Social Security Lawyers Near Me: SSDI—Massachusetts, MA

SSDI Denials and Appeals Guide for Massachusetts, Massachusetts

If you live in Massachusetts and your Social Security Disability Insurance (SSDI) claim was denied, you are not alone—and you have the right to appeal. The Social Security Administration (SSA) denies many initial SSDI applications nationwide. But federal law provides a structured appeals process and important claimant protections that you can use to seek a fair outcome. This comprehensive guide explains your rights, common reasons for denials, the federal regulations that apply, and step-by-step instructions to pursue an appeal in Massachusetts. It also highlights local resources and what to expect if you take your case to a hearing or federal court.

Massachusetts residents file SSDI claims under the same federal rules that apply across the country, but practical considerations—like where to submit paperwork, which local office will handle your case, and where a hearing may be scheduled—are local. The SSA’s Boston Region oversees operations in the Commonwealth, and Massachusetts Disability Determination Services (DDS) evaluates medical evidence at the initial and reconsideration stages. If you need to appeal, you typically have 60 days from when you receive a denial notice. Understanding precisely what the SSA requires—and when—can make the difference between a denied claim and a successful award of benefits.

This guide slightly favors the claimant’s perspective while remaining fact-based and aligned with federal law. It includes citations to key regulations (for example, 20 CFR Part 404) and sections of the Social Security Act, and it points to official resources to help you navigate each stage. Whether your case involves a severe physical impairment, a mental health condition, or a combination of both, your path forward begins with knowing your rights and following the correct steps on time.

Understanding Your SSDI Rights

Who qualifies for SSDI

SSDI is a federal insurance program for workers who become disabled. To qualify, you must satisfy both insured status and disability criteria. Insured status depends on your work history and payment of Social Security payroll taxes; the standards are detailed in 20 CFR Subpart B (see, e.g., 20 CFR 404.130). Separately, disability is defined by the Social Security Act as the inability to engage in any substantial gainful activity (SGA) by reason of a medically determinable impairment expected to result in death or that has lasted or can be expected to last for a continuous period of at least 12 months. See 42 U.S.C. § 423(d)(1)(A).

How SSA evaluates disability

SSA uses a five-step sequential evaluation process for adult SSDI claims, set out in 20 CFR 404.1520. In brief:

• Step 1 (SGA): Are you working at the level of substantial gainful activity? If yes, you are generally not disabled. See 20 CFR 404.1571–404.1574.
• Step 2 (Severity): Do you have a severe, medically determinable impairment—or combination of impairments—that significantly limits your ability to perform basic work activities and has lasted or is expected to last at least 12 months? See 20 CFR 404.1520(c), 404.1509.
• Step 3 (Listings): Do your impairments meet or equal the severity of a listed impairment in Appendix 1 to Subpart P of Part 404? If yes, you are disabled. See 20 CFR 404.1520(d), 404.1525, 404.1526.
• Step 4: Can you perform your past relevant work given your residual functional capacity (RFC)? If yes, not disabled. See 20 CFR 404.1520(f), 404.1560.
• Step 5: Considering your RFC, age, education, and work experience, can you adjust to other work that exists in significant numbers in the national economy? If yes, not disabled; if no, disabled. See 20 CFR 404.1520(g), 404.1560–404.1569a.

Your responsibilities and rights as a claimant

As an SSDI claimant, you must submit all evidence known to you that relates to your disability claim. See 20 CFR 404.1512. SSA will review medical evidence from acceptable medical sources, consultative examinations if needed, and other evidence (such as work history and function reports). For claims filed on or after March 27, 2017, SSA evaluates medical opinions using supportability and consistency as the most important factors; no opinion receives automatic controlling weight. See 20 CFR 404.1520c.

You have the right to be represented by an attorney or qualified non-attorney representative at any stage of the process. See 20 CFR 404.1705. Representation fees must be approved by SSA (see 42 U.S.C. § 406(a); 20 CFR 404.1720–404.1730). SSA’s fee agreement process generally caps the representative’s fee at a maximum amount set by SSA; as of a 2022 update, the cap is $7,200 for most fee agreements approved administratively. Always confirm the current cap on SSA’s official site.

