SSDI Attorney Guide: Missouri, Missouri

SSDI Attorney Guide for Missouri, Missouri: What to Do After a Denial

Receiving a Social Security Disability Insurance (SSDI) denial can be discouraging, especially when your health and income are on the line. If you live in Missouri, Missouri, understanding your rights under federal law and how to navigate the appeals process can make a meaningful difference. This comprehensive guide explains the SSDI appeals stages, strict filing deadlines, and practical steps to strengthen your case. It also provides Missouri-focused context so you can take action with confidence.

SSDI is a federal program administered by the Social Security Administration (SSA). While SSA rules are national, your experience as a claimant in Missouri is shaped by local medical providers, field offices, and where you will likely attend a hearing if you request one. Missouri claimants commonly interact with SSA field offices located across the state (including larger metro areas such as Kansas City and St. Louis). You can find your exact office and hours using SSA’s official office locator, and you may submit appeals online, by mail, or in person. This guide cites controlling federal law and SSA regulations so you can verify each step and avoid common pitfalls.

We present the process with a slight bias toward protecting claimants’ rights, while staying strictly factual and grounded in the Social Security Act and the Code of Federal Regulations (CFR). Whether you are preparing a reconsideration, requesting a hearing before an Administrative Law Judge (ALJ), or considering further review, the information below is designed to help you make informed, timely decisions.

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Understanding Your SSDI Rights

Eligibility basics

To qualify for SSDI, you must meet insured status requirements (sufficient work credits) and be unable to engage in substantial gainful activity (SGA) due to a medically determinable impairment that has lasted or is expected to last at least 12 months or result in death. The insured status framework is set out at 20 CFR 404.130, and the definition of disability is governed by the Social Security Act, 42 U.S.C. § 423(d). SSA evaluates disability using a five-step sequential evaluation process found at 20 CFR 404.1520.

Your core rights during the process

• Right to representation: You may appoint a qualified representative (attorney or eligible non-attorney) at any stage. See 20 CFR 404.1705 (who may serve as a representative) and 20 CFR 404.1706 (your representative’s qualifications and duties). SSA must approve representative fees under 42 U.S.C. § 406(a) and 20 CFR 404.1720–404.1730.
• Right to review your file and submit evidence: You can review your case file and submit new evidence. Evidence rules are detailed in 20 CFR 404.1512 (responsibility for evidence), 20 CFR 404.1513 (acceptable medical and nonmedical sources), and prehearing evidence deadlines in 20 CFR 404.935.
• Right to a fair hearing: If you request a hearing, you have rights under 20 CFR 404.929 (right to hearing) and 20 CFR 404.950 (presenting evidence and questioning witnesses). Hearings are generally de novo, meaning the ALJ reviews your case anew.
• Right to timely appeal: Deadlines are strict. Generally, you have 60 days from receipt of any denial notice to appeal to the next step, and SSA presumes you receive the notice 5 days after the date on it, unless you show otherwise. See 20 CFR 404.909 (reconsideration timing), 20 CFR 404.933 (requesting an ALJ hearing), 20 CFR 404.968 (Appeals Council review), and 20 CFR 422.210 (filing in federal court).

Missouri-specific context for claimants

As a Missouri, Missouri claimant, your initial and reconsideration decisions are processed by your state’s disability determination services (DDS) in coordination with SSA. Hearings are typically scheduled at an SSA Office of Hearings Operations (OHO) that serves your area, which for many Missouri residents will be in or near larger metro areas. You can request a video hearing or, in some circumstances, a telephone hearing if travel presents a hardship; see 20 CFR 404.936 for hearing scheduling and appearance rules.

Common Reasons SSA Denies SSDI Claims

Understanding why claims are denied helps you fix issues early and build a stronger appeal. While every case is unique, denials often involve one or more of the following:

