SSDI Denial Appeal Guide for Lowell, Texas

Introduction: Why Lowell Claimants Need a Focused SSDI Denial Appeal Guide

Living in Lowell, Texas—an unincorporated community in Hunt County about eight miles southeast of Greenville—means you are part of a tight-knit rural population. While the cost of living may be lower than in nearby Dallas, local jobs often require physical labor in agriculture, manufacturing, or the service industries that line U.S. Highway 69. When injury or chronic illness suddenly ends your ability to work, Social Security Disability Insurance (SSDI) benefits can provide a financial lifeline. Yet the Social Security Administration (SSA) denies roughly two-thirds of initial SSDI applications nationwide, and the denial rate in Texas mirrors that trend. If you have received a denial letter, you are not alone—but you must act quickly to protect your rights. This guide explains every step of the SSDI denial appeal process, grounding each point in federal law and offering local resources specific to Lowell and Hunt County.

Understanding Your SSDI Rights

SSDI is a federal insurance program funded by the payroll taxes you paid while working. Under §223 of the Social Security Act (42 U.S.C. §423) and 20 C.F.R. §404.1505, you are considered disabled if you cannot engage in substantial gainful activity (SGA) because of a medically determinable impairment expected to last at least 12 months or result in death. Key rights every Lowell claimant should know include:

• The Right to a Written Explanation. SSA must provide a notice that states why your claim was denied (20 C.F.R. §404.130).

• The Right to Administrative Review. You may pursue up to four appeal levels: Reconsideration, Administrative Law Judge (ALJ) hearing, Appeals Council review, and federal district court (20 C.F.R. §404.900).

• The Right to Representation. You can hire an attorney or qualified non-attorney representative. Fees are generally capped at 25 % of back pay or $7,200, whichever is lower, per 20 C.F.R. §404.1720.

The Right to Review Your File. SSA must let you inspect your electronic claims file upon request.

• The Right to Submit Additional Evidence. You can add medical or vocational evidence at each stage, but earlier is better under 20 C.F.R. §404.935.

Knowing these rights equips you to challenge a denial and increases the odds of success. Claimants who appeal with complete evidence and, when appropriate, legal counsel, ultimately prevail in roughly half of all cases decided at an ALJ hearing.

Common Reasons SSA Denies SSDI Claims

Understanding why claims fail helps you avoid pitfalls during appeal. The most frequent reasons in Texas include:

• Insufficient Medical Evidence. SSA may conclude that your records do not prove a severe impairment. For example, diagnostic tests might be missing, or treatment notes may focus on acute visits rather than functional limitations.

• Work Activity Above Substantial Gainful Activity (SGA). Earning more than the monthly SGA limit ($1,470 in 2023 for non-blind claimants) demonstrates to SSA that you can work.

• Failure to Follow Prescribed Treatment. If you did not adhere to reasonable medical advice without good cause, SSA can deny under 20 C.F.R. §404.1530.

• Non-Severe Duration. Your impairment must last—or be expected to last—at least 12 months (20 C.F.R. §404.1509).

• Insufficient Recent Work Credits. You generally need 20 credits earned in the 10 years before disability onset, though this varies by age (20 C.F.R. §404.140).

• Administrative or Technical Errors. Incorrect earnings records, mismatched medical evidence, or incomplete forms can trigger denials.

Lowell applicants often face additional hurdles. Rural residents may lack easy access to specialists, so medical documentation may be sparse or inconsistent—a situation that you can and should remedy at the appeal stage.

Federal Legal Protections & Key Regulations

SSDI appeals are governed by federal statutes and detailed regulations. Below are major laws that safeguard your claim:

Social Security Act §205(b)

This section guarantees you a right to a hearing after an unfavorable initial determination. The hearing must be fair, and you can present witnesses and evidence.

20 C.F.R. Part 404, Subpart J

Subpart J outlines the administrative review process, including time limits, evidence rules, and decision-making criteria. Two provisions frequently cited in appeals are:

• 20 C.F.R. §404.900 – Establishes the four required steps of administrative review.

• 20 C.F.R. §404.1520 – Details SSA's five-step sequential evaluation of disability.

60-Day Statute of Limitations

Under 20 C.F.R. §404.909(a)(1), you have 60 days from the date you receive the denial notice to request Reconsideration. SSA presumes you receive the notice five days after the mailing date. Missing the deadline typically ends your claim unless you show “good cause” per 20 C.F.R. §404.911.

