SSDI Denial Appeal Guide for Nebraska, NE Claimants

Introduction: Navigating SSDI Denials in Nebraska

Nebraska workers who paid into Social Security and can no longer work because of a severe, medically–documented impairment have the same federal right to Social Security Disability Insurance (SSDI) benefits as claimants in any other state. Unfortunately, the Social Security Administration (SSA) initially denies many legitimate applications. According to the SSA’s Annual Statistical Report on the Social Security Disability Insurance Program, 2023, fewer than four out of ten initial disability claims nationwide were approved; Nebraska’s approval rate follows a similar pattern. A denial is not the end of the road. Federal law gives you a multi-level appeals process, strict filing deadlines, and the right to representation. This guide—written for Nebraskans in Omaha, Lincoln, Grand Island, Kearney, Scottsbluff, and every community in between—explains how to protect your claim at each stage, cites the governing regulations, and highlights local resources you can turn to for help.

Understanding Your SSDI Rights

Federal Entitlement to Benefits

SSDI is a federally mandated insurance program funded by payroll taxes under Title II of the Social Security Act. If you have earned enough quarters of coverage and have a severe impairment expected to last at least 12 months or result in death, you are entitled to benefits. Your rights are not diminished because you live in Nebraska’s Panhandle or the Sandhills. Key statutory provisions include:

• Social Security Act §223(d) – Defines “disability.”

• Social Security Act §205(b) – Guarantees a right to a hearing and to decision review.

The Sequential Evaluation Process

SSA adjudicators evaluate adult claims through the five-step sequential process found at 20 C.F.R. §404.1520:

• Are you performing substantial gainful activity (SGA)?

• Do you have a severe medically determinable impairment?

• Does the impairment “meet” or “equal” a Listing?

• Can you perform your past relevant work (PRW)?

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

Children’s claims are evaluated under 20 C.F.R. §416.924 with a different three-step standard.

Your Procedural Rights

Under 20 C.F.R. §§404.900–404.999, you have the right to:

• Written notice of any adverse decision.

• Obtain and submit evidence.

• Be represented by an attorney or qualified non-attorney representative.

• Appeal through four administrative levels before seeking federal court review.

Common Reasons SSA Denies SSDI Claims

Understanding why claims are denied helps you focus your appeal on the facts the SSA needs to reverse course.

1. Medical Insufficiency

The SSA must have objective medical evidence—not just your statements—to prove a medically determinable impairment. Missing imaging studies, outdated treatment notes, or gaps in care often lead to unfavorable findings at Steps 2 or 3.

2. Residual Functional Capacity (RFC) Findings

At Steps 4 and 5, the adjudicator assesses your remaining ability to perform work activities. If the SSA concludes that you can lift, stand, sit, and concentrate long enough to perform past work or other jobs, a denial follows. Claimants sometimes underestimate how important detailed physician opinions are to the RFC analysis.

3. Earnings Above SGA

In 2024, gross earnings above $1,550 per month for non-blind claimants (SSA SGA Table) generally disqualify you at Step 1. Self-employment or farm income—common in rural Nebraska—counts, too.

4. Lack of Recent Work Credits

You must have paid enough FICA taxes in the 10-year period before disability onset. Seasonal and agricultural workers may discover their “date last insured” has expired.

5. Procedural Errors

Missed deadlines, incomplete forms, or failure to attend a Consultative Examination (CE) can also lead to denial. Fortunately, many procedural denials can be corrected on appeal.

Federal Legal Protections & Regulations

Key Regulations

• 20 C.F.R. §404.1512 – Your duty to submit evidence.

• 20 C.F.R. §404.909 – 60-day deadline to request reconsideration.

• 20 C.F.R. §404.933 – 60-day deadline to request a hearing before an Administrative Law Judge (ALJ).

• 20 C.F.R. §404.984 – Appeals Council review.

• Federal Rule of Civil Procedure 42 and 28 U.S.C. §405(g) – Judicial review in U.S. District Court.