Common Reasons SSA Denies SSDI Claims

Understanding why claims are denied can help you correct issues quickly on appeal. Frequent reasons include:

• Insufficient medical evidence: If your records do not document objective findings, longitudinal treatment, or functional limitations, SSA may find the impairment non-severe or not disabling. See 20 CFR 404.1512, 404.1520(c).
• Work above SGA: Earnings at or above SGA during the period you claim disability can result in a denial at Step 1. See 20 CFR 404.1571–404.1574.
• Duration problems: If SSA determines your impairment did not last or is not expected to last 12 continuous months, the claim can be denied. See 42 U.S.C. § 423(d)(1)(A); 20 CFR 404.1509.
• Non-compliance or missed exams: Missing consultative examinations or failing to cooperate with information requests may lead to an unfavorable decision when evidence is insufficient. See 20 CFR 404.1512 (duty to submit evidence) and 404.1517–404.1519t (consultative examinations).
• Residual functional capacity (RFC) assessment: SSA may find that, despite your limitations, you can perform past work (Step 4) or other work in the national economy (Step 5). See 20 CFR 404.1520(f)–(g), 404.1545.
• Insured status: If you lack sufficient recent work credits as of your alleged onset date or date last insured (DLI), SSA must deny under Title II’s insured-status requirements. See 20 CFR 404.130–404.132.

Even when a denial seems discouraging, many claims are approved after additional medical evidence, clarifying statements, or expert testimony are added on appeal. The key is to act quickly and provide complete, timely information.

Federal Legal Protections & Regulations

Appeals framework under federal rules

SSDI appeals are governed by 20 CFR 404.900–404.999d (Administrative Review Process). The four stages are:

• Reconsideration: Request within 60 days of receipt of the denial notice. See 20 CFR 404.909(a)(1). Receipt is presumed 5 days after the date on the notice unless you show otherwise. See 20 CFR 404.901.
• Hearing before an Administrative Law Judge (ALJ): If reconsideration is denied, request a hearing within 60 days. See 20 CFR 404.933(b).
• Appeals Council review: If the ALJ denies or dismisses your case, request Appeals Council review within 60 days. See 20 CFR 404.967–404.968.
• Federal court: If the Appeals Council denies review or issues an unfavorable decision, you may file a civil action in U.S. District Court within 60 days of receiving the Appeals Council’s notice. See 42 U.S.C. § 405(g); 20 CFR 404.981.

SSA may extend deadlines for “good cause.” Good cause factors include serious illness, records destroyed by events beyond your control, or other circumstances that prevented timely filing. See 20 CFR 404.911.

Your right to a full and fair hearing

At the ALJ stage, you have the right to submit evidence, examine the evidence used against you, and present witnesses and arguments. See 20 CFR 404.929–404.950. You may appear in person, by video, or telephone, subject to SSA’s procedures and scheduling. The ALJ must issue a written decision explaining the findings of fact and the reasons for the decision.

Judicial review standard

In federal court, the judge does not decide disability from scratch. Instead, the court reviews whether SSA’s final decision is supported by substantial evidence and whether the correct legal standards were applied. See 42 U.S.C. § 405(g). If the court finds legal error or insufficient support, it may remand the case to SSA for further proceedings or, in rare circumstances, order benefits.

Steps to Take After an SSDI Denial

1) Read the denial letter carefully

Your notice explains why SSA denied your claim and how to appeal. Mark the date on the notice and calculate your deadline. You generally have 60 days from when you receive the notice, and SSA presumes you receive it 5 days after the date on the notice unless you show otherwise. See 20 CFR 404.901, 404.909.

2) File your reconsideration request on time

Most Massachusetts SSDI claimants must file a reconsideration to challenge an initial denial. Submit your request online or by contacting your local SSA field office. Include any new medical records, updated contact information for your providers, and statements describing changes in your symptoms or limitations. Cite any hospitalizations, emergency visits, or new diagnoses since your initial application.

