SSDI Denial Appeal Guide—Aurora (CO), Texas

Introduction: Why This Guide Matters in Aurora (CO), Texas

The Social Security Disability Insurance (SSDI) program is a federal benefit, but the experience of applying—and being denied—often feels intensely local. If you live in or around Aurora (CO), Texas, you may have already mailed evidence to the Social Security Administration (SSA) field office in Decatur or driven 30 miles to the hearing office in Fort Worth only to receive a denial letter. According to SSA data released under the Freedom of Information Act, roughly 64% of initial SSDI applications nationwide were denied in 2023. Wise County and the wider Dallas–Fort Worth region track that national average. The good news is that most successful SSDI claims are awarded on appeal. This guide explains, step by step, how Aurora (CO) residents can overturn an unfavorable decision, what federal statutes protect your rights, and when an experienced Texas disability lawyer can tip the scales in your favor.

Understanding Your SSDI Rights

The Federal Definition of Disability

SSDI benefits are governed by the Social Security Act § 223(d) and implementing regulations at 20 C.F.R. § 404.1505. To win, you must prove that you have a medically determinable impairment expected to last at least 12 months (or result in death) that prevents substantial gainful activity (SGA). In 2024, SGA is $1,550 per month for non-blind claimants.

Your Procedural Due-Process Rights

• Notice and Explanation – The SSA must explain in writing why it denied you. See Social Security Act § 205(b).

• Four-Level Appeal – 20 C.F.R. § 404.900 guarantees the right to a four-step administrative review: Reconsideration, ALJ Hearing, Appeals Council, and Federal Court.

• 60-Day Deadline – You have 60 days (plus 5 for mailing) from the date you receive your denial to file each appeal.

Representation – You may appoint a qualified representative, including a Texas-licensed attorney, at any point. Fees are capped by SSA regulations and must be approved by the agency.

Knowing these rights allows you to push back against a denial from a position of strength.

Common Reasons SSA Denies SSDI Claims

Technical Denials

• Insufficient Work Credits – You generally need 20 quarters of coverage in the 40 quarters before disability onset (20 C.F.R. § 404.130).

• Earned Too Much After Onset – Excess earnings above SGA can sink a claim even with strong medical evidence.

• Missed Paperwork Deadlines – Failure to return SSA-827 medical releases or Adult Function Reports can trigger a technical denial.

Medical Denials

• Impairment Not “Severe” – The examiner believes your condition has minimal impact on work-related activities (20 C.F.R. § 404.1520(c)).

• Lack of Objective Evidence – X-rays, MRIs, or clinical tests were missing or outdated.

• Residual Functional Capacity (RFC) – DDS concluded you can still do past relevant work or adjust to other work.

Each denial code on your Notice of Disapproved Claim pinpoints which of these issues applies to you. Correcting the specific error is essential for a successful appeal.

Federal Legal Protections & Regulations

Key Statutes and Regulations Every Claimant Should Know

• 20 C.F.R. § 404.1512 – Your duty to provide medical evidence vs. SSA’s duty to develop the record.

• 20 C.F.R. § 404.1526 – Medical equivalence when you do not exactly meet a Blue Book listing.

• 42 U.S.C. § 406 – Attorney-fee caps (25% of past-due benefits or $7,200, whichever is less, as of Nov 2022).

• Social Security Ruling (SSR) 16-3p – Clarifies how symptom statements are evaluated without a “credibility” finding.

Recent Federal Court Decisions Impacting Texas Claimants

In Woods v. Kijakazi, 32 F.4th 785 (5th Cir. 2022), the Fifth Circuit held that an Administrative Law Judge (ALJ) must articulate how persuasive each medical opinion is under the 2017 “new rules.” Because Aurora (CO) falls within the jurisdiction of the Northern District of Texas for federal suits, this precedent can strengthen your district-court appeal if the ALJ discounted your treating physician without explanation.

Steps to Take After an SSDI Denial

1. File a Timely Request for Reconsideration

Use Form SSA-561 and submit it online or at the local field office within 60 days. Attach new evidence, such as updated MRIs or recent lab results. Missing the deadline usually forces you to start a new application and forfeit back-pay.

2. Prepare for the Administrative Law Judge Hearing

If reconsideration fails (and it often does), request a hearing. Average wait times at the Fort Worth Hearing Office were 10.6 months in FY 2023, according to SSA’s quarterly workload reports. During this period:

• Gather opinion letters from treating specialists.

• Create a daily-symptom diary to substantiate subjective pain.

Review the HALLEX rules on requesting subpoenas if a reluctant physician’s testimony is critical.

3. Appeals Council Review

You may submit written arguments pointing out ALJ legal errors (e.g., failure to consider non-exertional limitations). Roughly 13% of cases nationwide are remanded at this level.

4. Federal Court

The U.S. District Court for the Northern District of Texas (Fort Worth Division) has jurisdiction over Aurora (CO) SSDI cases. You must file within 60 days of the Appeals Council denial and serve the U.S. Attorney for the Northern District of Texas.

When to Seek Legal Help for SSDI Appeals

While you have the right to self-represent, the SSA’s own statistics show that claimants represented by attorneys are more likely to win benefits at the hearing level. Consider retaining counsel if:

• Your disability stems from complex conditions—e.g., a combination of PTSD and spinal stenosis—that require vocational expert cross-examination.

• You need to subpoena records from out-of-state VA hospitals or private clinics.

• Your initial onset date is disputed, affecting thousands in potential back-pay.

• You have a prior denial less than 12 months old and risk res judicata.

A qualified aurora (co) disability attorney licensed in Texas can gather medical opinions, draft legal briefs, and translate SSA jargon into plain English—all on a contingency-fee basis approved only if you win.

Local Resources & Next Steps

Nearest SSA Offices Serving Aurora (CO), Texas

• Decatur Field Office – 1701 S U.S. Hwy 81/287, Decatur, TX 76234. Phone: 866-593-0930.

• Fort Worth Hearing Office (ODAR) – 819 Taylor St., Fort Worth, TX 76102. Phone: 877-405-3543.

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

Hospitals & Treating Sources

Local medical evidence is vital. Wise Health System in Decatur and Baylor Scott & White Medical Center in Grapevine both provide digital radiology portals—making it easier for your attorney to upload records through SSA’s Electronic Records Express.

Free Community Help

• Legal Aid of Northwest Texas – Offers limited SSDI advice clinics (income caps apply).

• Area Agency on Aging—North Central Texas – Helps older claimants file appeals and access transportation to hearings.

Conclusion: Protect Your Right to Benefits

An SSDI denial is not the end of the road for Aurora (CO), Texas residents. By understanding federal regulations, meeting strict deadlines, and leveraging local resources, you can turn a "No" into a "Yes." The SSA appeal system is designed to correct its own mistakes—provided you insist on every protection the law affords.

Legal Disclaimer

This guide is for informational purposes only and does not constitute legal advice. For advice about your specific situation, consult a licensed Texas attorney.

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