• Insufficient work credits or date last insured (DLI) expired: If you do not have enough recent work credits under 20 CFR 404.130, or your DLI passed before you became disabled, SSA will deny SSDI. In an appeal, clarify your earnings record and argue for an earlier onset date if supported by medical evidence.
• Earnings above substantial gainful activity (SGA): If your average monthly earnings exceed SGA, SSA typically finds you are not disabled, per 20 CFR 404.1571–404.1574. Consider whether income was subsidized, unsuccessful work attempts, or special conditions applied—these issues can affect SGA analysis under the regulations.
• Insufficient medical evidence or no objective findings: SSA requires evidence from acceptable medical sources (20 CFR 404.1513). A denial may state there is not enough objective evidence to support functional limitations. On appeal, submit longitudinal treatment records, imaging, labs, and detailed provider opinions consistent with 20 CFR 404.1512.
• Impairment not “severe” or does not meet/ equal a listing: At step two, SSA may find your limitations non-severe (20 CFR 404.1520(c)). At step three, SSA finds whether you meet or equal a Listing in the Listing of Impairments. If not, the claim proceeds to residual functional capacity (RFC) and vocational steps.
• Failure to follow prescribed treatment without good reason: Under 20 CFR 404.1530, if you fail to follow treatment expected to restore your ability to work and you lack good cause, SSA can deny benefits. Document side effects, access issues, or medical advice that explains why you could not adhere.
• Noncooperation or missed consultative examination (CE): If you miss a scheduled CE or do not provide requested information, SSA can deny for insufficient evidence. See 20 CFR 404.1518 (failure to cooperate) and 20 CFR 404.1519a (consultative exams).
• Adverse credibility or symptom evaluation: While SSA does not assess “credibility” in the old sense, it evaluates the consistency of your statements with the evidence (see SSA policy guidance such as SSR 16-3p). Supporting statements from treating sources and third parties can be valuable.

These reasons are not exhaustive, but they cover many of the most common denial rationales. Your appeal should directly engage with the specific findings in your denial notice.

Federal Legal Protections & Regulations That Govern SSDI Appeals

SSDI claims and appeals are governed by the Social Security Act and SSA regulations. Key authorities include:

• Definition of disability: 42 U.S.C. § 423(d) defines disability for SSDI purposes.
• Procedural due process (hearings and decisions): 42 U.S.C. § 405(b) requires SSA to provide a hearing and a decision based on evidence.
• Judicial review: 42 U.S.C. § 405(g) authorizes civil actions in U.S. District Court after administrative remedies are exhausted.
• Appeal deadlines and procedures: 20 CFR 404.909 (reconsideration); 20 CFR 404.933 (requesting an ALJ hearing); 20 CFR 404.967–404.981 (Appeals Council review); and 20 CFR 422.210 (time to file in federal court).
• Five-step evaluation: 20 CFR 404.1520 explains the sequential evaluation process.
• Evidence and medical source rules: 20 CFR 404.1512 (evidence), 404.1513 (sources), and 404.1520c (persuasiveness of medical opinions for claims filed on or after March 27, 2017).
• SGA and work activity: 20 CFR 404.1571–404.1574 governs SGA.
• Failure to follow treatment: 20 CFR 404.1530.
• Hearing process and rights: 20 CFR 404.929–404.950.
• Good cause for late filing: 20 CFR 404.911.

Statutes of limitations for appeals are strict and generally as follows (always check your notice):

• Reconsideration: File within 60 days of receiving the initial denial (20 CFR 404.909). SSA presumes you receive the notice 5 days after the date on it, unless you can show otherwise (20 CFR 404.901 defines “date you receive notice”).
• ALJ Hearing: Request within 60 days after you receive the reconsideration denial (20 CFR 404.933).
• Appeals Council Review: Request within 60 days after you receive the ALJ decision (20 CFR 404.968).
• Federal Court: File a civil action within 60 days after receiving the Appeals Council’s decision or denial of review (42 U.S.C. § 405(g); 20 CFR 422.210(c)).

If you miss a deadline, you may still proceed if SSA finds “good cause” for late filing under 20 CFR 404.911. Provide documentation that explains the delay (for example, hospitalization, serious illness, or unavoidable mail issues).

Steps to Take After an SSDI Denial

1) Read your denial notice carefully

Your denial letter explains the reasons for denial and the deadline for appealing. Identify whether SSA denied for medical reasons (not severe enough, not meeting/ equal a listing, or RFC allows work) or non-medical reasons (insufficient work credits, SGA). Note any specific evidence SSA says is missing.

2) Calendar your deadline immediately

Appeal within 60 days of when you receive the notice, with a presumed 5-day mailing period. Missing this date can end your claim unless SSA grants good cause (20 CFR 404.911). Mark the deadline and plan to submit at least a protective appeal request well before the cutoff.