• Tip: Ask your doctors to provide functional assessments (e.g., lifting, standing, concentration limits). SSA evaluates functional impact, not just diagnoses. See 20 CFR 404.1545 (RFC assessment).
• Keep copies: Save proof of your filing date. If you mail documents, use a trackable method.

3) Prepare for the ALJ hearing

If reconsideration is denied, request an ALJ hearing within 60 days. See 20 CFR 404.933(b). At the hearing level, you can submit new evidence and arguments. The ALJ may call a vocational expert (VE) or medical expert (ME). You or your representative can cross-examine experts and present witnesses who know your limitations, such as former supervisors or family members familiar with your daily functioning.

• Evidence submission timing: SSA has evidence submission timing rules. Provide evidence as early as possible; if the deadline has passed, be prepared to show good cause for late submission.
• Written brief: A concise pre-hearing brief that maps your impairments to SSA’s five-step framework and cites supportive evidence can be persuasive.

4) Appeals Council review

If you receive an unfavorable ALJ decision, you may request Appeals Council review within 60 days. See 20 CFR 404.967–404.968. The Appeals Council can deny review, grant review and issue a decision, or remand to the ALJ for a new hearing. Be specific about alleged errors of law or fact—for example, misapplication of 20 CFR 404.1520c when evaluating medical opinions, or failure to address critical evidence.

5) Federal court filing in Massachusetts

If the Appeals Council denies review or issues an unfavorable decision, you may file a civil action in the U.S. District Court for the District of Massachusetts within 60 days of receiving the Appeals Council notice. See 42 U.S.C. § 405(g); 20 CFR 404.981. The lawsuit is filed against the Commissioner of Social Security. In court, briefing focuses on whether the final decision is supported by substantial evidence and free of legal error. If successful, the court may remand your case to SSA for a new hearing or, in limited instances, award benefits.

When to Seek Legal Help for SSDI Appeals

You have the right to representation at all stages of the SSDI process. See 20 CFR 404.1705. Many claimants seek a Massachusetts disability attorney or qualified non-attorney representative after the initial denial because deadlines, evidentiary rules, and hearing procedures are technical. A representative can help you:

• Identify and obtain missing medical evidence and opinion letters aligned with 20 CFR 404.1512 and 404.1520c.
• Prepare you for testimony and cross-examination of vocational or medical experts.
• Draft persuasive briefs that address each step of the sequential evaluation and the Listings.
• Protect the record for Appeals Council and federal court review, if needed.

Fees: SSA must approve representative fees. For most SSDI cases resolved at or before the Appeals Council through a fee agreement, SSA withholds and pays the approved fee from your past-due benefits, subject to a maximum cap set by SSA. See 42 U.S.C. § 406(a); 20 CFR 404.1720–404.1730. As of a 2022 update, SSA’s standard fee agreement cap is $7,200; verify current limits on SSA’s site.

Massachusetts licensing: If you choose an attorney, ensure they are admitted to practice law in Massachusetts and in good standing with the Massachusetts Board of Bar Overseers. For federal court representation, counsel should also be admitted to the U.S. District Court for the District of Massachusetts.

Federal Deadlines and How to Calculate Them

• Reconsideration: 60 days from receipt of the initial denial notice (presumed 5 days after the notice date). See 20 CFR 404.909(a)(1), 404.901.
• ALJ hearing: 60 days from receipt of the reconsideration determination. See 20 CFR 404.933(b).
• Appeals Council: 60 days from receipt of the ALJ decision. See 20 CFR 404.968(a).
• Federal court: 60 days from receipt of the Appeals Council action. See 42 U.S.C. § 405(g); 20 CFR 404.981.

If you miss a deadline, request an extension and explain your “good cause” under 20 CFR 404.911. Provide documentation (e.g., hospitalization records) where applicable.

Local Resources & Next Steps in Massachusetts

SSA field offices and how to find yours

Massachusetts residents can handle most SSDI tasks online or by contacting a local SSA field office. Many larger cities in the Commonwealth—such as Boston, Worcester, and Springfield—have SSA field offices that accept documents, answer basic questions, and provide appointments. For the most accurate, current address and hours of your nearest office, use SSA’s official locator:

Find Your Local Social Security Office (SSA Locator)Bring government-issued identification and copies of medical releases if you plan to submit or update medical evidence.

