Social Security disability: two different programs
When people say "disability benefits," they usually mean one of two federal programs administered by the Social Security Administration (SSA). They are different in important ways:
| Program | Who Qualifies | How Much |
|---|---|---|
| SSDI (Social Security Disability Insurance) | Workers with enough work credits (generally 5 of the past 10 years) | Based on your earnings history — average $1,537/mo in 2025 |
| SSI (Supplemental Security Income) | Low-income individuals with limited resources — including children | Maximum $967/mo (2025) — reduced by other income |
Both programs use the same definition of disability: a medical condition that prevents you from doing any substantial gainful work, and that has lasted or is expected to last at least 12 months or result in death. This is a strict definition. Partial disability and short-term disability do not qualify for Social Security benefits.
Why Social Security denies most applications
The SSA denies approximately 67% of initial applications and 82% of reconsideration requests. The most common reasons are:
- Insufficient medical evidence. The SSA needs detailed medical records documenting your condition, treatment, and functional limitations. Many applicants do not provide enough documentation.
- Lack of compliance with treatment. If you are not following prescribed treatment (without a good reason), the SSA may question whether your condition is as severe as claimed.
- Technical eligibility issues. Missing the work credit requirement for SSDI, or exceeding the asset limits for SSI.
- The condition does not meet duration requirements. Your condition must last (or be expected to last) at least 12 months.
- Inadequate description of limitations. The SSA assesses your "residual functional capacity" — what work you can still do. If your application does not clearly document your limitations, the SSA may conclude you can still do some work.
The Social Security appeals process
If you are denied, do not give up. There are four levels of appeal:
- Reconsideration — A different SSA employee reviews your application. Still denied about 82% of the time. File within 60 days of denial.
- Administrative Law Judge (ALJ) hearing — A hearing before an ALJ, where you can present testimony and additional evidence. This is where the majority of successful appeals happen. Approval rates with attorney representation are substantially higher. File within 60 days of reconsideration denial.
- Appeals Council review — The SSA's Appeals Council reviews ALJ decisions for legal errors.
- Federal court — If all else fails, you can file a lawsuit in federal district court.
How disability attorneys work and what they cost
Disability attorneys work on contingency and are paid only if you win. Their fee is strictly regulated by federal law:
- The fee is 25% of your back pay (the benefits you were owed while the case was pending)
- Maximum fee: $7,200 regardless of the back pay amount (this cap is adjusted periodically by the SSA)
- The SSA pays the attorney directly from your award — you never write a check
Because the fee is capped and paid from your award, there is no financial risk to you in hiring an attorney. Studies consistently show that represented claimants have significantly higher approval rates than unrepresented claimants.
Disability rights in the workplace: the ADA
The Americans with Disabilities Act (ADA) protects employees with disabilities from discrimination and requires employers to provide reasonable accommodations. A disability under the ADA is any physical or mental condition that substantially limits a major life activity. This is a broader definition than the SSA's disability definition — many people with conditions that do not qualify for Social Security benefits are still protected by the ADA at work.
Reasonable accommodations might include:
- Modified work schedule or reduced hours
- Work-from-home arrangements
- Modified job duties
- Accessible parking or workspace modifications
- Leave of absence for medical treatment
- Assistive technology or equipment
An employer must provide a reasonable accommodation unless it causes undue hardship — a significant difficulty or expense given the employer's resources. Employers with 15+ employees are covered by the ADA. Many states have even broader protections.
Long-term disability insurance claims
If your employer provides long-term disability (LTD) insurance, you may have benefits through that policy as well. LTD insurers (companies like MetLife, Hartford, Unum, Cigna) are notorious for approving claims initially and then cutting off benefits when you reach the point where a different — more restrictive — definition of disability kicks in. An attorney who handles ERISA disability claims can help you fight these denials.
Talk to a disability attorney today.
Whether you need help with a Social Security appeal, a long-term disability claim, or ADA rights at work, we can connect you with a disability attorney in your area for a free consultation.
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Related Guides
How to Win a Social Security Disability Hearing
What ALJ hearings look like and how to prepare.
SSDI vs SSI: What Is the Difference?
Two different programs, two different eligibility rules.
What to Do After a Social Security Disability Denial
The appeal process, step by step.
Reasonable Accommodations Under the ADA
What employers must provide and how to request it.
Long-Term Disability Insurance Denials: Your Rights
How ERISA works and what to do when your insurer cuts off benefits.