3) Choose your appeal level and file the correct form

• Reconsideration (first appeal after the initial denial): Request reconsideration using SSA’s online system or by filing the appropriate forms described on SSA’s appeals page (20 CFR 404.909).
• Hearing before an ALJ (after reconsideration denial): Request a hearing within 60 days (20 CFR 404.933).
• Appeals Council Review (after an ALJ decision): Request review within 60 days (20 CFR 404.968).
• Federal Court (after Appeals Council action): File a civil action in the U.S. District Court where you live within 60 days (42 U.S.C. § 405(g); 20 CFR 422.210).

4) Strengthen the medical record

SSA bases decisions on medical and vocational evidence. Work proactively with your Missouri healthcare providers to obtain:

• Complete treatment notes from relevant specialists and primary care over a longitudinal period.
• Objective testing (imaging, lab results, pulmonary function tests, ejection fraction, neuropsychological testing) where applicable.
• Detailed functional assessments describing specific work-related limitations (sitting, standing, lifting, reaching, concentration, attendance, and pace), consistent with 20 CFR 404.1512 and persuasiveness factors in 20 CFR 404.1520c.

If SSA schedules a consultative examination (CE), attend it unless you have a compelling reason not to (and promptly reschedule). Missing a CE can lead to a denial for insufficient evidence under 20 CFR 404.1518.

5) Address SGA, work history, and transferable skills

At steps four and five of the process (20 CFR 404.1520), SSA considers whether you can return to past relevant work or adjust to other work. Provide accurate work history, including job titles, duties, skill levels, exertional levels, and dates. If your earnings exceeded SGA, consider whether any income was subsidized or whether attempts to work were unsuccessful under 20 CFR 404.1574.

6) Prepare for the hearing

At the hearing stage, you can testify, submit evidence, and question vocational or medical experts under 20 CFR 404.950. To prepare:

• Submit all evidence at least five business days before the hearing, unless an exception applies, in accordance with 20 CFR 404.935.
• Organize a concise theory of disability that matches the five-step framework, highlighting how your impairments and functional limits preclude sustained competitive employment.
• Consider requesting a video or telephone hearing if travel is difficult (20 CFR 404.936).
• Be ready to explain gaps in treatment, activities of daily living, and variability of symptoms. Consistency across medical records, forms, and testimony strengthens credibility under SSA policy.

7) Appeals Council and beyond

If you disagree with the ALJ decision, seek Appeals Council review within 60 days (20 CFR 404.968). The Appeals Council may deny review, remand, or issue a decision. If the Appeals Council denies review or issues an unfavorable decision, you can file a federal court action within 60 days (42 U.S.C. § 405(g); 20 CFR 422.210). In Missouri, you would file in the U.S. District Court for the district where you reside (Eastern or Western District of Missouri, depending on your county).

When to Seek Legal Help for SSDI Appeals

While you may represent yourself, many Missouri claimants choose to work with an attorney experienced in SSDI appeals, particularly at the hearing level where the record must be fully developed and expert testimony interpreted. A knowledgeable representative can:

• Identify missing evidence and obtain tailored medical source statements that address SSA’s RFC criteria.
• Develop a hearing strategy, prepare you for testimony, and cross-examine vocational or medical experts.
• Navigate complex procedural issues (e.g., reopening prior applications, amending onset dates, and good-cause arguments for late evidence under 20 CFR 404.935 and late filings under 20 CFR 404.911).
• Advise on post-hearing briefs and potential Appeals Council arguments (e.g., challenges based on legal error or lack of substantial evidence).

Under federal law, SSA regulates representative fees. Typically, a fee agreement is limited to a percentage of past-due benefits up to an SSA-approved cap, and all fees must be approved by SSA. See 42 U.S.C. § 406(a) and 20 CFR 404.1720–404.1730. You should not be charged a fee on future monthly benefits, and costs (e.g., medical records fees) are separate from representative fees.

Attorney licensing in Missouri

If you want legal advice specific to Missouri law or to file suit in a Missouri court, work with a lawyer licensed by the Supreme Court of Missouri. For SSDI administrative proceedings, a representative need not be Missouri-licensed to appear before SSA, but for courtroom litigation and Missouri-law issues, a Missouri-licensed attorney is recommended.

