SSDI Denial Appeal Guide for Claimants | Indiana, IN

Introduction: Why This SSDI Guide Matters to Hoosiers

Indiana workers who become unable to work because of a severe medical impairment rely on Social Security Disability Insurance (SSDI) benefits to protect their families and keep a roof over their heads. Unfortunately, the Social Security Administration (SSA) denies most initial SSDI applications. According to the SSA’s 2023 State-level data, only about 36% of Indiana claims were approved at the initial level—slightly below the national average. A denial is not the end of the road; federal law gives you the right to appeal, and many Hoosiers ultimately win benefits on appeal. This comprehensive, strictly factual guide explains:

• Why SSDI claims get denied in Indiana

• The federal rules that govern your appeal, including 20 C.F.R. §§ 404.900–404.999 and Social Security Act § 205(b), 42 U.S.C. § 405

• The four-step SSA appeal process and filing deadlines

• Local resources—from Indianapolis to Evansville—that can help

• When and how an Indiana disability attorney can tilt the odds in your favor

This article slightly favors the claimant, yet it is grounded only in verifiable, authoritative sources such as SSA regulations, federal statutes, and published court opinions. If you live anywhere in the Hoosier State—Indianapolis, Fort Wayne, Evansville, South Bend, or beyond—read on to protect your rights after an SSDI denial.

Understanding Your SSDI Rights Under Federal Law

What SSDI Provides

SSDI pays monthly cash benefits and Medicare eligibility to workers who:

• Have a medically determinable impairment expected to last at least 12 months or result in death; and

• Have earned enough quarters of coverage under the Federal Insurance Contributions Act (FICA).

These requirements are defined in 20 C.F.R. § 404.1505. Benefits continue as long as you remain disabled within the meaning of 20 C.F.R. § 404.1512.

Your Right to Due Process

Under Social Security Act § 205(b) and 20 C.F.R. § 404.900, every claimant is entitled to:

• Written notice explaining any adverse determination

• An opportunity to examine the evidence and submit new evidence

• A hearing before an impartial Administrative Law Judge (ALJ)

• Further review by the Appeals Council and federal courts

Strict Appeal Deadlines

The SSA allows 60 days from the date you receive a denial notice (SSA presumes receipt five days after mailing) to file an appeal at each stage. Missing the deadline usually means starting over with a new application, although the SSA may extend the deadline for good cause (20 C.F.R. § 404.911).

Common Reasons SSA Denies SSDI Claims in Indiana

Technical, Non-Medical Denials

Roughly 30% of Indiana denials are for technical reasons, including:

• Insufficient work credits: You generally need 20 quarters of coverage in the 10 years before disability onset (20 C.F.R. § 404.130).

• Earnings above Substantial Gainful Activity (SGA): In 2024, gross monthly earnings above $1,550 for non-blind claimants trigger a technical denial (SSA POMS DI 10501.015).

• Failure to cooperate: Not returning SSA forms or missing Consultative Exams.

Medical Denials

Medical denials arise when the Disability Determination Bureau (DDB)—Indiana’s state agency that makes initial medical decisions—finds you do not meet the SSA’s definition of disability. Common rationales include:

• Impairments deemed non-severe (20 C.F.R. § 404.1520(a)(4)(ii)).

• Condition does not meet or equal a Listing of Impairments.

• Residual Functional Capacity (RFC) assessment finds you can perform past relevant work or adjust to other work in the national economy.

Documentation Gaps

Many denials stem from missing medical records, sporadic treatment, or lack of specialist support. Claimants who submit comprehensive, up-to-date records—especially imaging, lab studies, and detailed physician narratives—have significantly higher approval rates.

Federal Legal Protections & Key Regulations

Four Levels of Administrative Review

• Reconsideration (20 C.F.R. § 404.907): A different DDB examiner reviews your file. No appearance is required, but new evidence is welcome.

• ALJ Hearing (20 C.F.R. § 404.929): You (and your attorney) can question vocational and medical experts. Hearings in Indiana are typically held at the Indianapolis Office of Hearings Operations, 6511 Brotherhood Way, Indianapolis, IN 46268, or by video.

