Thinking About Applying for Social Security Disability? Here Is What to Know
If you are sick or hurt and cannot work, you may want to know if you can get Social Security Disability benefits.
Getting these benefits can be hard to understand. There are a few different programs. Each one has strict rules about your health and your work. You may also have to ask for a review more than once. When you learn how it works, you can do things to make your case stronger.
At Netzer Krautter Law Firm P.C., we help people who were told no on their Social Security Disability claim. Below are answers to some of the most common questions people ask us about Social Security Disability.
What Is Social Security Disability?
The Social Security Administration runs two main programs that pay money to people who have a disability: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Both programs use almost the same health rules to decide if an adult has a disability. But each one has different money rules.
Social Security Disability Insurance (SSDI)
Social Security Disability Insurance (SSDI) is for people who have worked and paid Social Security taxes long enough. When you work and pay these taxes, you earn work credits. To get SSDI, you usually need two things: a disability that counts under the rules, and enough work credits.
Supplemental Security Income (SSI)
Supplemental Security Income (SSI) helps people who do not have much money or many things they own. It pays money each month to people who have a disability, are blind, or are 65 or older. SSI is different from SSDI. You do not need work credits to get SSI. Some people can get both SSDI and SSI. The Social Security Administration has more information that explains the differences between Social Security benefits and SSI.
What Does Social Security Consider a “Disability” and Can I Work While Applying for Social Security Disability?
Just having a health problem does not always mean you are disabled under Social Security's rules.
For adults, Social Security usually looks for a health problem of the body or the mind, found by a doctor, that keeps you from doing substantial gainful activity (this is a legal term for a set amount of money you can earn each month, and the amount changes every year). The health problem must also have lasted, or be expected to last, at least 12 months, or be likely to cause death. You can read Social Security's definition of disability and explanation of the disability determination process.
For 2026, the monthly Substantial Gainful Activity (SGA) dollar limit each month is usually:
- $1,690 each month for people who are not blind
- $2,830 each month for people who are blind under the law
The big question is not just “What is your health problem?” but instead, “How does your health problem change how well you can work day after day?”
For example, someone may have back pain, depression, anxiety, heart disease, diabetes, arthritis, or nerve pain and still not get disability just from the name of the illness. The proof must show how bad the problem is and how it limits what you can do. Social Security looks at both physical and mental impairments, and it looks at how several problems add up together.
What Medical Evidence Do I Need?
Medical proof is one of the most important parts of your claim.
Social Security looks at many things. This includes your medical records and your past care. It looks at test results and the medicines you take. It also looks at how well you can do daily tasks. And it looks at how your health problems make it hard to work.
Social Security's rules say you must have medical proof of a real health problem. This can be a problem with your body or with your mind. Just telling them how you feel is not enough. You need proof. You can read more in Social Security's Disability Evaluation Under Social Security.
The proof that helps most depends on your health problem. It may include:
- pictures of your body, like an MRI, CT scan, or X-ray;
- lab tests, like blood tests;
- records from any surgery;
- notes from physical therapy;
- records from mental health care;
- brain and thinking tests;
- visits with special doctors;
- a list of medicines you have taken;
- notes that show your symptoms and what you cannot do; and
- your doctors' opinions about what you can and cannot do.
A strong claim is not just about how many records you send. What matters most is that the records show what keeps you from working.
Do I Have to Meet One of Social Security's Disability Listings?
Not necessarily.
Social Security has a big list called the Listing of Impairments, also known as the “Blue Book.” This list tells the medical rules for many health problems. It covers problems with your bones and muscles, your heart, your brain and nerves, your mind, cancer, and more. If your health problem meets all the rules in the list, Social Security may decide that you are disabled.
But if your health problem does not match this list, it does not always mean you are not disabled.
Social Security explains this in its overview of the Listing of Impairments. Even if your health problem is not on the list, Social Security does not stop there. It keeps looking at your case in more steps before it decides.
One of these steps looks at your Residual Functional Capacity (RFC). This is just a simple way of asking what you can still do, even with your health problems in your body and mind.
This matters a lot for people who have multiple medical conditions.
