SSDI Denial? Social Security Attorney Guide – New York, NY

Introduction: SSDI Denials in New York, NY

If you live or work in New York City and recently received a Social Security Disability Insurance (SSDI) denial letter, you are not alone. According to publicly available Social Security Administration (SSA) data, more than half of first-time SSDI applications filed in New York State are initially denied. Yet many of those denials are reversed on appeal when claimants understand their rights, assemble stronger medical evidence, and—when needed—retain qualified legal counsel. This comprehensive guide explains every stage of the SSDI denial appeal process with a slight, evidence-based bias toward protecting New York claimants. You will also find local addresses, deadlines, and federal regulations that apply specifically to residents of New York, NY. By the end, you will know exactly how to launch an SSDI denial appeal new york new york and place yourself in the best position to secure the benefits you have earned through years of FICA contributions.

Understanding Your SSDI Rights

Who Qualifies for SSDI?

SSDI is a federal insurance program funded through payroll taxes. To qualify, you must:

• Have a medically determinable impairment expected to last at least 12 months or result in death.

• Be unable to engage in substantial gainful activity (SGA) because of that impairment.

• Possess sufficient work credits—typically 20 credits earned in the 10 years before disability onset.

Your right to seek benefits is codified in Section 223 of the Social Security Act and detailed in 20 CFR §404.

The Right to Written Notice and Evidence Review

Under 20 CFR §404.904, the SSA must issue every applicant a written notice stating the reasons for approval or denial and advising of appeal rights. You also have the right to examine and copy your claims file, a critical step in preparing for any appeal.

Strict Time Limits Protect—and Threaten—Your Claim

The SSA imposes a 60-day federal statute of limitations (with an extra five days for mailing) to appeal each decision tier. Missing these deadlines usually means starting over with a new application. However, good-cause extensions are allowed under 20 CFR §404.911 when circumstances such as hospitalization or mailing errors prevented timely filing.

Common Reasons SSA Denies SSDI Claims

1. Insufficient Medical Evidence

The SSA relies heavily on objective medical findings. If your file lacks imaging studies, specialist evaluations, or longitudinal treatment records, the agency may decide your condition is not severe or long-lasting enough to prevent SGA.

2. Failure to Follow Prescribed Treatment

Under 20 CFR §404.1530, claimants generally must follow prescribed treatment unless it is against their religious beliefs or the treatment is unaffordable. Non-compliance can trigger a denial.

3. Earning Above the SGA Threshold

In 2024 the SGA level is $1,550 per month for non-blind claimants. Earning more can lead to a technical denial even when you have a severe impairment.

4. Lack of Work Credits

Applicants who have worked primarily in informal or cash-based jobs may lack the requisite work credits. Although this is a non-medical denial, you may still qualify for Supplemental Security Income (SSI) if financially eligible.

5. Prior Denial Not Addressed

Filing a new application without appealing a recent denial often results in another denial for the same reasons. The SSA’s electronic case matching spots these duplicates quickly.

Federal Legal Protections & Regulations

Key Statutes and Regulations

• Social Security Act §205(b): Guarantees a right to a hearing and to representation.

• 20 CFR §404.900–404.999: Lays out the sequential administrative review process.

• 20 CFR §404.1512: Specifies the claimant’s burden to submit all evidence that "relates to" disability.

Sequential Evaluation Process

• Are you working above SGA?

• Is your impairment severe?

• Does it meet or equal a Listing in 20 CFR Part 404, Subpart P, Appendix 1?

• Can you perform past relevant work?

• Can you adjust to other work in the national economy?

If the SSA denies your claim at any step, you may challenge that finding through the administrative appeals process described below.

Steps to Take After an SSDI Denial

1. Request for Reconsideration (60 Days)

This is a complete review by a new Disability Examiner and medical consultant. Provide any missing medical records, updated test results, or treating-physician opinions.

2. Request a Hearing Before an Administrative Law Judge (ALJ) – 60 Days

If reconsideration fails, file Form HA-501. Hearings are held in person, by video, or via telephone. In New York City, the Downtown Hearing Office is located at 201 Varick Street, Room 409, New York, NY 10014.

3. Appeals Council Review – 60 Days

The Appeals Council in Falls Church, VA, will review the ALJ’s decision for legal error. You may submit written arguments but usually no new evidence unless it relates back to the period before the ALJ decision (20 CFR §404.970).

4. Federal District Court Lawsuit – 60 Days

Your final administrative remedy is filing a civil action in the U.S. District Court for the Southern or Eastern District of New York, depending on the borough. The complaint challenges whether the ALJ applied the correct legal standards and whether substantial evidence supports the decision.

Timeline Snapshot

• Reconsideration decision: ~4–6 months.

ALJ wait time in NYC: Approximately 11 months, according to TRAC SSA Hearing Wait Times.

• Appeals Council: 8–12 months.

• Federal Court: 6–18 months.

When to Seek Legal Help for SSDI Appeals

Why Representation Matters

SSA statistics show claimants represented by attorneys or qualified advocates are more likely to win benefits at the ALJ level. Representation evens the playing field by ensuring:

• All medical evidence is obtained and submitted in SSA-compliant format.

• Treating-physician opinions follow 20 CFR §404.1520c supportability and consistency factors.

• Vocational experts are cross-examined to challenge unreliable job numbers.

• Post-hearing briefs preserve legal issues for Appeals Council and federal court.

Contingent Fees & New York Attorney Licensing

Under 42 U.S.C. §406(a) and 20 CFR §404.1720, attorney fees are capped at 25% of past-due benefits or $7,200, whichever is lower, unless a federal court awards a higher fee. In New York, lawyers must be admitted to the New York State Bar and comply with N.Y. Rules of Professional Conduct §1.5(c) when charging contingent fees.

Local Resources & Next Steps

Key SSA Offices for New York, NY Residents

New York Federal Plaza Field Office 26 Federal Plaza, Room 2900 New York, NY 10278 Brooklyn Field Office 154 Pierrepont Street, 6th Floor Brooklyn, NY 11201 Harlem Field Office 2265 5th Avenue New York, NY 10037

Always call 1-800-772-1213 to confirm hours and COVID-19 protocols before visiting.

Free and Low-Cost Advocacy

NYC HRA Disability Advocacy Program Urban Justice Center – Safety Net Project

Medical Evidence Sources

Hospitals such as NYU Langone, Mount Sinai, and NewYork-Presbyterian maintain dedicated disability record departments. Written requests must comply with HIPAA and may involve modest copying fees.

Putting It All Together

An SSDI denial is not the end of the road. By understanding federal regulations, gathering persuasive medical documentation, and meeting every deadline, New York claimants can significantly raise their chance of a favorable outcome. Whether you tackle the process alone or retain counsel, insist on accurate, comprehensive evidence and protect your rights at each procedural step.

Legal Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult a licensed New York attorney regarding your specific situation.

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