SSDI Denial Appeals Guide for Burbank, Texas Claimants

Introduction: Why This Guide Matters to Burbank, Texas Residents

Being denied Social Security Disability Insurance (SSDI) can feel overwhelming, especially if you live in Burbank, Texas—a small San Antonio neighborhood served by the San Antonio South Social Security field office. Yet, a denial is not the end of your claim. According to the Social Security Administration (SSA) Office of Retirement and Disability Policy, roughly two-thirds of initial SSDI applications are denied nationwide, but many denials are overturned on appeal. Knowing your rights, the federal regulations that protect you, and the local procedures that apply to Burbank residents can greatly improve your odds of success. This comprehensive, location-specific guide explains every step of the appeals process and highlights local resources so you can move forward with confidence.

Understanding Your SSDI Rights

Who Qualifies for SSDI?

SSDI provides cash benefits to workers who have accumulated sufficient work credits and who meet the SSA’s definition of disability under 42 U.S.C. § 423(d) (Social Security Act §223). In brief, you must:

• Have a medically determinable physical or mental impairment expected to last at least 12 months or result in death.

• Be unable to perform substantial gainful activity (SGA) as defined in 20 CFR 404.1572.

• Have earned the required number of work credits (generally 20 credits in the 10 years before disability onset for adults age 31 or older).

Texas workers pay into the Social Security system through payroll taxes, so these benefits are insurance you have earned—not a handout. If your initial claim is denied, federal law gives you a clear, multi-level appeal path.

Your Due-Process Protections

Under Social Security Act § 205(b) (42 U.S.C. § 405(b)) and its implementing regulation 20 CFR 404.900, you have a constitutional right to notice and an opportunity to be heard at every stage of the SSDI adjudication process. This includes:

• A written denial explaining the specific reasons and the evidence SSA used.

• A 60-day window (plus five days for mailing) to request further review.

• The right to submit additional medical evidence and appear before an impartial Administrative Law Judge (ALJ).

These protections apply equally in Burbank, Texas, whether your claim is handled by SSA staff in San Antonio or by a federal judge on appeal.

Common Reasons SSA Denies SSDI Claims

Understanding why SSA frequently denies claims can help you frame a stronger appeal:

• Insufficient medical evidence. SSA may decide your records do not prove a severe impairment under 20 CFR 404.1520(a)(4).

• Ability to perform past relevant work. If SSA believes you can still do your previous job, denial will follow at Step 4 of the five-step evaluation.

• Ability to adjust to other work. At Step 5, SSA may determine there are other jobs in the national economy you can do.

• Non-medical technical issues. Lack of sufficient work credits or earnings above the SGA limit can trigger an early denial.

• Failure to cooperate. Missing consultative exams, deadlines, or forms can result in denial under 20 CFR 404.911.

Many of these issues can be corrected by submitting updated records, vocational evidence, or witness statements during the appeal.

Federal Legal Protections & Regulations

Key Regulations Every Claimant Should Know

Below are the most frequently cited federal regulations in SSDI appeals. Each is publicly available through the Electronic Code of Federal Regulations.

• 20 CFR 404.1505 – Defines disability for SSDI.

• 20 CFR 404.1520 – Five-step sequential evaluation process.

• 20 CFR 404.1512 – Evidence rules: your duty to provide medical evidence.

• 20 CFR 404.900–404.999 – Administrative review process and deadlines.

• 20 CFR 404.979 – ALJ’s authority to develop evidence at a hearing.

Statute of Limitations for SSDI Appeals

Under 20 CFR 404.909(a)(1), you have 60 days from receiving any unfavorable determination to request the next administrative step. SSA presumes you receive notices within five days of mailing (20 CFR 404.901). Missing the deadline usually forfeits your right to further review, although good-cause extensions exist under 20 CFR 404.911. After the Appeals Council denial, you have 60 days to file a civil action in the U.S. District Court for the Western District of Texas, San Antonio Division (the proper venue for residents of Burbank).

