Complete SSDI Denial & Appeal Guide – Nevada, NV

Introduction: Why This Guide Matters to Nevada Claimants

Every year, hundreds of Nevadans—from Las Vegas and Henderson to Elko’s mining communities—apply for Social Security Disability Insurance (SSDI). Yet according to Social Security Administration (SSA) data, fewer than one-third of first-time SSDI applications from Nevada are approved at the initial level. If you recently received a denial letter, you are not alone—and you are not without options. This comprehensive guide, grounded in federal regulations and Nevada-specific resources, is designed to help you understand your rights, meet critical deadlines, and strengthen your SSDI denial appeal. It slightly favors the claimant, because the SSA already commands vast resources; this guide aims to level the playing field while staying strictly factual.

You will learn:

• Key claimant protections under 20 C.F.R. §§404.900–404.979 and Social Security Act §205(b)

• Common denial reasons and how to counter them with solid evidence

• Exact appeal deadlines (60 days plus five for mailing) and how to file in Nevada

• When to retain a Nevada-licensed disability attorney

• Local SSA contacts, hearing offices, and medical providers that routinely submit evidence

Understanding Your SSDI Rights

1. What SSDI Provides

SSDI pays monthly cash benefits to workers who have accumulated sufficient “quarters of coverage” and who can no longer engage in substantial gainful activity (SGA) due to a medically determinable impairment expected to last at least 12 months or result in death (20 C.F.R. §404.1505).

2. Core Rights After a Denial

Under Social Security Act §205(b) and 20 C.F.R. §404.907, every claimant has the right to:

• Written notice of denial with a statement of reasons

• Copy of the evidence file (electronic or paper)

• Representation by an attorney or qualified non-attorney

• Multi-level administrative review—Reconsideration, ALJ hearing, Appeals Council, and federal court

• Due process hearing before an impartial Administrative Law Judge (ALJ)

3. Nevada-Specific Context

Nevada is served by the San Francisco Region of SSA’s Office of Hearings Operations (OHO). The Las Vegas Hearing Office historically records an average ALJ approval rate close to—but slightly lower than—the national average. Reno’s Hearing Office often posts shorter wait times (approximately 8–10 months) but a lower approval rate. Understanding these regional trends can help you manage expectations and craft a stronger case.

Common Reasons SSA Denies SSDI Claims

Insufficient Medical Evidence The SSA may decide your records do not prove an impairment lasting 12 months or more. Nevada claimants sometimes submit incomplete files from fast-moving emergency room visits on the I-15 corridor or gaps in treatment caused by rural provider shortages.

Lack of Objective Tests SSA regulations require signs, laboratory findings, or both (20 C.F.R. §404.1521). For example, migraines documented only by subjective pain logs often fail without MRI or neurological exams.

Earnings Above SGA In 2024, SGA equals $1,550/month for non-blind claimants. Uber drivers in Las Vegas or Reno frequently cross that threshold unintentionally, triggering denials.

Non-Compliance With Treatment Failure to follow prescribed therapy, absent a good cause cited in 20 C.F.R. §404.1530(c), can sink a claim. Nevada’s limited public transportation may justify missed appointments, but you must document obstacles.

Insufficient Work Credits You typically need 20 credits earned in the last 10 years. Casino workers paid in cash tips that were not reported to IRS often face this problem.

Federal Legal Protections & Regulations

1. Key Regulations

• 20 C.F.R. §404.900 – Establishes the four-step administrative review process.

• 20 C.F.R. §404.1512 – Defines claimant’s burden to submit “all evidence… that relates to” disability.

• Social Security Act §205(g) – Grants claimants the right to judicial review in U.S. District Court (for Nevada, the District of Nevada in Las Vegas or Reno).

2. Time Limits Are Strict

You have 60 days from the date you receive a denial letter (SSA presumes five days for mailing) to request the next appeal level. Missing a deadline usually requires you to start over, unless you prove good cause per 20 C.F.R. §404.911.

3. Evidence Rules

All evidence must be submitted at least five business days before the ALJ hearing ("five-day rule") under 20 C.F.R. §405.331, unless you prove extraordinary circumstances. Nevada ALJs strictly enforce this rule.