Your Right to Counsel

Section 406 of the Social Security Act caps contingency fees at 25% of past-due benefits or $7,200, whichever is less (as adjusted). Attorneys must be in good standing with the Nebraska State Bar Association and the SSA to collect direct payment of fees.

Statute of Limitations for Civil Actions

If the Appeals Council denies your request for review or issues an unfavorable decision, you have 60 days from receipt of the notice to file a civil action in the U.S. District Court for the District of Nebraska, pursuant to 42 U.S.C. §405(g). A five-day mailing presumption applies.

Steps to Take After an SSDI Denial

1. Read the Denial Letter Carefully

The SSA’s Form SSA-4268 explains the medical and vocational findings that led to the decision. Note the date printed at the top right; your 60-day clock starts the next day.

2. File a Timely Request for Reconsideration

Most Nebraska claimants must complete Form SSA-561 (Request for Reconsideration) and SSA-3441 (Disability Report – Appeal). You can file online, by mail, or in person at your local SSA field office. Missing the deadline usually forces you to start a new application, losing months of potential back pay.

3. Submit Additional Medical Evidence

Ask your treating physicians for updated progress notes, imaging, lab results, and detailed Medical Source Statements that describe specific functional limitations (e.g., maximum sitting/standing time, need to elevate legs).

4. Request an Administrative Law Judge Hearing

If reconsideration is denied—common in roughly 85% of cases—immediately request a hearing. Hearings are held via video or in person at the Omaha Office of Hearings Operations (OHO) or the Kansas City National Hearing Center. An ALJ hearing is your best opportunity to present live testimony and cross-examine vocational and medical experts.

5. Appeals Council Review

The Appeals Council in Falls Church, Virginia, reviews ALJ decisions to ensure they comply with the law. It can deny review, remand, or issue its own decision.

6. Federal Court

If the Appeals Council does not grant you relief, file a complaint in U.S. District Court (Omaha or Lincoln Division). No jury is involved; a federal judge decides whether the ALJ applied the proper legal standards and whether substantial evidence supports the decision.

When to Seek Legal Help for SSDI Appeals

You have the right to represent yourself (pro se), but statistics show represented claimants enjoy higher success rates—especially at the ALJ level. The Government Accountability Office reported in 2018 that claimants with representatives were nearly three times more likely to win benefits than those without. Attorneys can:

• Gather and organize medical evidence per SSA’s Program Operations Manual System (POMS).

• Draft pre-hearing briefs pinpointing legal errors.

• Question vocational experts to eliminate jobs inconsistent with your RFC.

• Negotiate on-the-record (OTR) decisions to avoid hearings.

Because fees are contingency-based and SSA-approved, hiring counsel poses little financial risk.

Local Resources & Next Steps in Nebraska

Key SSA Field Offices

Omaha SSA Office 604 N 109th Court, Omaha, NE 68154 Lincoln SSA Office 100 Centennial Mall N, Lincoln, NE 68508 Grand Island SSA Office 115 N Webb Rd Ste 1, Grand Island, NE 68803

Find additional locations using the SSA’s Office Locator Tool.

State and Community Assistance

• Legal Aid of Nebraska – May provide free representation for low-income claimants.

• Nebraska VR – Vocational rehabilitation services that can supply additional functional evidence.

• University of Nebraska Medical Center – Tertiary care specialists for complex conditions.

Stay Organized

Maintain a single binder with every SSA notice, medical record, and written statement. Bring copies to all SSA appointments and attorney meetings. Use certified mail or SSA online receipts to document timely filings.

Important Deadlines Recap

• 60 days: Request Reconsideration.

• 60 days: ALJ hearing request after reconsideration denial.

• 60 days: Appeals Council request after ALJ decision.

• 60 days: Civil action in U.S. District Court after Appeals Council action.

Conclusion

SSDI appeals require patience, precision, and perseverance, but thousands of Nebraskans ultimately obtain the benefits they earned. By understanding the federal regulations, gathering persuasive medical evidence, and meeting every deadline, you maximize your chances of a favorable outcome. If you feel overwhelmed, professional legal help can level the playing field against the SSA’s complex bureaucracy.

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