SSDI Denial Appeal Guide – Garland, Texas

Introduction: Why Garland, Texas Residents Need a Targeted SSDI Denial Guide

Garland is home to more than 245,000 Texans, and according to U.S. Census data, roughly 8% of the city’s working-age population lives with a disability that may impair full-time employment. If you are among those who have applied for Social Security Disability Insurance (SSDI) and received an unpleasant Notice of Disapproved Claim from the Social Security Administration (SSA), you are not alone. In fiscal year 2023, the SSA denied about two-thirds of initial SSDI claims nationwide. Fortunately, federal law supplies several layers of administrative appeal designed to protect claimants’ rights.

This comprehensive, evidence-based guide explains the exact appeal steps, deadlines, and legal standards that apply to Garland claimants. It slightly favors the claimant’s point of view while remaining strictly factual under the Social Security Act, Title II regulations in 20 CFR §404, and binding federal court precedent. Whether you filed online, at a nearby SSA field office, or through a representative, the information below will help you challenge a denial effectively and on time.

Understanding Your SSDI Rights

1. What Benefits SSDI Provides

SSDI pays monthly cash benefits and provides Medicare eligibility (24 months after entitlement) to insured workers who meet:

• Non-medical eligibility: sufficient work credits, usually 20 of the last 40 quarters under 42 U.S.C. §423(c)(1)(B).

Medical eligibility: inability to perform substantial gainful activity (SGA) lasting or expected to last at least 12 months or result in death (20 CFR §404.1505).

2. Due-Process Protections

Section 205(b) of the Social Security Act (42 U.S.C. §405(b)) guarantees every claimant the right to:

• Written notice of an adverse decision with reasons.

• An opportunity for a hearing before an impartial Administrative Law Judge (ALJ).

• Representation by an attorney or qualified non-attorney representative.

These rights are reinforced by the four-step administrative review process in 20 CFR §404.900.

3. Statutory Deadlines You Cannot Miss

• Request for Reconsideration: 60 days from the date you receive the denial (SSA presumes 5 days for mailing)—20 CFR §404.909(a)(1).

• Request for ALJ Hearing: 60 days after the reconsideration determination—20 CFR §404.933(b).

• Appeals Council Review: 60 days after the ALJ decision—20 CFR §404.968(a).

• U.S. District Court: 60 days after Appeals Council denial or unfavorable decision—42 U.S.C. §405(g).

Missing any deadline without a showing of “good cause” (20 CFR §404.911) will almost always terminate your appeal rights, so act promptly.

Common Reasons SSA Denies SSDI Claims

The SSA bases medical decisions on the Sequential Evaluation Process in 20 CFR §404.1520. Understanding where your case faltered helps you fix it on appeal.

1. Insufficient Medical Evidence (Step 2 & Step 3)

The Disability Determination Services (DDS) unit in Austin may conclude that your condition is not “severe” or does not meet a Listing. Often, claimants underestimate the importance of longitudinal treatment records and detailed Residual Functional Capacity (RFC) assessments from treating physicians.

2. Earnings Above Substantial Gainful Activity (Step 1)

If you earned more than the SGA monthly threshold ($1,470 for non-blind individuals in 2024), the SSA will issue a technical denial without reviewing medical evidence.

3. Ability to Perform Past Relevant Work (Step 4)

The agency may find you can still perform your prior job as generally performed in the national economy, even if you can’t perform it as you did. Vocational evidence and a persuasive function-by-function RFC are crucial to rebutting this finding.

4. Ability to Adjust to Other Work (Step 5)

Using the Medical-Vocational Guidelines (Grid Rules) in 20 CFR Part 404, Subpt. P, App. 2, SSA can deny older claimants by citing alternative sedentary jobs. Cross-examining the vocational expert (VE) at the hearing is often the key to reversal.

5. Procedural Errors

Mistakes such as incomplete work history reports, missed consultative examinations, or unsigned SSA-827 medical releases can trigger denials that are easier to correct on reconsideration.

Federal Legal Protections & Regulations

1. Key Statutes and Regulations

• Social Security Act Title II (42 U.S.C. §401 et seq.).

• Administrative Procedure Act, 5 U.S.C. §§551-559 (governs federal agency hearings).

• 20 CFR §404 Subparts J–R (claims, evidence, appeals, representation).

2. The Sequential Evaluation – How It Works

• Step 1: Are you engaging in SGA?

• Step 2: Do you have a medically determinable severe impairment?

• Step 3: Does your impairment meet or equal a Listing?

• Step 4: Can you perform past relevant work?

• Step 5: Can you adjust to other work in the national economy?

