SSDI Denial Appeals Guide – Overland Park, Texas

Introduction: Why an SSDI–Specific Guide for Overland Park, Texas Matters

If you live in Overland Park, Texas and your claim for Social Security Disability Insurance (SSDI) was denied, you are far from alone. Texas consistently ranks among the five states with the highest number of disability filings, yet according to the Social Security Administration’s (SSA) FY 2022 State Agency Workload Data, only about 38 % of initial Texas applications were approved—slightly below the national average.1 That means roughly six out of ten Texans must enter the appeals process to secure the benefits they worked and paid taxes for. This comprehensive guide explains every appeal level, cites governing federal regulations, and pinpoints local resources—from the nearest SSA field office to the Dallas hearing office that schedules most Overland Park cases. Our goal is to empower you with strictly factual, evidence-based information while gently emphasizing the rights of claimants.

Understanding Your SSDI Rights

SSDI Is an Earned Benefit—Not a Handout

SSDI is funded through the Federal Insurance Contributions Act (FICA) taxes you paid while working. Under Section 223 of the Social Security Act, you have a statutory right to monthly disability insurance payments if you (1) meet the earnings requirements and (2) cannot engage in substantial gainful activity because of a medically determinable impairment expected to last at least 12 months or result in death.

Key Rights Guaranteed by Federal Law

• Due Process: Section 205(b) of the Social Security Act and 20 CFR 404.902 give you the right to written notice explaining the reasons for any unfavorable determination.

• Four-Level Appeals Structure: Under 20 CFR 404.909, 404.933, 404.967, and 422.205, you can request (1) reconsideration, (2) a hearing before an Administrative Law Judge (ALJ), (3) review by the Appeals Council, and (4) federal court review.

• Representation: You may appoint any qualified representative, including an attorney licensed by the State Bar of Texas (Texas Government Code §81.051).

• Access to Your File: Under 20 CFR 404.1615, you can inspect or obtain copies of all medical and vocational records the SSA used in making its decision.

Common Reasons SSA Denies SSDI Claims

Technical (Non-Medical) Denials

• Insufficient Work Credits: Workers generally need 20 credits earned in the 10 years before disability onset.2

• Excess Substantial Gainful Activity (SGA): In 2024, earning more than $1,550 per month (non-blind) disqualifies you at Step 1 of the sequential evaluation.

• Missed Deadlines: Failing to respond to SSA requests or to appeal within 60 days (+ 5 for mailing) leads to dismissal.

Medical Denials

• Severity Not Established: Lack of objective testing, minimal treatment history, or primarily subjective complaints.

• Condition Did Not Last 12 Months: Acute injuries expected to heal can trigger denial at Step 2.

• Residual Functional Capacity (RFC) Findings: DDS physicians may find you can still perform past work (Step 4) or other work in the national economy (Step 5).

Understanding the exact reason in your Notice of Disapproved Claim is essential for crafting a winning appeal.

Federal Legal Protections & Regulations Every Texan Should Know

Appeal Deadlines and Statutes of Limitations

• Reconsideration (20 CFR 404.909): 60 days from receipt of denial.

• ALJ Hearing (20 CFR 404.933): 60 days from reconsideration denial.

• Appeals Council Review (20 CFR 404.968): 60 days from hearing decision.

• U.S. District Court (42 U.S.C. §405(g)): 60 days from Appeals Council denial.

Missing any deadline usually forces you to start a brand-new claim—costly and time-consuming—unless you qualify for good-cause reopening under 20 CFR 404.911.

Burden of Proof and the Five-Step Sequential Evaluation

At Steps 1–4, the claimant bears the burden of proof; at Step 5, SSA bears the burden to show other work exists. 20 CFR 404.1520 outlines these steps in detail.

Attorney Fees Are Federally Capped

Under 42 U.S.C. §406(a)(2)(A), fees are generally limited to 25 % of past-due benefits, not to exceed $7,200 (as adjusted periodically), and must be approved by SSA.

Conflicts of Interest & Licensing in Texas

Texas attorneys must follow the Texas Disciplinary Rules of Professional Conduct.3 Always verify your lawyer is in good standing via the State Bar of Texas Attorney Lookup.

Steps to Take After an SSDI Denial

1. Read the Notice Carefully

The denial letter lists the medical exhibits, work history considered, and statutory basis for denial. Mark the date on the envelope or the letter (whichever is later) to calculate your 60-day appeal window.

2. File a Timely Request for Reconsideration

Submit SSA-561 (Request for Reconsideration) and SSA-3441 (Disability Report – Appeal) online or at any SSA office.4 Attach new medical evidence and clarify errors (e.g., wrong onset date).

3. Bolster the Medical Record

• Ask treating doctors to complete SSA-specific Residual Functional Capacity (RFC) forms.

• Collect imaging, lab results, operative reports, and therapy notes covering the entire claimed period.

• If you lack continuous treatment, consider community clinics such as Parkland Health’s E. Carlyle Smith Jr. Clinic, approximately 25 miles from Overland Park, which offers sliding-scale fees.

4. Prepare for an ALJ Hearing Early

In Texas, average wait time for a hearing is about 10–12 months.5 Use this gap to:

Request your electronic claims file (e-Folder) via mySSA.

• Arrange vocational expert (VE) interrogatories if warranted under HALLEX I-2-5-55.

• Organize non-medical evidence—employer statements, symptom diaries, third-party function reports (SSA-3380).

5. Keep Income Below the SGA Threshold

Even part-time earnings above SSA’s monthly SGA limit jeopardize retroactive benefits. Track all income and consult counsel before attempting trial work periods (20 CFR 404.1592).

When to Seek Legal Help for SSDI Appeals

Indicators You Need a Lawyer or Representative

• Complex Medical Evidence: Multiple conditions, mental health comorbidities, or rare diseases.

• Prior Denials: A second or third denial suggests systemic issues that legal expertise can address.

• Adverse Vocational Evidence: The DDS or a VE claims you can perform sedentary work despite severe limitations.

• Critical Financial Need: An attorney can request an on-the-record (OTR) decision to speed up payment.

Why Representation Improves Outcomes

National SSA statistics show claimants with representatives are nearly three times more likely to be approved at hearing.6 Experienced lawyers know how to cross-examine vocational experts, submit pre-hearing briefs, and preserve issues for federal court review.

Local Resources & Next Steps for Overland Park Claimants

Nearest SSA Field Offices

Dallas Oak Cliff SSA Office 2475 Cliff Creek Crossing Dr. Dallas, TX 75237 Phone: 866-331-9091 Dallas Northeast SSA Office 10824 N. Central Expy. Dallas, TX 75231 Phone: 866-593-1341

Hearing Office Serving Overland Park, TX

Dallas Office of Hearings Operations (OHO) 1301 Young St., Suite 340 Dallas, TX 75202

Medical Providers Familiar With SSA Forms

• Baylor Scott & White Medical Center – Irving (forms completed for a small fee)

• Parkland Health Community Clinics (sliding-scale RFC and narrative letters)

Free or Low-Cost Legal Clinics

• Legal Aid of NorthWest Texas – Disability Benefits Unit

• Dallas Volunteer Attorney Program (DVAP) – Monthly intake clinics in Irving and Grand Prairie

Authoritative References

SSA – Official Appeals Process 20 CFR 404.909 – Reconsideration Social Security Act § 205(b) SSA Field Office Locator

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.