Social Security Disability in Somerville

How social security disability cases proceed under Massachusetts law

Social Security Disability is a matter of federal administrative law, not Massachusetts state law, so a claimant in Somerville proceeds through a federal system that is the same nationwide. There are two benefit programs. Social Security Disability Insurance (SSDI) under 42 U.S.C. sec. 423 is based on work credits earned through past employment, while Supplemental Security Income (SSI) under 42 U.S.C. sec. 1382 is needs-based and depends on limited income and assets. The governing regulations are at 20 C.F.R. Parts 404 and 416, and many claimants qualify under one program, the other, or both.

The Social Security Administration decides disability using a five-step sequential evaluation set out at 20 C.F.R. sec. 404.1520. The steps ask, in order, whether the claimant is working at a substantial level, whether the impairment is severe, whether it meets or equals a listed impairment, whether the claimant can still do past work, and whether the claimant can adjust to other work given age, education, and residual functional capacity. Where an impairment does not meet a listing, the case often turns on residual functional capacity, which is the assessment of what the claimant can still do despite the impairment. A claimant in Somerville moves through this same federal framework regardless of where in Massachusetts they live.

The process moves through defined stages: the initial application, then reconsideration if the application is denied, then a hearing before an Administrative Law Judge, then the Appeals Council, and finally review in the United States District Court under 42 U.S.C. sec. 405(g). Massachusetts claimants are served by the Social Security hearing offices in Boston and Lawrence, where the Administrative Law Judge hearings for the region are held. Because most claims are denied at the initial and reconsideration stages, the hearing before the Administrative Law Judge is frequently where the case is won or lost, which is why preparation for that hearing matters so much.

Massachusetts statutes and case law

• 42 U.S.C. sec. 423. Social Security Disability Insurance (SSDI); benefits based on work credits earned through past covered employment.
• 42 U.S.C. sec. 1382. Supplemental Security Income (SSI); needs-based benefits depending on limited income and assets.
• 20 C.F.R. Parts 404 and 416. The federal regulations governing SSDI (Part 404) and SSI (Part 416) disability determinations.
• 20 C.F.R. sec. 404.1520. The five-step sequential evaluation the Social Security Administration uses to decide disability.
• 42 U.S.C. sec. 406. Attorney-fee provision; the fee is the lesser of 25 percent of past-due benefits or the national cap set by the Social Security Administration, and no fee is owed unless back benefits are awarded.
• 42 U.S.C. sec. 405(g). Federal-court review of a final Social Security decision in the United States District Court.

Common social security disability case patterns in Somerville

1. An initial application denial for a claimant in Somerville: the first denial is common, and the case proceeds to reconsideration.
2. A reconsideration denial: the matter advances toward a hearing before an Administrative Law Judge at the Boston or Lawrence hearing office.
3. Preparation for the Administrative Law Judge hearing: developing the medical record and the residual functional capacity evidence, often the decisive stage.
4. A listing-level impairment versus a residual functional capacity case: whether the impairment meets a listing or the case turns on what work the claimant can still do.
5. An SSDI versus SSI eligibility question, or a continuing disability review: determining which program applies, or defending benefits already awarded.

Typical timeline for a Somerville social security disability matter

The process begins with the initial application, where the claimant's impairments, work history, and medical evidence are submitted. A claimant in Somerville files through the Social Security Administration, and the agency applies the five-step sequential evaluation under 20 C.F.R. sec. 404.1520. Because a large share of initial applications are denied, the early focus is on building a complete and well-documented medical record from the start.

If the application is denied, the matter proceeds to reconsideration and then, if still denied, to a hearing before an Administrative Law Judge. Massachusetts claimants are heard at the Boston or Lawrence Social Security hearing offices. This hearing stage is often where the case is decided, so the preparation, the medical evidence, the residual functional capacity assessment, and the claimant's testimony, is developed carefully. The wait for a hearing can be lengthy given the volume of cases.

If the Administrative Law Judge denies the claim, the next stage is the Appeals Council, and after that, review in the United States District Court under 42 U.S.C. sec. 405(g). Throughout the process, the attorney fee is governed by 42 U.S.C. sec. 406 rather than a standard contingency: it is the lesser of 25 percent of past-due benefits or the national cap set by the Social Security Administration, and no fee is owed unless back benefits are awarded.

What can be recovered in a social security disability case

• Monthly SSDI benefits under 42 U.S.C. sec. 423 where the claimant qualifies based on work credits.
• Monthly SSI benefits under 42 U.S.C. sec. 1382 where the claimant qualifies based on limited income and assets.
• Past-due benefits (back pay) calculated from the established onset date through the award.
• Continued eligibility for benefits, subject to periodic continuing disability review.
• Associated Medicare or Medicaid eligibility that can accompany an award, depending on the program.
• Reinstatement or defense of benefits in a continuing disability review where the agency questions ongoing eligibility.

More questions Somerville residents ask about social security disability

• What is the difference between SSDI and SSI for a Somerville claimant?

  Social Security Disability Insurance (SSDI) under 42 U.S.C. sec. 423 is based on work credits you earned through past employment. Supplemental Security Income (SSI) under 42 U.S.C. sec. 1382 is needs-based and depends on limited income and assets rather than work history. Some claimants qualify under one program, some under the other, and some under both. The first telephone consultation reviews which program fits your situation in Somerville.

• Why was my Somerville disability application denied, and what happens next?

  A large share of initial applications are denied, often because the medical record does not yet fully document how the impairment limits the ability to work under the five-step sequential evaluation at 20 C.F.R. sec. 404.1520. After an initial denial, the matter proceeds to reconsideration and then to a hearing before an Administrative Law Judge at the Boston or Lawrence hearing office, which is frequently where the case is decided. Building a complete medical record is the key task at each stage.

• Where will my Somerville disability hearing be held?

  Massachusetts claimants are served by the Social Security hearing offices in Boston and Lawrence, where the hearings before an Administrative Law Judge for the region are held. The hearing is often the decisive stage, so the medical evidence, the residual functional capacity assessment, and your testimony are prepared carefully in advance. Because this is a federal administrative process, it is the same wherever in Massachusetts you live.

• How are attorney fees handled in a Somerville Social Security disability case?

  Social Security disability fees are set by federal law, not by a standard contingency. Under 42 U.S.C. sec. 406, the fee is the lesser of 25 percent of your past-due benefits or the national cap set by the Social Security Administration, and no fee is owed unless back benefits are awarded. This federal fee structure applies to your Somerville matter regardless of which attorney handles it.

• Does Jim Glaser Law handle Social Security disability for Somerville residents?

  Social Security disability is evaluated on the same intake call. The firm either handles the matter or connects the client with a Massachusetts Social Security disability partner attorney at no extra cost. Because this is a federal administrative practice, the fee is set by 42 U.S.C. sec. 406 (the lesser of 25 percent of past-due benefits or the national cap, with no fee unless back benefits are awarded), and the first telephone consultation is offered without charge.