You cannot work, someone has told you no, and you are not entirely sure which system your problem even belongs to.
That confusion is normal and it is the reason this page exists. “Disability” covers three separate benefit systems with three separate rulebooks, three separate deadlines, and three separate ways of losing. Marc Whitehead & Associates works in disability claims, and the first useful thing we can do is help you work out which one you are in.
Ask for a free review. We will tell you which system your claim falls under and what the deadline is.
Which Kind of Disability Claim Do You Have?
Look at who denied you. That single fact usually settles it.
| This is you if | You are in | Where to go next |
|---|---|---|
| The letter came from the Social Security Administration, and your benefit depends on work credits or on limited income | Social Security disability | Social Security disability lawyer |
| The letter came from an insurance company, and the coverage came through your employer or a policy you bought | Long-term disability insurance | long-term disability lawyer |
| The letter came from the Department of Veterans Affairs, and the claim relates to service-connected conditions | VA disability | VA disability claim denials |
The systems do not overlap in law, and the deadlines are nothing like each other. A Social Security appeal window is 60 days from receipt of the notice. An insurance appeal under federal benefits law is usually at least 180 days. VA claims run on their own schedule entirely.
People frequently hold claims in more than one at the same time. An approval in one is not a decision in another, and insurers and agencies will sometimes cite one against the other.
How do the three systems differ once you are in one?
In almost every respect that matters.
| Social Security | Long-term disability insurance | VA disability | |
|---|---|---|---|
| Who decides | A federal agency | An insurer or plan administrator | A federal agency |
| The test | Can you do any work that exists in significant numbers | Usually your own occupation first, then any occupation | Service connection and a rating percentage |
| Appeal window | 60 days from receipt of the notice | Commonly at least 180 days under 29 C.F.R. § 2560.503-1 for employer plans | Its own schedule and review options |
| Can you add evidence later | Yes at the earlier stages, tightening as you go | Often not, once the internal appeal closes | Depends on the review path chosen |
| What it pays | A monthly benefit set by formula | A percentage of prior earnings, subject to offsets | A monthly amount set by the rating |
Holding claims in two systems at once is common, and the interaction between them is not always friendly. Insurers frequently require you to apply for Social Security benefits and then reduce their own payment by whatever you are awarded.
For a free legal consultation with a Disability lawyer serving Nationwide, call (800) 562-9830
What Does a Disability Lawyer Do?
Builds the record that decides your claim, then argues it under whichever set of rules applies.
The work looks different in each system, but the shape is the same. Somebody has decided that the paperwork does not establish that you cannot work. The response is not indignation. It is finding what the file is missing, getting it, and making the argument in the form the decision-maker is required to consider.
What that means in practice:
Getting the actual file. Not the letter. The file the decision was made from, including the reviewer’s assessment and the records that were and were not obtained.
Finding the specific finding that sank it. Every denial rests on one. Different findings need different answers.
Developing evidence about function. Records describe treatment. Decisions turn on limitation. Closing that gap is most of the job.
Meeting the deadline. The one part that cannot be fixed afterward.
Nationwide Disability Lawyer Near Me (800) 562-9830
Social Security Disability
For people who cannot work and whose benefit comes from the federal government, either through work credits or through need.
Two programs sit inside it. Social Security Disability Insurance is earned through covered employment, and eligibility can expire if too much time passes after you stop working. Supplemental Security Income is needs-based, with income and resource limits, and no work history requirement. The medical standard is identical in both.
Claims are decided under a five-step test at 20 C.F.R. § 404.1520, and most denials happen at the last two steps, which are about work capacity rather than diagnosis.
Depth on all of it lives on our Social Security disability lawyer page, including the appeal ladder, the deadlines, and what each stage involves.
Long-Term Disability Insurance
For people whose income replacement comes from a policy rather than from the government.
If the coverage came through an employer, the claim is almost certainly governed by a federal statute called ERISA rather than by state insurance law. That changes nearly everything: the appeal comes before any lawsuit, the record generally closes at the end of that appeal, and the remedies available are narrower than in an ordinary insurance dispute.
If you bought the policy yourself, state law usually applies instead, and the case looks much more like a conventional contract claim.
Which one you are in is not a detail. It decides the deadline, the evidence a court can look at, and what you can recover. Our long-term disability lawyer page covers both.
VA Disability
For veterans whose service-connected claims have been denied or rated lower than the evidence supports.
This is a separate adjudication system with its own evidence rules, its own rating schedule, and its own review options. Nothing about a Social Security decision or an insurance decision carries over into it, in either direction.