Massachusetts Disability Determination Services (DDS)

At the initial and reconsideration stages, disability decisions are made by Massachusetts DDS, a state agency that works with SSA to gather medical evidence and evaluate claims under federal regulations. DDS may schedule consultative examinations if needed. For background about the state’s DDS, see Mass.gov’s official information page:

Massachusetts Disability Determination Services (Official)Send medical updates to SSA promptly so DDS can review the most complete record possible.

Hearing locations and scheduling

The SSA schedules hearings at locations serving Massachusetts claimants. Your Notice of Hearing will specify the location, date, and whether the hearing will be in person, by video, or by telephone. You may request a different appearance method for good reason. If you need disability accommodations, notify SSA as early as possible.

Federal court in Massachusetts

If your case reaches federal court, it is filed in the U.S. District Court for the District of Massachusetts, which serves the entire Commonwealth. Procedures and local rules are available on the court’s official website:

U.S. District Court for the District of Massachusetts## Building a Stronger Record on Appeal

Medical evidence strategy

• Objective findings: Imaging, lab results, and clinical exams that corroborate symptoms.
• Longitudinal treatment: Regular visits and consistent documentation of symptoms, response to treatment, and side effects.
• Function-focused opinions: Provider statements that translate medical findings into specific physical or mental work-related limitations (e.g., off-task time, need for breaks, lifting limits, absenteeism).
• Consistency and supportability: Ensure opinions cite underlying records and are consistent with the longitudinal evidence, in line with 20 CFR 404.1520c.

Work history and vocational evidence

SSA looks closely at your past work, skills, and whether those skills transfer to other jobs. Detailed job descriptions (lifting, standing, complexity of tasks) and explanations of why you can no longer perform them can be decisive at Steps 4 and 5. If a vocational expert testifies, your representative can challenge job numbers or the applicability of certain occupations based on your limitations.

Daily activities and third-party statements

Function reports and statements from people who observe your daily limitations can support your claim, especially for conditions that fluctuate (e.g., chronic pain, migraines, mental health conditions). Be specific about frequency, duration, and severity of symptoms.

Frequently Asked Questions for Massachusetts Claimants

How long do I have to appeal?

Generally 60 days from receipt of each decision, with a 5-day mailing presumption. See 20 CFR 404.901, 404.909, 404.933, 404.968, and 404.981. You can request more time for good cause. See 20 CFR 404.911.

Can I keep working while appealing?

Work activity can affect SSDI eligibility if it reaches substantial gainful activity levels. See 20 CFR 404.1571–404.1574. If you attempt work, report it to SSA and discuss the implications with your representative.

Do I need a Massachusetts disability attorney?

You are not required to have a lawyer, but representation can help with evidence, deadlines, and hearing strategy. See 20 CFR 404.1705. If you hire an attorney, ensure they are licensed in Massachusetts and, if your case goes to court, admitted in the District of Massachusetts.

What if I missed a deadline?

File immediately and explain good cause with documentation. See 20 CFR 404.911.

Key Federal Citations You Can Use

• Definition of disability: 42 U.S.C. § 423(d)(1)(A).
• Administrative review process and deadlines: 20 CFR 404.900–404.999d; reconsideration (404.909), hearings (404.929–404.950, 404.933), Appeals Council (404.967–404.981), federal court (42 U.S.C. § 405(g)).
• Evidence and medical opinions: 20 CFR 404.1512, 404.1520c, and RFC (404.1545).
• Five-day receipt presumption: 20 CFR 404.901.
• Good cause for late filing: 20 CFR 404.911.
• Right to representation and fee approval: 20 CFR 404.1705, 404.1720–404.1730; 42 U.S.C. § 406(a).