Steps to Take After an SSDI Denial

1. Request Reconsideration

Most Burbank applicants receive their first denial from the Disability Determination Services (DDS) in Austin. File the SSA-561 Request for Reconsideration within 60 days. You may submit new evidence and written statements. According to SSA data, roughly 13% of Texas reconsiderations are allowed, so do not be discouraged—this step is required to reach the hearing level.

2. Prepare for Your ALJ Hearing

If reconsideration is denied, request a hearing using Form HA-501. Your case will likely be scheduled at the Social Security OHO Hearing Office in San Antonio located at 727 Isom Rd, Suite 200, San Antonio, TX 78216.

• Exchange evidence early. 20 CFR 405.331 requires evidence submission at least five business days before the hearing.

• Line up witnesses. Vocational or medical experts can clarify how your impairments limit work.

• Review your entire file. You can access your electronic folder through my Social Security or request a CD copy.

As of the SSA’s FY 2023 data, the San Antonio hearing office reported an average approval rate of about 52%, slightly higher than the national average (source: SSA OHO Public Service Data).

3. Appeals Council Review

If the ALJ denies your claim, submit Form HA-520 to the Appeals Council in Falls Church, Virginia. You may ask for a review based on errors of law, abuse of discretion, or new and material evidence per 20 CFR 404.970. Less than 2% of claims are approved outright at this level, but around 10% are remanded for a new hearing.

4. Federal Court Action

The final option is filing suit in the U.S. District Court. Federal judges review the record for “substantial evidence” and legal errors. You must file within 60 days of the Appeals Council denial and serve the U.S. Attorney for the Western District of Texas.

When to Seek Legal Help for SSDI Appeals

While claimants may represent themselves, SSA’s own statistics show that represented claimants have significantly higher approval rates at the hearing level. Reasons to consider hiring a burbank disability attorney include:

• Gathering objective medical opinions tied to SSA disability criteria.

• Questioning vocational experts effectively.

• Meeting tight evidence and filing deadlines.

• Preparing written legal briefs citing governing regulations and Fifth Circuit precedent.

Under 20 CFR 404.1720, all representatives must be attorneys in good standing or SSA-qualified non-attorneys. Texas attorneys are licensed by the State Bar of Texas and bound by ethical rules set by the Texas Supreme Court. Fee arrangements are strictly regulated: maximum 25% of past-due benefits, capped at $7,200 (2024 limit) per 42 U.S.C. § 406(a)(2)(A).

Local Resources & Next Steps

Key SSA Offices Serving Burbank, Texas

Field Office (San Antonio South) 3438 E Southcross Blvd, San Antonio, TX 78223 Phone: 866-593-0675 Hours: 9 a.m.–4 p.m., Mon–Fri Hearing Office (OHO) 727 Isom Rd, Ste 200, San Antonio, TX 78216

Community Medical Providers Familiar with SSA Documentation

Submitting consistent treatment records is critical. Burbank residents often rely on nearby providers such as University Health System–Robert B. Green Campus and the Baptist Medical Center downtown. Always request full charts, imaging, and RFC (Residual Functional Capacity) assessments.

Support Organizations

• Texas RioGrande Legal Aid (TRLA) – Offers limited SSDI advice to qualifying low-income residents.

• Disability Rights Texas – The federally designated Protection & Advocacy (P&A) agency for Texans with disabilities.

Action Plan Checklist

• Mark your 60‐day appeal deadline on a calendar.

• Request all updated medical records.

• File the correct SSA form (SSA-561, HA-501, etc.) on time.

• Consult a qualified SSDI appeals attorney before the hearing stage.

• Prepare witness testimony and written briefs citing 20 CFR 404.1520.

Authoritative References

20 CFR 404.1520 – Five-Step Evaluation

Social Security Act §223 – Disability Insurance Benefits

SSA Administrative Appeals Chart

SSA OHO Hearing Office Disposition Data

Legal Disclaimer

This guide is for informational purposes only and does not constitute legal advice. Consult a licensed Texas attorney for advice about 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.