• Appeals Council Review (20 C.F.R. § 404.967): The Council may affirm, reverse, remand, or dismiss your case.

• Federal District Court: Filed under 42 U.S.C. § 405(g) in the U.S. District Court for the Southern or Northern District of Indiana.

Evidentiary Standards

The ALJ must base findings on substantial evidence. Federal courts will reverse or remand if the ALJ failed to build an accurate and logical bridge between evidence and conclusions (see Briscoe ex rel. Taylor v. Barnhart, 425 F.3d 345 (7th Cir. 2005)).

Attorney’s Fees Regulated by Federal Law

Disability lawyers generally charge a contingent fee of 25% of back pay, capped at $7,200 for 2024, subject to SSA approval (42 U.S.C. § 406(a)). No fee is owed if you lose.

Steps to Take After an SSDI Denial

1. Read the Denial Letter Carefully

The notice lists the medical and vocational evidence considered and explains why the claim was denied.

2. Mark Your 60-Day Deadline

File SSA-561 Request for Reconsideration online, by mail, or in person. Attach Form SSA-3441 (Disability Report – Appeal) to add new evidence.

3. Gather Missing Medical Evidence

Focus on objective tests, specialist opinions, and longitudinal records that pre-date your alleged onset date. Indiana claimants often obtain key documentation from leading facilities such as:

• Indiana University Health Methodist Hospital—Indianapolis

• Franciscan Health Rehabilitation Hospital—Indianapolis

• Parkview Regional Medical Center—Fort Wayne

• Deaconess Midtown Hospital—Evansville

4. Track Your Appeal Online

Create a mySSA account to check status and upload evidence.

5. Prepare for the ALJ Hearing

Your best chance of success—52% nationally and 47% in Indiana—occurs at the hearing level. Typical steps include:

• Requesting your case file via Electronic Records Express

• Submitting a Pre-Hearing Brief citing medical listings and vocational rules

• Practicing testimony on daily limitations

• Cross-examining the Vocational Expert (VE) about Dictionary of Occupational Titles job numbers

When to Seek Legal Help for SSDI Appeals

Complex Cases Benefit Most

You should strongly consider hiring an Indiana disability attorney if you:

• Have prior denials and an approaching ALJ hearing

• Need to subpoena uncooperative medical providers

• Face adverse VE testimony requiring cross-examination

• May need a closed-period or onset date amendment

• Plan to present mental health evidence requiring detailed functional analyses

Attorney Licensing in Indiana

Attorneys must hold an active law license from the Indiana Supreme Court and register with the SSA as an eligible representative by obtaining an Appointed Representative Services (ARS) ID.

Local Resources & Next Steps

Indiana SSA Field Offices

While claims are filed online or by phone, local offices can accept appeal forms and provide status updates. Major Indiana offices include:

• Indianapolis Downtown SSA Office, 575 N. Pennsylvania St., Rm 685, Indianapolis, IN 46204

• Fort Wayne SSA Office, 2122 Lincolnway Ct., Fort Wayne, IN 46819

• Evansville SSA Office, 2300 N. First Ave., Evansville, IN 47710

• South Bend SSA Office, 602 S. Michigan St., South Bend, IN 46601

For a full directory, visit the SSA’s Field Office Locator.

State Vocational & Rehabilitation Services

Indiana’s Vocational Rehabilitation Services (VRS) can supply occupational therapy records and functional assessments that bolster your claim. Contact VRS at 1-800-545-7763.

Mental Health & Community Clinics

Low-cost clinics like HealthNet Community Health Centers (Indianapolis) and Matthew 25 Health and Dental Clinic (Fort Wayne) help fill treatment gaps that often sink SSDI claims.

Authoritative Sources & Further Reading

SSA: The Appeals Process eCFR: Title 20, Part 404 — Federal Disability Regulations SSA Annual Statistical Report on the Disability Insurance Program Indiana Vocational Rehabilitation Services

Legal Disclaimer

This guide is for informational purposes only and does not constitute legal advice. Laws and regulations can change. Consult a licensed Indiana attorney regarding your individual situation.

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