SSDI Denial & Appeal Guide – Murfreesboro, Texas

Introduction: Why This Guide Matters to Murfreesboro, Texas Claimants

If you live in Murfreesboro, Texas and your Social Security Disability Insurance (SSDI) claim has been denied, you are not alone. In 2022, the Social Security Administration (SSA) denied roughly two-thirds of initial SSDI applications nationwide. Texas is home to more than 627,000 disabled workers who already receive SSDI benefits, according to the SSA’s Annual Statistical Report on the Social Security Disability Insurance Program. Thousands more Texans, including residents of small communities such as Murfreesboro, are still fighting for the benefits they earned through years of payroll contributions.

This comprehensive, facts-only guide explains your rights under federal law, the specific regulations the SSA must follow, and the exact steps to appeal a denial. It is tailored to Murfreesboro claimants, slightly favoring the interests of disabled workers while remaining strictly professional and evidence-based.

Understanding Your SSDI Rights

What SSDI Is—and Is Not

SSDI is an insurance program funded by FICA payroll taxes. If you have worked long enough to earn sufficient quarters of coverage (also called work credits) and you become unable to engage in substantial gainful activity (SGA) because of a medically determinable impairment expected to last at least 12 months or result in death, you may qualify for benefits under Title II of the Social Security Act.

• Federal Statutory Authority: 42 U.S.C. § 423 (Social Security Act § 223)

• Key Regulation: 20 C.F.R. § 404.1505 (disability standard for adults)

Your Procedural Rights

The SSA must follow the Administrative Procedure Act and its own regulations, giving you:

• A written notice explaining why your claim was denied, with citations to the evidence considered (20 C.F.R. § 404.904).

• An absolute right to appeal through four administrative levels, each with its own deadlines (explained below).

• The right to submit new medical or vocational evidence at every stage before the Appeals Council.

• The right to be represented by an attorney or qualified non-attorney representative (20 C.F.R. § 404.1705).

How Federal Disability Rules Interact with Texas Law

SSDI is exclusively federal. However, Texas regulates how attorneys may advertise, handle trust accounts, and charge fees. Under Texas Disciplinary Rules of Professional Conduct Rule 1.04, contingency fees must be reasonable. Attorney fees for SSDI cases are also capped by the SSA (currently the lesser of 25 percent of past-due benefits or $7,200 as of November 2022; see 86 Fed. Reg. 64,796).

Common Reasons SSA Denies SSDI Claims

Knowing why claims are denied helps you prepare a stronger appeal. The most frequently cited reasons in SSA statistical reports include:

• Insufficient medical evidence: Records do not prove that your condition prevents work for at least 12 continuous months.

• Lack of recent treatment: The SSA’s consultative examiner may conclude your impairment is not severe if you have large gaps in care.

• Residual Functional Capacity (RFC) findings: The agency determines you can still perform your past relevant work or adjust to other work.

• Failure to meet or equal a Listing: You do not satisfy the exact criteria in the Listing of Impairments (20 C.F.R. Part 404, Subpart P, Appendix 1).

• Technical issues: Not enough work credits, earnings above SGA thresholds, or missing documentation.

Federal Legal Protections & Regulations

The Five-Step Sequential Evaluation Process

Under 20 C.F.R. §§ 404.1520 & 416.920, every claim is analyzed using five steps:

• Are you currently engaging in SGA (2023 threshold: $1,470/month for non-blind claimants)?

• Is your impairment “severe” under federal standards?

• Does the impairment meet or equal a listed impairment in Appendix 1?

• Can you perform your past relevant work?

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

If the SSA errs at any step, a denial may be reversed on appeal.

Appeal Deadlines—Statutes of Limitation

• Reconsideration: File within 60 days of the date you receive the denial notice (SSA presumes 5 days for mailing).

• Administrative Law Judge (ALJ) Hearing: Request within 60 days of the Reconsideration denial.

