SSDI Denial Appeals Guide for Des Moines, Texas

Introduction: Why This SSDI Denial Appeal Guide Matters to Des Moines, Texas Residents

Receiving a Social Security Disability Insurance (SSDI) denial can feel overwhelming, especially if you live in a small Texas community like Des Moines. Although Des Moines is unincorporated and does not have its own Social Security field office, residents fall under the jurisdiction of the Social Security Administration (SSA) Dallas–Fort Worth regional office (Region VI). According to SSA data, more than two million disability claims are filed nationwide each year, and roughly 65 percent of initial applications are denied (SSA Annual Statistical Report). With denial rates this high, understanding the appeals process and your federally protected rights is essential. This location-specific guide explains what Des Moines claimants need to know about SSDI denials and appeals. We cite authoritative federal regulations—including 20 C.F.R. §404.909 (Request for Reconsideration) and 20 C.F.R. §404.1505 (Definition of Disability)—and key provisions of the Social Security Act, such as §223(d) and §205(b). Our goal is to equip you with clear, factual information so you can protect your benefits, meet strict deadlines, and decide whether working with a des moines disability attorney makes sense for your situation.

Understanding Your SSDI Rights

Federal Definition of Disability

Under Social Security Act §223(d)(1)(A), you are considered disabled if you are unable to engage in any substantial gainful activity (SGA) because of a medically determinable physical or mental impairment that has lasted—or is expected to last—at least 12 months or result in death. In regulatory language, this standard is elaborated in 20 C.F.R. §404.1505. Importantly, SSA evaluates disability functionally, meaning the agency looks at how your condition limits work-related activities rather than just the diagnosis label.

Core Rights After an SSDI Denial

• Written Notice: SSA must issue a denial letter that explains the specific reason(s) for its decision (Social Security Act §205(b)).

• Right to Appeal: You may challenge an adverse decision through up to four administrative levels, followed by federal court review.

• Representation: You can hire an attorney or non-attorney representative; fees are regulated by 42 U.S.C. §406 and 20 C.F.R. §404.1720-404.1799.

• Evidence Submission: SSA must consider all “material evidence” you submit at each stage (20 C.F.R. §404.1512).

• No Up-Front Attorney Fees: Most SSDI lawyers work on contingency, meaning they are paid only if benefits are awarded, subject to a statutory fee cap.

Common Reasons SSA Denies SSDI Claims

While each denial is fact-specific, SSA decision writers often refer to the same regulatory standards when rejecting an application. Understanding these rationales helps you gather targeted evidence for appeal.

1. Insufficient Medical Evidence

Under 20 C.F.R. §404.1513, objective medical evidence must come from acceptable medical sources such as licensed physicians or psychologists. If your file lacks imaging studies, laboratory results, or consistent treatment notes, SSA may conclude that your impairment is not “severe” under 20 C.F.R. §404.1520(c).

2. Residual Functional Capacity (RFC) Assessment

SSA evaluates your ability to sustain work activities using an RFC analysis (20 C.F.R. §404.1545). Many claimants are denied because the agency finds they can perform past relevant work or adjust to other work in the national economy—even if they cannot return to their former job.

3. Substantial Gainful Activity (SGA)

For 2024, monthly earnings of $1,550—or $2,590 if you are blind—generally disqualify you from SSDI (SSA SGA Guidelines). If SSA records show earnings above the SGA level during the alleged onset period, the claim will likely be denied.

4. Non-Medical Technical Denials

• Insufficient Work Credits: Claimants must have worked long enough and recently enough in covered employment (20 C.F.R. §404.130–404.132).

• Missed Deadlines: Failure to respond to SSA requests for information or consultative exams can trigger a technical denial.

• Residency/Citizenship Issues: Certain non-citizens must meet additional eligibility criteria.

Federal Legal Protections & Regulations

Key Regulations Every Des Moines Claimant Should Know

20 C.F.R. §404.909 – Request for Reconsideration Sets the 60-day deadline (plus five mailing days) to appeal an initial denial. Missing it generally bars further review unless you show “good cause.” 20 C.F.R. §404.933 – Hearing Before an Administrative Law Judge (ALJ) Details how to request a hearing, scheduling procedures, and evidence submission rules. 20 C.F.R. §404.967 – Appeals Council Review Explains the Appeals Council’s discretion to deny, dismiss, or grant review of an ALJ decision. 42 U.S.C. §405(g) – Federal Court Review Provides the statutory basis for filing suit in U.S. District Court within 60 days of an Appeals Council denial.