If your denial came from the Department of Veterans Affairs, our page on VA disability claim denials sets out how that system is structured and what the review options are.
Not sure which system you are in? Send us the letterhead and the date on it.
Do You Need a Disability Lawyer Near You?
Less than you would think. Disability claims are largely paper claims, and most of the work happens nowhere near an office.
Social Security disability is federal. The same regulations apply in every state, hearings are frequently held by video or telephone, and claim files move electronically. Long-term disability appeals under federal benefits law are written proceedings, submitted by mail and email, with no in-person stage at all before litigation.
What that means practically is that where a firm sits matters far less than whether it works in this area of law and can meet your deadline.
Marc Whitehead & Associates is based in Houston and handles disability claims across the country. For claimants in Texas, we maintain pages with state and local detail:
- Texas Social Security disability claims
- Houston disability lawyers
- Texas long-term disability claims
If you are outside Texas, send the letter anyway. The analysis does not change with the postmark.
When Should You Talk to a Lawyer?
Before the deadline on your letter, and ideally as early as the day it arrives.
Three situations make it more pressing than usual.
The record closes at some point. In federal benefits appeals under ERISA, evidence added after the internal appeal is generally too late, and a court will not look at it. Getting the right material in before that door shuts is the whole game.
Deadlines are shorter than they look. A 60-day Social Security window includes the time it takes to get records from providers, which is rarely fast.
Early mistakes travel. An onset date, an unchallenged assessment, a gap in treatment, or a poorly worded form follows the claim through every later stage. Fixing it at stage one costs almost nothing. Fixing it at stage three is sometimes impossible.
What Does a Disability Lawyer Cost?
It depends on the system, and in none of them do you pay to find out where you stand.
Social Security disability representation is contingent. No retainer, no hourly bill, and any payment is taken from past-due benefits only after the Social Security Administration has approved the amount. That approval is what makes the arrangement non-negotiable between you and a representative, and the agency’s fee rules are public.
Long-term disability cases are also generally handled on a contingency basis, though the arrangement differs from the Social Security model because the claims and the recoveries work differently.
The consultation costs nothing in every case.
Free review, contingency fee, and no charge if we do not recover benefits.
Disability Claim Questions
I get Social Security disability and my employer’s insurance also pays me. Is that allowed?
Usually yes, and it is common. Most group long-term disability policies expect it, and many require you to apply for Social Security benefits. What typically happens is that the insurer reduces its payment by the amount of your Social Security benefit under an offset provision. That can create an overpayment the insurer then asks you to repay in a lump sum. The provision is worth reading before the award arrives rather than after.
My claim was denied by both an insurer and Social Security. Are those the same fight?
No. They are separate proceedings under separate law with separate deadlines, and the standards are genuinely different. An insurance policy usually asks whether you can do your own occupation, at least for an initial period. Social Security asks whether you can do any work that exists in significant numbers. It is entirely possible to lose one and win the other.
Do I need a lawyer for the initial application, or only after a denial?
You can file yourself, and many people do. Representation matters most where mistakes are hard to undo, which means claims involving conditions without clear objective testing, claims where insured status is close to expiring, and any situation where a deadline is near. If you have already been denied, the calculation changes, because from that point every stage is adversarial in substance if not in name.
How long do these claims take?
Long enough that it is worth planning around. Social Security claims are measured in months at each stage, and a case that goes to a hearing typically takes the longest. Insurance appeals under federal benefits rules run on defined timeframes that are shorter but far less forgiving, because the record closes at the end of them.
Does the firm handle claims outside Texas?
Yes. Social Security disability is federal and the rules do not vary by state. Long-term disability claims governed by federal benefits law are similarly national in character. The location of the claimant is rarely what determines how the work gets done.
What should I have ready before I call?
The letter, if you have one. That is genuinely the only essential item, because it tells us the system, the stage, the reason, and the deadline. A list of your treating providers and a rough work history for recent years help, but nothing should delay the call.
Three Systems, One Letter, One Date
Marc Whitehead, Disability Attorney
Whichever system your claim sits in, the same thing is true of it. There is a document that explains why you were told no, and there is a date after which that answer stops being reviewable.
Almost everything else is still open. The evidence can be developed, the assessment can be challenged, the argument can be made properly this time.
Read us the letterhead and the date. Ten minutes will tell you which rulebook you are under and how long you have.
Marc Whitehead & Associates. Free review of your denial, whichever system it came from.
Our Main Houston Office
403 Heights Blvd
Houston, TX 77007
(713) 929-2856
Call or text (800) 562-9830 or complete a Free Case Evaluation form