• Appeals Council Review: File within 60 days after the ALJ decision.

• Federal District Court: Commence a civil action within 60 days of the Appeals Council’s denial or dismissal (42 U.S.C. § 405(g)).

Missing any of these deadlines usually forfeits your appeal unless you can show “good cause” under 20 C.F.R. § 404.911.

Evidence Rules at Each Stage

The SSA must consider all material evidence, including new evidence submitted at the Appeals Council so long as it is chronologically pertinent (20 C.F.R. § 404.970). Federal courts will review whether the agency ignored material evidence (See Johnson v. Comm’r of Soc. Sec., E.D. Tex. 2017)).

Steps to Take After an SSDI Denial

1. Read the Denial Letter Carefully

Identify which elements of the five-step process led to the denial and note the stated evidence gaps. Make a calendar entry for the 60-day deadline.

2. Gather Updated Medical Evidence

• Request full treatment records from every provider you have seen in the last 12–24 months.

• Ask your treating physician to complete a Medical Source Statement detailing functional limitations.

• If pain is an issue, obtain objective tests (e.g., MRI, EMG) whenever clinically appropriate.

3. File a Request for Reconsideration (SSA-561)

You may file online or submit the form at any SSA field office. Online submission generates a timestamp confirming timely filing. Always keep copies.

4. Prepare for the ALJ Hearing

The hearing is your best chance statistically: nationwide, about 55 percent of claims are approved at this stage. To maximize your odds:

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

• Consider written statements from family or former supervisors describing work limitations.

• Review potential Vocational Expert (VE) questions. Your representative can cross-examine the VE about job numbers and transferable skills.

5. Appeals Council and Federal Court

If the ALJ rules against you, you may:

• Ask the Appeals Council to review for error of law, abuse of discretion, or new and material evidence.

• File suit in the appropriate U.S. District Court for the Eastern District of Texas (for residents of Murfreesboro, assuming county alignment) under 42 U.S.C. § 405(g). No jury is available; a federal judge reviews the administrative record.

When to Seek Legal Help for SSDI Appeals

While you may represent yourself, disability cases involve complex medical and vocational evidence, cross-examination of expert witnesses, and strict procedural deadlines. Statistics published by the Government Accountability Office in 2018 show that claimants with representation are nearly three times more likely to be approved at the ALJ hearing.

A murfreesboro disability attorney licensed in Texas can:

• Obtain and organize medical records in SSA-friendly formats (narrative reports, RFC forms).

• Prepare you for testimony and handle VE cross-examination.

• Spot legal errors for Appeals Council briefs and federal court complaints.

• Charge only SSA-approved contingency fees, paid from past-due benefits if you win.

Local Resources & Next Steps

Finding Your Nearest SSA Office

Murfreesboro residents can locate the closest field office using the SSA’s online tool: SSA Office Locator. Field offices in nearby counties handle SSDI applications, Reconsiderations, and record requests.

Texas Hearing Offices (OHO)

• Dallas North

• Dallas Downtown

• Fort Worth

• Houston (Bissonnet and North)

• San Antonio

Your hearing will be scheduled at the OHO with jurisdiction over your ZIP code or by video conference.

Medical Facilities Serving Murfreesboro Claimants

If you need additional diagnostics or specialty care, consider regional hospitals such as:

• UT Health East Texas (Tyler)

• Christus Good Shepherd Medical Center (Longview)

Bring all test results to your attorney or representative promptly.

Free or Low-Cost Assistance

State Bar of Texas Lawyer Referral Service

• Legal Aid of NorthWest Texas (for income-qualified residents)

Authoritative References

20 C.F.R. § 404.1505 – Disability Defined SSA Listing of Impairments (Blue Book) SSA Annual Statistical Report on the SSDI Program

Legal Disclaimer

This guide is provided for informational purposes only and does not constitute legal advice. Laws and regulations change frequently. Consult a licensed Texas attorney to obtain advice 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.