You might have more than one health problem, and no single one may match the list by itself. But when all of your problems are added up together, they may still stop you from working a full-time job.
What Happens If Social Security Denies My Initial Application?
If Social Security says no to your first application, you have the right to ask them to look at it again. But you must do this within the time they give you. Do not give up if you are turned down. Being turned down is common, and it can happen for many reasons, like missing medical records. Many people who apply for SSI or SSDI are turned down one or two times before they are finally approved.
The lawyers at Netzer Krautter Law Firm, P.C. are happy to talk with you about whether they can help you appeal after you are turned down. They can also help you get ready for a hearing with a judge, called an Administrative Law Judge. It is best to call a lawyer soon after you are turned down, not right before your hearing. Calling early gives the lawyer time to look at your case, find weak spots, get more medical records, see if you need more testing, and get your case ready as it moves through the appeal steps.
What does the Initial Application and Appeal Process Look Like?
A claim for SSI or SSDI can go through several steps of review. These steps are:
- The first decision on your claim;
- A second look, called reconsideration;
- A hearing with a judge, called an Administrative Law Judge (ALJ);
- A review by the Appeals Council; and
- A review by a federal court.
Many disability cases are decided after a hearing with an Administrative Law Judge. At the hearing, you get to explain how your health problems affect what you can do and how you can work. The judge will also listen to a job expert, called a vocational expert. This expert talks about the jobs you did before and whether there are jobs you could do with your health problems.
Getting ready for the hearing is very important. It is one of the main things the lawyers at Netzer Krautter Law Firm, P.C. work on. They help people get ready so they can give the judge the best and strongest information possible.
Why Hire an Attorney After My Claim Is Denied?
A Social Security Disability case is really about proof. A lawyer can look at the papers already in your Social Security file and find spots that need more work. A lawyer can also match your health problems and symptoms to the rules Social Security uses (called the Blue Book) to decide who is disabled.
Depending on your case, a lawyer may help by:
- looking at your Social Security file;
- getting and sending in new medical records;
- finding medical proof that is missing;
- checking proof that could hurt your case;
- seeing if doctor notes or new tests could help;
- helping you get ready to speak;
- looking at the jobs you did before;
- writing the legal reasons for your case;
- asking job and medical experts questions when needed; and
- speaking for you at your hearing with a judge.
Getting a lawyer soon after your first denial gives more time to build a strong record before the hearing, instead of trying to fix problems at the last minute.
How Much Does a Social Security Disability Attorney Cost?
Social Security limits how much a lawyer can charge you. Under Social Security's standard fee-agreement process, the lawyer's fee is usually the smaller of two amounts: 25% of your past-due benefits, or the largest dollar amount Social Security allows.
Right now, the most a lawyer can be paid this way is $9,200. This is for cases you win with a good decision made on or after November 30, 2024. The fee comes out of your past-due benefits only if you win, and Social Security must approve it first.
Some cases follow different fee rules. This can happen when a case goes further in the appeals process or to federal court. You may also have to pay other costs tied to your case. This depends on the deal you make with your lawyer.
Can Netzer Krautter Law Firm Represent Me If I Don't Live in Montana or North Dakota? Yes.
Social Security Disability is a federal program. That means the state you live in does not matter. You can live in Montana, North Dakota, or any other state. The attorneys at Netzer Krautter Law Firm, P.C. can still help you with your Social Security Disability appeal.
When Should I Contact Netzer Krautter Law Firm P.C. about Assistance with Social Security Disability?
If you are just starting to apply for disability, you can send your first application to the Social Security Administration yourself. A friend or family member can also help you. Social Security has helpful information about applying for disability benefits and determining whether you may qualify. If you get approved without a lawyer, you will not owe any lawyer fees.
But if your application is denied, that is a good time to call our office. We can talk about helping you. When you get a lawyer early, your lawyer has more time to look at your case, find missing proof, gather your medical records, and get ready for a future hearing.
Call Netzer Krautter Law Firm, P.C. at 406-433-5511 right away after you get a Social Security Disability denial. We can talk about your appeal choices.
This article is only for general information. It is not legal advice. Social Security rules and payment amounts can change. Every disability case is different.