Only a “no” at Steps 4 and 5, combined with a “yes” at Step 2, can produce a fully favorable decision.

3. Evidentiary Standards

The burden of proof rests on the claimant through Step 4; at Step 5 it shifts to the SSA to prove other jobs exist (Bowen v. Yuckert, 482 U.S. 137 (1987)). Evidence must be “objective medical evidence from an acceptable medical source” (20 CFR §404.1502).

4. Federal Court Oversight

If the Appeals Council denies review, you may file a civil action in the U.S. District Court for the Northern District of Texas, Dallas Division. The court can reverse, remand, or affirm under the “substantial evidence” standard (42 U.S.C. §405(g)).

Steps to Take After an SSDI Denial

1. File a Timely Request for Reconsideration

Complete SSA-561 online, by mail, or at any field office. Attach new evidence: test results, updated treatment notes, or a detailed Medical Source Statement from your doctor.

2. Prepare for the Administrative Law Judge Hearing

The ALJ hearing is your best opportunity to present testimony, cross-examine the VE, and submit additional evidence. Garland cases are scheduled through the Dallas North Office of Hearings Operations (OHO):

• Dallas North OHO, 1301 Young St., Suite 430, Dallas, TX 75202; phone (866) 931-9946.

You may request an in-person, video-teleconference, or phone hearing. Under 20 CFR §404.935, evidence must be submitted no later than five business days before the hearing, unless you show good cause.

3. Appeals Council Review

When filing Form HA-520, specify legal errors: e.g., misapplication of Listing 1.04 or failure to analyze treating-physician opinions under Shinaberry v. Saul, 952 F.3d 113 (5th Cir. 2020). The Appeals Council can issue a favorable decision or remand to the ALJ.

4. Federal Litigation

File a complaint in federal court within 60 days. Many claimants hire counsel at this stage because of complex briefing requirements under Local Rule 7.1 of the Northern District of Texas.

When to Seek Legal Help for SSDI Appeals

1. Complexity of Medical-Vocational Issues

Chronic pain, mental health impairments, and combined conditions require specialized legal arguments and RFC evidence. A licensed Texas disability attorney can coordinate medical experts, summarize longitudinal records, and prepare you to testify.

2. Contingent-Fee Representation Authorized by Federal Law

Under 42 U.S.C. §406(a)(2)(A), attorney fees are limited to the lesser of 25% of past-due benefits or $7,200 (2024 cap) absent a fee petition. No upfront fees are allowed, easing financial barriers for claimants.

3. Representation Statistics

SSA data show nationally that represented claimants were approved at nearly double the rate of unrepresented claimants at the ALJ level in FY 2022. While results vary, professional advocacy often clarifies the medical record and sharpens legal arguments.

Local Resources & Next Steps

1. SSA Field Offices Serving Garland Residents

• Dallas North Field Office, 10824 N. Central Expressway, Dallas, TX 75231 (approx. 12 miles from downtown Garland). Phone: 800-772-1213.

• Dallas Oak Cliff Field Office, 2475 Cliff Creek Crossing Dr., Dallas, TX 75237.

Use the SSA’s Field Office Locator to confirm hours before visiting.

2. Medical Evidence Sources in Garland

• Methodist Richardson Medical Center – 2831 E President George Bush Hwy, Richardson, TX 75082.

• Parkland Garland Health Center – 802 Hopkins St., Garland, TX 75040.

Promptly request complete treatment records, including imaging and specialist notes, to meet the five-day evidence rule.

3. Vocational & Rehabilitation Services

• Texas Workforce Solutions–Vocational Rehabilitation Services, 217 N. 10th St., Garland, TX 75040. These records can prove unsuccessful work attempts or document job accommodation limits.

4. State Bar of Texas Attorney Lookup

Verify that any “garland disability attorney” you hire is licensed and in good standing via the State Bar of Texas.

5. Mental-Health Documentation

For psychiatric impairments, counseling notes from local providers such as Metrocare Services in nearby Dallas can bolster Paragraph B criteria under Listing 12.04 (Depressive, Bipolar, and Related Disorders).

Conclusion & Action Plan

• Mark your 60-day deadline immediately after a denial.

• Gather missing medical evidence and obtain detailed RFC statements.

• Submit your Request for Reconsideration online or at the Dallas North SSA office.

• If reconsideration is denied, request an ALJ hearing and consider retaining counsel experienced in SSDI appeals.

By following the federal rules, leveraging local resources, and being proactive with documentation, Garland claimants can significantly improve their chances of reversing an SSDI denial.

Legal Disclaimer: This guide is for informational purposes only and does not constitute legal advice. Consult a licensed Texas 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.