How to Apply for Disability in Texas

Co-authored by Clinton M. Sandvick, JD, PhD

Last Updated: December 13, 2022 References

State and federal programs offer income-replacement benefits to people with short-term or permanent disabilities. The Social Security Administration (SSA) administers the federal government's disability insurance programs known as Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). While some states, like California, also administer state benefits, Texas only administers the federal programs.

Part 1

Part 1 of 3:

Understanding the Disability Eligibility Requirements

1
Learn who is eligible. To be eligible for federal disability benefits, you must have a qualifying disability. This means that you must be unable to engage in "substantial gainful activity" for at least 12 months.^{[1]
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42 U.S.C. 423 (d)(1)(A)} Furthermore, SSA considers an individual disabled if:
- They cannot do the work they did before.
- They cannot adjust to other work because of a medical condition.
- The disability has lasted or is expected to last for at least 1 year or result in death.^{[2]
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  US Social Security Administration
  Independent U.S. government agency that administers Social Security and related information
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2
Understand which agency administers benefits. While disability benefits are funded by the federal government (SSA), Texas's Division for Disability Determination Services (DDS) makes the eligibility determination. To do so, individuals apply for Social Security benefits at their local Social Security Office, and their applications are then forwarded to DDS for a disability determination.^{[3]
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Research source} The final decision to grant or deny benefits, however, lies with SSA.^{[4]
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3
Calculate your benefits. The amount of SSDI benefits that you can receive will depend on how much you paid into the Social Security system during your working years. By contrast, SSI is a need-based program; monthly payments are established by the federal government.^{[5]
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- The maximum amount of SSI an individual may receive each month is $733; a couple may receive $1,100.
- To view the SSI federal payment amounts for 2015, click here.

Part 2

Part 2 of 3:

Applying for Benefits

1
Gather information. You will need to provide information about the following to SSA:^{[6]
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US Social Security Administration
Independent U.S. government agency that administers Social Security and related information
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- Your date and place of birth, as well as your Social Security number
- Information about your current spouse, as well as any former spouses (name, date of birth and death, Social Security numbers, and the date and location of your marriages and divorces)
- Names and dates of birth of your minor children
- The name and contact information of someone who knows about your medical condition, such as a doctor
- The names, addresses, and phone numbers for all doctors, hospitals, and clinics where you were treated, as well as your patient ID numbers and dates of treatment
- The name and contact information of your employer for this year and the past year
- The amount of money you earned this year and last year
- A list of the jobs (up to 5) that you worked in the past 15 years before you became unable to work, and the dates you worked those jobs
- the beginning and ending dates of any military service you had before 1968
- Your bank’s Routing Transit Number and the account number (if you want benefits electronically deposited)
2
Locate necessary documents. To apply for benefits, you will need various documents that establish your legal status as well as your financial and medical history. Gather these documents before applying:
- Birth certificate
- Proof of U.S. citizenship or lawful alien status if you were not born in the United States
- A copy of your Social Security statement^{[7]
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  Trustworthy Source
  US Social Security Administration
  Independent U.S. government agency that administers Social Security and related information
  Go to source}
- W-2 forms and/or self-employment tax returns for last year
- Award letters, pay stubs, settlement agreements or other proof of any temporary or permanent workers' compensation-type benefits
- Information about any workers' compensation benefits that you applied for or intend to apply for^{[8]
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  Trustworthy Source
  US Social Security Administration
  Independent U.S. government agency that administers Social Security and related information
  Go to source}
- Medical evidence, including medical records, doctor's reports, names of medicines taken, and recent test results
- U.S. military discharge papers if you had military service before 1968
3
Complete an application. You can apply for benefits in-person or online. To find your closest SSA office, you can use the SSA's office locator system and enter your ZIP code. Alternately, you can call SSA's toll-free number at 1-800-772-1213.
- To fill out an online application, visit SSA's website.
4
Undergo a medical examination (if requested). After applying for the benefits, your application will be sent to a Disability Specialist. If the Disability Specialist needs more information about your disability, then you may be asked to undergo a medical exam.
- Exams are often scheduled where little evidence supports the claim of injury or where sufficient time has elapsed since you have seen a doctor.^{[9]
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- The exam will be brief—maybe only 10 minutes.^{[10]
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- You should attend the exam. A Disability Specialist can close a file for “failure to cooperate” and declining a medical exam would justify denying your claim.^{[11]
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5
Await benefit determination. Disability claims are decided within 90-120 days.^{[12]
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- If you are determined to be disabled, then you will begin receiving retroactive disability benefits. Alternately, if your claim is denied, then you may appeal.
- If you are denied, you will be sent a denial letter. Save this. It will contain important contact information as well as information about appeals.

Part 3

Part 3 of 3:

Appealing the Denial of Disability Benefits

1
Request reconsideration. If your claim is denied, you should request reconsideration.^{[13]
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Research source} Another DDS representative will review your claim and possibly request additional information. Contact the Social Security Office that denied your claim to request reconsideration.^{[14]
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- You have only 60 days to request reconsideration, so it is best not to wait. Once you receive your denial letter, call and request the reconsideration paperwork.
- You might want to provide updated medical records, statements from treating physicians about your medical condition, or a reason why you think your claim should be approved.
- The success rate for reconsideration is very low (around 13%).^{[15]
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  Research source} Nevertheless, requesting reconsideration is a necessary first step that allows you to subsequently appeal to an administrative law judge, where your chances (should you have legal representation) are higher.
- If the second DDS representative denies your claim, then you may appeal.
2
Request an appeal hearing. To appeal a denial, you must request a hearing with an administrative law judge. In Texas, you must request an appeal within 60 days of the date of the prior denial.
- You should seek out an attorney at this point. The attorney will request the appeal paperwork and file it.
- The average wait time for a hearing in Texas is 8 months.^{[16]
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3
Hire an attorney or SSA advocate. Based on the nature and complexity of your case, it may be beneficial to consult with an attorney or advocate. Advocates may be lawyers or non-lawyers.^{[17]
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Research source} Securing legal representation may significantly improve your chances of getting your disability claim approved.^{[18]
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- More than 60% of cases are won at this level when the claimant is represented by an attorney or advocate.^{[19]
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- Disability attorneys and advocates work on contingency. Under this arrangement, you will not pay any fees unless you win the appeal.
- You will still have to cover costs, such as the cost of mailing, photocopying, or requesting medical records. You should anticipate costs of around $200.^{[20]
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  Research source} Typically, an attorney will front these costs; if you win, then the amount will be deducted from your back-award benefits. If you lose, you will then be billed.
- By law, attorneys and advocates can collect only 25% of the award of the past-due benefits awarded, up to $6,000.^{[21]
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- To find an experienced attorney, you can search the Texas Bar Association’s Referral Service. Or you can search “disability lawyer” and your city or county into a web browser. Because attorneys in this field work on contingency, your consultation should be free.
4
Prepare for your appeal hearing. Disability hearings are conducted before an administrative law judge who will evaluate the information you provided. To win, the administrative law judge must determine that you have a disability based on SSA laws.
- Your attorney will need to gather documents to use as exhibits, such as medical records, and prepare to share them with the court.^{[22]
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- You may also need to undergo another medical exam. A claim cannot be made unless you present recent medical records (i.e., those within the past 90 days).^{[23]
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5
Attend the hearing. The judge will review your medical records and see if you have a severe medical impairment. Also, the impairment must qualify as a disability for a year or more.^{[24]
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- An impairment qualifies as a “disability” if it meets SSA's list of impairments or prevents you from engaging in work that will produce substantial, gainful income.^{[25]
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