How do I appeal a denied Social Security disability claim in New York?
1. Federal Program. SSDI (Title II) needs work credits; SSI (Title XVI) is needs-based. Both apply the 5-step sequential evaluation (20 C.F.R. § 404.1520; § 416.920).
2. Initial Determination. New York's Division of Disability Determinations, under OTDA, makes medical decisions. About 67% denied initially.
3. Level 1: Reconsideration. SSA-561 within 60 days; different examiner re-reviews.
4. Level 2: ALJ Hearing. HA-501 within 60 days. OHO offices serve New York from Brooklyn, Queens, Manhattan, Bronx, Jericho, White Plains, Albany, Buffalo, and Syracuse. Wait 12-16 months; video/telephonic standard.
5. Level 3: Appeals Council. HA-520 within 60 days; Falls Church, VA.
6. Level 4: Federal District Court. 42 U.S.C. § 405(g); file in the Southern, Eastern, Northern, or Western District of New York within 60 days.
7. New York Supplemental. NY Disability Benefits Law (DBL) under N.Y. Workers' Comp. Law § 200 et seq. provides up to 26 weeks of short-term wage replacement (max $170/wk), funded by employer/employee premiums — separate from SSDI.
8. Continuing Disability Reviews. Every 3-7 years; cessation appeals available.
9. Attorney Fees. Capped at 25% of past-due benefits or $9,200 (2024) (42 U.S.C. § 406(a)).
10. Concurrent State Aid. New York is a "1634 state" — SSI eligibility automatically confers Medicaid. New York also adds a State Supplement Program (SSP) cash benefit on top of SSI.
This is legal information, not legal advice.
- Reconsideration denied and you're preparing for an ALJ hearing
- You have complex medical-vocational profile or non-English testimony
- Your federal court appeal under § 405(g) needs filing
- 42 U.S.C. § 405(g)
- 20 C.F.R. § 404.1520
- 20 C.F.R. § 416.920
- N.Y. Workers' Comp. Law § 200
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.