How to File Your Appeal in Massachusetts

• Start online: File reconsideration or hearing requests through SSA’s portal. Include new medical evidence and provider contacts. Keep confirmations. Contact your local field office: If you prefer in-person or phone assistance, use the locator to find the nearest Massachusetts office and schedule an appointment. SSA Field Office Locator- Track deadlines: Calendar 60-day due dates for each stage and add the 5-day mailing rule. See 20 CFR 404.901, 404.909, 404.933, 404.968.
• Strengthen the record: Request updated records, testing, and detailed provider opinions tied to functional limits and Listings. See 20 CFR 404.1520c, 404.1525, 404.1526.
• Consider representation: A Massachusetts disability attorney or qualified representative can help at every stage, including federal court if necessary. See 20 CFR 404.1705.

Local Context for Massachusetts Claimants

Massachusetts residents pursue SSDI under uniform federal rules, but your paperwork and hearing logistics are local. The Boston Region of SSA oversees services in the Commonwealth, and hearings for Massachusetts claimants are scheduled at locations serving your residence. Your treating sources in Massachusetts—such as community clinics and major medical centers—can provide the longitudinal records and opinion evidence SSA expects. If your condition limits travel, discuss remote appearance options with SSA as soon as you receive a hearing notice.

For quick access to official guidance and regulations that govern your appeal, use these authoritative resources:

SSA: Appeal a DecisioneCFR: Title 20 Part 404 (Disability Insurance)42 U.S.C. § 405 (Hearings; Judicial Review)SSA: Your Right to Representation

Search Phrases and How They Fit Your Case

If you’re searching for help, you may encounter phrases like “social security disability,” “massachusetts disability attorney,” “SSDI appeals,” and the primary term SSDI denial appeal massachusetts massachusetts. These simply reflect the same federal process applied in Massachusetts and can guide you to local, qualified help familiar with SSA’s rules, the Boston Region’s procedures, and the District of Massachusetts’s federal court requirements.

Practical Tips to Improve Your Chances on Appeal

• Be consistent: Ensure your statements to SSA, your doctors, and any insurers align regarding onset dates, symptoms, and limitations.
• Explain gaps: If you have breaks in treatment, provide reasons (e.g., access, cost, transportation) and resume care as you are able.
• Medication side effects: Document fatigue, dizziness, or cognitive effects that impact work-related functions.
• Objective corroboration: When possible, obtain updated imaging or testing consistent with your condition.
• Daily activities: Describe what you can do on “bad days” versus “better days,” including the frequency of bad days per month.
• Follow-up: After any emergency visit or hospitalization, send records to SSA quickly.

What to Expect at the ALJ Hearing

Hearings are non-adversarial, but the ALJ will question you about your work history, symptoms, daily activities, and treatment. A vocational expert may testify about jobs a person with your limitations could perform. Your representative can challenge hypothetical questions that do not match your actual limitations and can question the basis for job-number estimates. The ALJ will issue a written decision after the hearing. If unfavorable, you have 60 days to request Appeals Council review. See 20 CFR 404.967–404.968.

If You Win: Onset Dates, Back Pay, and Medicare

If you are approved, SSA will determine your established onset date (EOD). Back pay depends on the EOD, your date last insured, and the statutory five-month waiting period for SSDI benefits. Medicare entitlement generally begins after a waiting period measured from the month of entitlement to cash benefits. These matters are governed by federal statute and regulations under Title II of the Social Security Act and 20 CFR Part 404. If you disagree with parts of a partially favorable decision (for example, onset date), consult a representative before appealing further, as appeals can risk the favorable portion.

Checklist: Immediate Actions After an SSDI Denial in Massachusetts

• Calendar your deadline: 60 days from receipt (add the 5-day mailing presumption). See 20 CFR 404.901, 404.909.
• Request reconsideration online or through your local SSA office right away.
• Collect records: Ask providers for updated notes, imaging, labs, and function-based opinion letters.
• Track submissions: Keep copies and tracking for anything you send to SSA.
• Consider representation: Contact a Massachusetts disability attorney or qualified representative to review your case strategy.

Disclaimer

This guide is for informational purposes only and is not legal advice. Consult a licensed Massachusetts attorney about your specific situation.

Need Help Now?

If your SSDI claim was denied, call Louis Law Group at 833-657-4812 for a free case evaluation and claim review.