. A year to a year-and-a-half wait is not uncommon.

Due to the lengthy process, you should file for SSD as soon as possible. You should file as soon as you know that you will be out of work for at least twelve (12) straight months OR if your condition is expected to result in death. You should talk to y our doctor to see how long he/she expects you to be unable to work. Your doctor’s support is incredibly important to your case so talk to him/her before making the decision to apply.

In order to make sure that you get the maximum amount of benefits you’re entitled to, your application must be filed within 17 full months from the time that you become disabled and unable to work. If you’ve already been out of work for a year or more, consider putting in an application right away to prevent any loss of benefits you would otherwise be entitled to.

In New York, Social Security disability benefits are offset by workers’ compensation. There is an 80% ceiling on concurrent WC and SSD translates as follows: A disabled individual (including dependent family benefits) cannot exceed 80% of highest gross income of the last five years worked, together with workers’ compensation benefit. This is computed on a monthly basis. If exceeded, social security is offset. Many of my clients have multiple concurrent medical issues – they may have a back injury as a result a work related accident but they may also have diabetes or a prior leg condition. Social Security takes all of these medical conditions into account to determine whether or not you are entitled to benefits. Your entitlement to SSD is based upon your overall medical condition and not just your workers’ compensation claim. While no one plans on getting injured or disabled, you should plan on knowing what you are entitled to before the unthinkable occurs.

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What Is Chained CPI And Why Is It Bad For Elderly And Disabled People?

Chained CPI Infographic – click to zoom in

Chained CPI is back in the news. What does this mean for the elderly and disabled who rely on Social Security benefits? The short answer to this question is “nothing good.” Before we discuss why chained CPI is such bad news, I should explain exactly what it is.

Chained CPI is a different way of calculating the amount of inflation that occurred in a given year, and the amount that Social Security benefits will increase in response to inflation. Currently, the Social Security Administration uses the Consumer Price Index for urban wage earners and clerical workers (CPI-W). Due to the way it is calculated, chained CPI measures inflation at a lower rate than CPI-W. Chained CPI assumes that individuals have the ability to buy cheaper items in place of more expensive items – the classic example is buying pork instead of chicken or beef – in order to bring their expenses down. According to the Congressional Budget Office (which provides nonpartisan analysis for Congress), chained CPI is likely to measure inflation as being 0.25 percentage points lower than CPI-W does.

A one-quarter of one percent decrease may not sound like much. In fact, it would only result in the loss of a few dollars per month in benefits. The problems with this approach really become apparent when you think about how your benefits will be affected several years down the road. Due to the fact that you receive a smaller inflation adjustment each year, your benefits grow at a slower rate as the years go by. Eventually, this one-quarter of one percent decrease will have a very large effect.

The average age of an individual receiving disability benefits is just over 53. Most individuals who stop receiving Social Security disability benefits have their benefits stopped because they attain full retirement age and are no longer entitled to disability benefits. Based on this, we know that many individuals receive disability benefits from Social Security for a long period of time – many years in most cases. This means that the cumulative effect of the switch to chained CPI will hit the disabled hardest.

This decrease is an especially big problem when you realize how important Social Security benefits are to the disabled and retired. According to the Administration, Social Security benefits provide 50% or more of household income for 53% of elderly married couples and 74% of unmarried individuals, and provide 90% or more of household income for 23% of elderly married couples and 46% of unmarried individuals. 71.7% of all disabled workers receive 50% or more of their household income from Social Security disability benefits.

Switching to chained CPI would result in a loss of benefits to the retired and disabled – those who are least able to afford such a loss. There are news reports that a switch to chained CPI is being considered by lawmakers in Congress. You should make sure that your elected representatives know that you do not support such a switch. You can find contact information for your Congressional representatives at House.gov and Senate.gov. Let them know that reducing future Social Security benefits for the elderly and disabled is unacceptable.

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Disability, USA? A Different Point of View About Social Security Disability Benefits

You may have seen a recent report on 60 Minutes regarding the Social Security Administration’s disability program. If, after watching that report, you became concerned that either a) Social Security would soon run out of money, or b) Social Security was paying disability benefits to either outright frauds or those who just aren’t disabled, I wouldn’t blame you. That’s not because those things are true, but because this “report” was extremely biased and inaccurate. The truth is that Social Security is well-funded and will be able to pay benefits well into the future, if not indefinitely.

It’s true that applications for Social Security disability benefits increase when the unemployment rate goes up. What’s not true, however, is that otherwise healthy people are drawing a disability check during bad economic times. The Center for Retirement Research at Boston College recently published a report that concluded that applications for benefits did rise when the unemployment rate went up, but that most of these “extra” claims were denied. Those who were approved tended to be older individuals working physically demanding jobs whose bodies were just worn out after years of hard labor.

Applications for disability benefits have increased recently, and a large part of that increase can be attributed to the fact that Americans are simply getting older. One of the consequences of getting older is that your body doesn’t work as well as it used to, and you become much more likely to get a chronic disease such as diabetes. It’s no surprise that disability applications will increase as more and more Americans enter the most disability-prone category of their lives.

People might worry that this increase in applications means that Social Security will soon run out of money to pay benefits. 60 Minutes didn’t do anything to allay those fears, stating several times that the trust fund is going broke in the next few years. The disability trust fund currently only receives a fraction of the amount collected in payroll taxes, with the vast majority going to the retirement trust fund. There is a simple fix for this problem – the government can either give more of each dollar to the disability fund, or transfer some money from the retirement fund to the disability fund. In fact, this has been done several times, but with the money going from the disability fund to the retirement fund. Social Security is well-funded and in no danger of going broke – don’t let anyone tell you otherwise.

60 Minutes also made it appear that disability benefits are there for anyone who applies, with no need to present any medical documentation to back up their claims. Those who have been through the process know that this is just false. The standard of disability for Social Security’s program is extremely high. Only those who are truly disabled – and who have the documentation to back it up – are awarded benefits.

There are some people who try to game the system and get benefits that they are not eligible for. Due to Social Security’s strict standards, most of these people are denied benefits in the first place. For those that do resort to fraud, Social Security has an investigative unit dedicated to finding these individuals. Once caught, they face stiff penalties, including restitution and jail time.

Despite what 60 Minutes would have you believe, Social Security’s disability program is well-funded, and only pays benefits to those who can prove they deserve them. Don’t be fooled by sensationalistic programs designed to mislead rather than inform.

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