Burbank, Texas SSDI Denial Appeal Guide

Introduction: Why a Burbank-Specific SSDI Guide Matters

Burbank, Texas may be a small community, but residents here face the same complex Social Security Disability Insurance (SSDI) system as claimants in Houston, Dallas, or any other large Texas city. According to the Social Security Administration (SSA), roughly two-thirds of initial SSDI applications nationwide are denied.* A denial letter can feel overwhelming, especially when medical bills and household expenses keep piling up. This comprehensive guide explains exactly what Burbank claimants need to know—from federal appeal deadlines to the address of the nearest Social Security field office in San Antonio. While the information slightly favors protecting claimants, every statement is grounded in authoritative sources such as the Social Security Act, the Code of Federal Regulations (CFR), and published SSA materials. Primary SEO phrase used: "SSDI denial appeal burbank texas"

Understanding Your SSDI Rights

1. What SSDI Provides

SSDI is a federal insurance program funded through your payroll (FICA) taxes. If you have earned enough quarters of coverage and a medically determinable impairment prevents substantial gainful activity for at least 12 months, you may qualify for monthly cash benefits and eventual Medicare eligibility.

2. The Sequential Evaluation Process

Under 20 C.F.R. § 404.1520, SSA uses a five-step analysis to determine disability:

• Substantial Gainful Activity (SGA): Are you working and earning above the SGA threshold?

• Severity: Does your impairment significantly limit basic work activities?

• Listings: Does your impairment meet or equal an SSA Listing of Impairments?

• Past Relevant Work: Can you perform work you did in the past 15 years?

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

Understanding these steps helps pinpoint why an application was denied and what evidence you need to add for an appeal.

3. Non-Medical Eligibility Requirements

• Work Credits: Most adults need 20 quarters of coverage earned in the 10 years before disability onset. Younger workers need fewer credits.

• Insured Status: You must remain “insured” through the date SSA finds you disabled.

• Residency: U.S. citizenship or qualified alien status is required.

Common Reasons SSA Denies SSDI Claims

SSA’s own statistics cite these top reasons for denial:

• Insufficient Medical Evidence. Records do not show functional limitations severe enough to meet SSA criteria.

• Residual Functional Capacity (RFC) Too High. SSA concluded you can still perform past or other work.

Failure to Follow Prescribed Treatment. Under 20 C.F.R. § 404.1530, benefits can be denied if you refuse medically necessary treatment without good reason.

• Drug or Alcohol Involvement. If substance use is a material contributing factor, SSA must deny benefits.

• Technical Denials. Not enough work credits or missed deadlines (discussed next).

Federal Legal Protections & Key Regulations

1. Your Right to Administrative Review

Under Section 205(b) of the Social Security Act and 20 C.F.R. § 404.900, you are entitled to:

• Reconsideration by a different SSA examiner.

• Administrative Law Judge (ALJ) Hearing—a de-novo review with sworn testimony.

• Appeals Council review.

• Federal District Court review in the Western District of Texas if SSA still denies.

2. Strict Deadlines

60-Day Rule: You must file each appeal stage within 60 days of receiving the denial notice. SSA presumes you receive the letter five days after the mailing date (20 C.F.R. § 404.909(a)(1)). Missing this deadline generally forfeits your right to further review unless you show “good cause.”

3. Attorney Fees Are Capped

Under 20 C.F.R. § 404.1720, attorney fees in most SSDI cases cannot exceed 25% of your past-due benefits or $7,200, whichever is less, and must be approved by SSA. Texas disability lawyers must also be in good standing with the State Bar of Texas.

Steps to Take After an SSDI Denial

Step 1: Read the Denial Letter Carefully

The SSA denial letter specifies the medical and technical reasons for denial. Note the “Date on the Notice” and start counting the 60-day clock.

Step 2: File a Request for Reconsideration (Level 1)

Use SSA Form 561 or file online through your mySocialSecurity account. Add missing medical records—hospitalizations, specialist reports, imaging results—and ask treating doctors for Medical Source Statements addressing functional limitations.

Step 3: Build the Medical Record

• Get objective tests: MRIs, CT scans, pulmonary function tests.

• Request functional capacity evaluations (FCE).

• Document side effects of medications.

Step 4: Prepare for the ALJ Hearing (Level 2)

If reconsideration is denied, request an ALJ hearing via SSA Form 501. Average wait times in Texas vary but often exceed nine months. While waiting:

• Continue medical treatment and keep receipts.

• Maintain a symptom diary.

• Line up witnesses—family, coworkers—to testify about daily limitations.

Step 5: Appeals Council & Federal Court (Levels 3 & 4)

The Appeals Council in Falls Church, Virginia reviews alleged errors of law or procedure. If it declines review or issues an unfavorable decision, you may file suit in the U.S. District Court for the Western District of Texas, San Antonio Division, within 60 days.

When to Seek Legal Help for SSDI Appeals

Although you may represent yourself, data from the SSA Office of the Inspector General shows claimants with representation are more likely to succeed—especially at the ALJ level. A burbank disability attorney can:

• Obtain and organize medical records to satisfy 20 C.F.R. evidence rules.

• Draft an on-the-record (OTR) request that could win benefits without a hearing.

• Cross-examine vocational experts and argue Medical-Vocational Grid Rules for claimants aged 50+.

• Handle post-hearing briefs and federal court complaints if necessary.

Because attorney fees are contingent and capped, hiring counsel poses little financial risk.

Local Resources & Next Steps for Burbank Claimants

1. Nearest SSA Field Office

Burbank falls under the San Antonio SSA service area. As of this writing, the closest field office is:

Social Security Administration – San Antonio (Loop 410)

727 NW Loop 410, Suite 100

San Antonio, TX 78216

Phone: 1-800-772-1213 (TTY 1-800-325-0778) Verify current hours and any COVID-related changes with SSA’s Field Office Locator: SSA Office Locator.

2. Office of Hearings Operations (OHO)

ALJ hearings for Burbank residents are generally held at the San Antonio OHO:

Office of Hearings Operations – San Antonio

10127 Moreno Padilla, Suite 500

San Antonio, TX 78224 (Check SSA’s OHO locator for updates.)

3. Medical Providers Familiar with SSA Forms

• University Health System – Robert B. Green Campus (downtown San Antonio).

• Christus Santa Rosa Hospital South.

• UT Health San Antonio specialty clinics.

These facilities frequently handle SSA disability paperwork and can supply narrative statements or RFC forms.

4. Community Resources

• Bexar County Veterans Service Office – Assists veterans with both VA and SSA disability claims.

• Texas RioGrande Legal Aid – May offer free representation for very low-income claimants.

• Texas Workforce Commission – Vocational Rehabilitation Services – Can provide SSA-friendly work limitation assessments.

Conclusion

An SSDI denial is not the end—just the beginning of a defined appeals path laid out by federal law. Understanding strict deadlines, gathering compelling medical evidence, and taking advantage of local resources dramatically improve your odds. For most Burbank residents, partnering with an experienced SSDI appeals lawyer provides the strategic edge needed to secure benefits.

Legal Disclaimer: This guide is for informational purposes only and does not constitute legal advice. Laws and SSA policies change frequently. Consult a licensed Texas 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.