Statute of Limitations for Federal Court Appeals

After exhausting administrative remedies, a claimant must file a civil action in the appropriate U.S. District Court within 60 days of receiving the Appeals Council’s final decision (42 U.S.C. §405(g)). Courts generally presume receipt five days after the date on the notice, mirroring SSA mailing rules.

Steps to Take After an SSDI Denial

1. Read the Denial Letter Carefully

Your denial notice will detail medical and technical reasons for rejection. Flag each issue for rebuttal. SSA rules require “specific” rationale, and failure to provide it can constitute procedural error (see Sims v. Apfel, 530 U.S. 103 (2000)).

2. Calendar Your Deadline (60 days)

Under 20 C.F.R. §404.909(a), you have 60 days after receipt to file a Request for Reconsideration. Missing this deadline without good cause will force you to start over with a new application, resetting your potential back-pay period.

3. Strengthen Your Medical Record

• Request updated treatment notes from all healthcare providers.

• Obtain objective tests (e.g., MRIs, EMGs, neuro-psych evaluations) that document functional limitations.

• Ask your treating physician for a Medical Source Statement that addresses your ability to sit, stand, lift, and maintain concentration.

4. Submit a Detailed Work History Report

SSA form SSA-3369-BK requests detailed descriptions of your past work. Clarity here can make or break the RFC analysis, because improperly classified jobs may appear easier than they were.

5. File the Reconsideration

You may file online through SSA’s official appeal portal, by mail, or in person at your servicing field office. Keep a stamped copy or electronic confirmation as proof of timely filing.

6. Prepare for an ALJ Hearing

If Reconsideration is denied (nationally, about 88 percent are), request a hearing. Hearings are typically conducted by video from your nearest Office of Hearings Operations (OHO). For most residents in the Texas Panhandle—including Des Moines—the Amarillo OHO (Swift Building, 8th Floor, 300 Potter St., Amarillo, TX 79106) handles disability hearings. Always verify with the SSA’s hearing office locator.

7. Consider Appeals Council and Federal Court Options

The Appeals Council reviews fewer than 20 percent of requests, but filing preserves your right to federal court. A federal judge can affirm, reverse, or remand your case for a new hearing if the ALJ’s decision is not supported by substantial evidence.

When to Seek Legal Help for SSDI Appeals

While SSA does allow self-representation, federal data show that claimants represented by attorneys are statistically more likely to win benefits at the ALJ level (SSA Office of Retirement and Disability Policy, 2023). Below are scenarios in which hiring a des moines disability attorney may be crucial:

• Complex Medical Conditions: Multiple impairments or rare disorders require careful mapping to SSA Listing criteria (20 C.F.R. Pt. 404, Subpt. P, App. 1).

• Past Work Above SGA Level: An attorney can present trial work periods or unsuccessful work attempts to counter SSA earnings arguments.

• Prior Denials: Counsel can decide whether to reopen an old claim for a longer back-pay period (20 C.F.R. §404.988).

• Imminent Hearing: Hearings require cross-examining vocational and medical experts—tasks best handled by trained advocates.

Texas lawyers must be admitted to the State Bar of Texas and, for federal court actions, admitted to practice in the relevant U.S. District Court. Ethical rules for advertising and contingency fees are governed by Texas Disciplinary Rules of Professional Conduct and federal SSA fee regulations.

Local Resources & Next Steps for Des Moines Residents

SSA Field Office Information

Because Des Moines, Texas does not host its own SSA branch, residents typically visit or correspond with the Amarillo Social Security Field Office at 5710 Amarillo Blvd W, Suite 110, Amarillo, TX 79106 (Phone: 866-964-4929). Always confirm via the SSA Field Office Locator before visiting.

Nearby Medical Facilities

• Northwest Texas Healthcare System (Amarillo): Provides diagnostic imaging and specialist referrals helpful for objective medical evidence.

• Texas Tech University Health Sciences Center (Amarillo Campus): Offers multidisciplinary clinics and can complete SSA-required consultative exams.

Vocational & Community Support

The Texas Workforce Commission’s Vocational Rehabilitation Services office in Amarillo assists individuals with disabilities who want to explore return-to-work options without jeopardizing benefits (TWC Vocational Rehabilitation).

Checklist: Your Next 30 Days

• Mark the 60-day appeal deadline on your calendar.

• Request complete medical records and RFC questionnaires from all providers.

• Create an SSA.gov account to monitor your appeal status.

• Consult a qualified SSDI attorney if you have complex medical or technical issues.

Legal Disclaimer

This guide is for informational purposes only and does not constitute legal advice. Laws and regulations change frequently. You should consult a licensed Texas attorney about your specific situation.

Take Action Today

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