Attorney Licensing Rules in Texas

Only attorneys licensed by the Supreme Court of Texas and in good standing with the State Bar may practice law in Texas. They must follow the Texas Disciplinary Rules of Professional Conduct and are subject to oversight by the State Bar of Texas.

Steps to Take After an SSDI Denial

1. Read the Denial Letter Carefully

Your “Notice of Disapproved Claim” explains why SSA believes you are not disabled. Identify the listed exhibit numbers, the sequential evaluation step that caused denial, and any technical issues (e.g., earnings records).

2. Do Not File a New Application

Filing a new claim forfeits potential back pay and generally leads to another denial for the same reasons. Instead, follow the official appeal process.

3. File a Request for Reconsideration

Submit Form SSA-561-U2 within 60 days. In Texas, you can file online through SSA’s Appeals Portal or mail/hand-deliver paperwork to the nearest SSA field office (see local resources below).

4. Gather Updated Medical Evidence

Ask your doctors for:

• Recent progress notes and diagnostic imaging

• Objective functional capacity evaluations

• Medical opinion letters detailing work-related limitations

• Records from Hunt Regional Medical Center, Texas Health Presbyterian Hospital Greenville, or any visiting specialist clinics

Timing matters: under 20 C.F.R. §404.1512, the burden is on the claimant to provide evidence.

5. Consider Non-Medical Evidence

Third-party statements from family, employers, and vocational experts can corroborate your limitations, especially valuable for “invisible” conditions like chronic pain or mental health disorders.

6. Prepare for the Administrative Law Judge (ALJ) Hearing

If Reconsideration is denied (this happens in about 85 % of Texas cases), immediately file a request for an ALJ hearing using Form HA-501-U5. The ALJ for Lowell residents sits at the Dallas North Hearing Office, but in many cases, video hearings are held at the Greenville Social Security Tele-Site.

• Submit hearing evidence at least five business days before the hearing per 20 C.F.R. §404.935.

• Review the ALJ Exhibit List to ensure nothing is missing.

• Practice testimony focusing on daily limitations, not medical jargon.

7. Appeals Council and Federal Court

If the ALJ rules against you, request Appeals Council review within 60 days. The Council in Falls Church, Virginia, examines legal and procedural errors. If they deny or affirm the ALJ decision, you may file a civil action in the U.S. District Court for the Eastern District of Texas. You must file within 60 days of receiving the Appeals Council denial (42 U.S.C. §405(g)).

When to Seek Legal Help for SSDI Appeals

You are entitled to represent yourself, but the complex federal regulations can be overwhelming. Retaining a Lowell disability attorney can improve your odds by:

• Developing a theory of the case aligned with the five-step sequential evaluation.

• Requesting treating physician opinions that meet 20 C.F.R. §404.1520c supportability and consistency factors.

• Cross-examining Vocational Experts (VEs) to challenge job numbers at Step 5.

• Ensuring all deadlines are met and procedural errors preserved for appeal.

Texas attorneys charge on a contingency basis, meaning no fee unless you win. Any fee agreement must be approved by SSA under 20 C.F.R. §404.1725.

Local Resources & Next Steps

Nearest SSA Field Office

SSA Greenville Office

2717 Terrell Road

Greenville, TX 75402

Phone: 1-866-614-2739

Hours: Monday–Friday, 9 a.m.–4 p.m.

Dallas North Hearing Office (for ALJ Hearings)

1301 Young Street, Suite 340

Dallas, TX 75202

Medical Facilities Serving Lowell Residents

• Hunt Regional Medical Center, 4215 Joe Ramsey Blvd E, Greenville, TX 75401

• Texas Health Presbyterian Hospital Greenville, 6101 Wesley St, Greenville, TX 75402

• Primary Care Clinics: Carevide Community Health Center, Hunt Regional Family Practice

Free or Low-Cost Legal & Vocational Services

Disability Rights Texas – Statewide nonprofit that offers advocacy and limited representation. State Bar of Texas Lawyer Referral – Verified Texas attorneys.

• Texas Workforce Commission Vocational Rehabilitation Services – May fund functional capacity evaluations.

Authoritative Legal References

Social Security Act §205(b) 20 C.F.R. §404.900 – Administrative Review Process

Legal Disclaimer

This article is for informational purposes only and does not constitute legal advice. Laws and regulations change. Consult a licensed Texas 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.