Local Resources & Next Steps for Missouri, Missouri Claimants

Finding your local SSA office

Missouri residents can locate their nearest SSA field office, including address, hours, and services, using SSA’s official Office Locator. This is the most reliable way to confirm up-to-date contact information and service options (in-person, phone, appointments, and online services).

• Use the SSA Office Locator to find your local Missouri office and confirm hours.
• Appeals can often be filed online, which helps you meet deadlines.
• If you need help with accessibility or an interpreter, contact your office in advance; SSA provides language and disability-related accommodations.

Medical evidence from Missouri providers

To strengthen your appeal, coordinate with your Missouri clinicians for comprehensive records and functional assessments. Encourage detailed documentation of symptoms, objective findings, medication side effects, and work-related limitations. For mental health claims, longitudinal therapy notes and standardized testing (when applicable) are often critical.

Transportation, video hearings, and accommodations

If travel is difficult due to health or distance, you may request to appear by online video or telephone in accordance with 20 CFR 404.936. If you require specific accommodations (mobility, vision, hearing, or language), notify SSA as early as possible. SSA considers reasonable accommodations to ensure you can fully participate in your hearing.

Coordinating benefits and avoiding pitfalls

• Workers’ compensation and other benefits: Report any workers’ compensation or public disability benefits; offsets may apply.
• Continuing to work: If you work while appealing, keep detailed records. Earnings above SGA can affect eligibility per 20 CFR 404.1571–404.1574.
• Continuing disability reviews (CDRs): If you are later approved, SSA may conduct CDRs to confirm ongoing disability.

Frequently Asked Questions (Missouri, Missouri)

How long do I have to appeal my SSDI denial?

Generally, 60 days from the date you receive the notice, with a presumed 5-day mailing period. See 20 CFR 404.909, 20 CFR 404.933, 20 CFR 404.968, and 20 CFR 422.210.

Do I need a Missouri-based attorney?

For SSA administrative proceedings, a representative may be licensed in any U.S. jurisdiction if they meet SSA’s representative rules (20 CFR 404.1705). For Missouri-specific legal advice or court actions within Missouri, choose an attorney licensed by the Supreme Court of Missouri.

What if I missed my deadline?

You can ask SSA to extend time based on “good cause” under 20 CFR 404.911. Provide detailed documentation of the reason (e.g., hospitalization, serious illness).

Will I need to attend an in-person hearing in Missouri?

Hearings are typically scheduled at an OHO serving your area. You may request a video or telephone appearance per 20 CFR 404.936.

What evidence carries the most weight?

SSA evaluates the persuasiveness of medical opinions and prior administrative medical findings under 20 CFR 404.1520c. Consistent, longitudinal records from acceptable medical sources (20 CFR 404.1513) that document specific functional limitations are often pivotal.

Checklist: Building a Stronger SSDI Appeal in Missouri

• Mark your 60-day appeal deadline immediately.
• Request reconsideration or hearing online or through your local SSA office.
• Obtain complete medical records from Missouri providers and ensure they cover the full period at issue.
• Secure detailed functional statements from treating sources addressing work-related limitations.
• Prepare testimony aligned with the five-step sequential evaluation (20 CFR 404.1520).
• Address SGA and unsuccessful work attempts (20 CFR 404.1574).
• Submit evidence at least 5 business days before the hearing (20 CFR 404.935).
• Consider representation to manage evidence, experts, and legal arguments.

How to Start Your Appeal Today

You can appeal quickly and securely online. The SSA’s portal supports reconsideration and hearing requests, lets you upload evidence, and confirms submissions with timestamps—helpful for meeting your deadline. If you prefer in-person help, use the Office Locator to find your nearest Missouri field office and ask about appointment availability and accommodations.

Helpful authoritative links

SSA: How to Appeal a DecisionSSA Office Locator (Find Your Local Office)eCFR: 20 CFR Part 404 (Disability Insurance)42 U.S.C. § 405 (Hearings; Judicial Review)The Missouri Bar (Attorney Licensing & Directory)

Legal Disclaimer

This guide is for informational purposes only and is not legal advice. Laws and regulations change, and outcomes depend on specific facts. Consult a licensed Missouri attorney about your situation.

Free Case Evaluation

If your SSDI claim was denied, call Louis Law Group at 833-657-4812 for a free case evaluation and claim review.