Steps to Take After an SSDI Denial

Step 1 – File a Timely Reconsideration (if initial denial)

Use Form SSA-561 and submit it:

• Online via the SSA secure portal

• By mail to your local field office (e.g., Las Vegas FO, 1250 S. Buffalo Dr., Suite 150, Las Vegas, NV 89117)

• In person by scheduling an appointment at 1-800-772-1213

Tip: While Nevada field offices accept walk-ins, scheduling reduces wait time.

Step 2 – Strengthen Medical Evidence

• Request complete treatment records (in Nevada, providers may charge reasonable copying fees capped by NRS 629.061).

• Obtain Medical Source Statements using SSA-4734 (Physical RFC) or SSA-4734-SUP (Mental RFC).

• If lacking objective tests, ask your physician for updated imaging via Renown Regional Medical Center (Reno) or University Medical Center (Las Vegas).

Step 3 – Understand Your DDS Examiner

During Reconsideration, Nevada Disability Determination Services (DDS) in Carson City re-evaluates your file. Examiners follow Program Operations Manual System (POMS), not personal opinions. Provide targeted evidence matching Listing of Impairments criteria.

Step 4 – Request an ALJ Hearing if Reconsideration Fails

Submit Form HA-501. Nevada hearings are typically held:

• By video at the Las Vegas SSA Hearing Office (3360 W. Sahara Ave., Suite 180)

• In person at the Reno Hearing Office (300 Booth St., Suite 210)

Prepare: Vocational expert testimony is routine. Bring a written brief citing 20 C.F.R. Medical-Vocational Guidelines („the Grids”) relevant to Nevada’s labor market.

Step 5 – Appeals Council & Federal Court

If the ALJ denies benefits, file a written request with the Appeals Council in Falls Church, VA, within 60 days. Should that fail, file a civil action in the U.S. District Court, District of Nevada, paying the filing fee ($402 as of 2024) or applying to proceed in forma pauperis.

When to Seek Legal Help for SSDI Appeals

1. Complexity of Medical Evidence

Claimants with multiple conditions (e.g., PTSD plus orthopedic injuries common among Nellis AFB veterans) benefit from counsel experienced in correlating impairments.

2. Adverse Vocational Findings

If the DDS or ALJ relies on transferable skills or sedentary work assumptions drawn from Nevada’s casino industry, an attorney can cross-examine the vocational expert under SSR 96-9p.

3. Contingency Fee Protection

Federal law caps fees at the lesser of 25% of past-due benefits or $7,200, subject to SSA approval (42 U.S.C. §406). You pay nothing up front.

Attorney Licensing in Nevada

Only lawyers admitted by the State Bar of Nevada may give legal advice regarding Nevada law. Verify bar status at State Bar of Nevada.

Local Resources & Next Steps

Key SSA Offices in Nevada

• Las Vegas Field Office – 1250 S. Buffalo Dr., Las Vegas, NV 89117, phone 1-888-397-1517

• Reno Field Office – 1170 Harvard Way, Reno, NV 89502, phone 1-866-931-8549

• Carson City DDS – 6930 Sierra Center Parkway, Suite 100, Reno, NV 89511 (handles disability determinations statewide)

Free or Low-Cost Medical Clinics

• Volunteers in Medicine of Southern Nevada (VMSN) – provides records at no cost to uninsured claimants

• Northern Nevada HOPES (Reno) – integrated behavioral health records crucial for mental health claims

Vocational Rehabilitation

The Nevada Department of Employment, Training & Rehabilitation (DETR) offers vocational evaluations that can support an unsuccessful work attempt argument under 20 C.F.R. §404.1574(c).

Authoritative References

SSA Official Appeals Process 20 C.F.R. §404.900 – Administrative Review Process 42 U.S.C. §405 – Social Security Act §205 SSR 96-9p – Medical-Vocational Guidelines

Final Checklist

• Mark your 60-day deadline.

• Request and review your electronic claims file (E-FOLDER).

• Update medical records and RFC opinions.

• Write a concise request for review citing specific errors.

• Consult a Nevada disability attorney if unsure.

Disclaimer: This guide is for informational purposes only and does not constitute legal advice. Consult a licensed Nevada attorney for guidance on 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.