SSDI Denial Guide for Montana, Montana Claimants

Introduction: Why a Local SSDI Guide Matters to Montana Residents

Montana’s sweeping plains, rugged mountains, and tight-knit communities make it unique, but they do not insulate its residents from serious injuries and illnesses. In 2023 the Social Security Administration (SSA) reported that more than 9,000 Montanans relied on Social Security Disability Insurance (SSDI) benefits to keep a roof over their heads and food on the table. Unfortunately, the SSA initially denies roughly two-thirds of all SSDI applications nationwide. If you live in Billings, Missoula, Great Falls, Bozeman, or any of Montana’s rural counties and recently received a denial letter, this guide explains—step by step—how to protect your rights, meet every federal deadline, and present the strongest possible appeal.

The information below slightly favors claimants because you, the disabled worker, face the steepest personal and financial stakes in the process. At the same time, every statement is grounded in authoritative sources such as the Social Security Administration, the Code of Federal Regulations (20 CFR Part 404), and published federal court decisions from the Ninth Circuit, which has appellate jurisdiction over Montana.

Understanding Your SSDI Rights

The Legal Foundation

SSDI is a federal insurance program authorized by Title II of the Social Security Act. If you have earned sufficient quarters of coverage (work credits) and meet the SSA’s definition of disability—an impairment lasting at least 12 months or expected to result in death—you are entitled to benefits. Key federal protections include:

• Due Process (42 U.S.C. § 405(b)): You have the right to written notice of any adverse decision and an opportunity for a hearing.

• Sequential Evaluation (20 CFR § 404.1520): SSA must follow a five-step process when evaluating disability claims, considering work activity, severity of impairment, listings, past work, and other work.

• Non-Adversarial Hearings (20 CFR § 404.900 et seq.): Administrative Law Judges (ALJs) must develop the record fully and fairly.

Your Right to Representation

Federal law (42 U.S.C. § 406) allows you to appoint a qualified representative, and attorney’s fees are generally capped at 25 percent of past-due benefits or $7,200, whichever is lower, unless a fee petition is filed. In Montana, attorneys must be licensed by the State Bar of Montana and compliant with its professional responsibility rules.

Common Reasons SSA Denies SSDI Claims

The SSA issues millions of technical and medical denials every year. The most frequent grounds include:

• Insufficient Work Credits: If you have not worked enough in covered employment within the required date last insured, SSA will deny the claim under 20 CFR § 404.130.

• Earnings Above Substantial Gainful Activity (SGA): For 2024, non-blind workers earning more than $1,550 per month are generally ineligible (20 CFR § 404.1571).

• Lack of Medical Evidence: A denial may cite insufficient objective findings, such as MRIs, lab results, or specialist opinions.

• Failure to Follow Prescribed Treatment (20 CFR § 404.1530): The SSA can deny if you do not comply with recommended therapy without good cause.

• Ability to Perform Past Relevant Work: If the vocational analysis finds you can still do work you performed in the past 15 years, the claim fails at Step 4.

Understanding the specific reason in your Notice of Disapproved Claim is critical because it dictates the medical and vocational evidence you must gather for appeal.

Federal Legal Protections & Regulations

Key Statutes and Regulations

• 20 CFR § 404.900–404.999: Governs the SSA’s four-level administrative review process—Reconsideration, Administrative Law Judge Hearing, Appeals Council review, and Federal Court.

• 20 CFR § 404.1512: Outlines the claimant’s burden to provide medical and vocational evidence.

• 42 U.S.C. § 405(g): Authorizes judicial review in U.S. District Court after administrative remedies are exhausted.

Deadlines You Cannot Miss

You generally have 60 days from the date you receive any denial notice to file the next appeal step. The SSA presumes you received the letter five days after mailing (20 CFR § 404.901). Missing the deadline can forfeit your rights unless you show good cause under 20 CFR § 404.911.

Steps to Take After an SSDI Denial

1. Reconsideration (First Appeal Level)

If your initial application was processed by Montana’s Disability Determination Services (DDS) in Helena and denied, the first step is a Reconsideration. A new examiner and medical consultant review your file. You may submit additional evidence, such as:

• Updated hospital records from Benefis Health System in Great Falls.

• Specialist reports from St. Patrick Hospital in Missoula or Billings Clinic.

• Functional capacity evaluations or mental health assessments from local providers.

Tip: Send evidence early; DDS reviewers must receive it at least 10 days before they issue a determination (20 CFR § 404.1512).

2. Administrative Law Judge (ALJ) Hearing

If Reconsideration fails, request an ALJ hearing. As of 2024 ALJ hearings for Montana residents are typically held by video or in person at the following hearing office:

Billings ODAR Hearing Office 2900 4th Avenue N, Ste 500 Billings, MT 59101

You may introduce new evidence and call witnesses, including vocational experts (VEs) and medical experts (MEs). The ALJ will issue a fully favorable, partially favorable, or unfavorable decision.

3. Appeals Council Review

If the ALJ denies your claim, you have 60 days to ask the Appeals Council in Falls Church, Virginia, to review the decision. The Council may:

• Deny your request, making the ALJ’s ruling final.

• Grant review and issue its own decision.

• Remand the case back to the ALJ for further proceedings.

Statistics: In fiscal year 2022, the Appeals Council granted review in roughly 14 percent of cases nationwide, according to SSA data.

4. Federal Court

After exhausting administrative remedies you may file a civil action in the U.S. District Court for the District of Montana. The court reviews the record under the substantial evidence standard and may affirm, reverse, or remand the case. Appeals from the district court go to the U.S. Court of Appeals for the Ninth Circuit.

When to Seek Legal Help for SSDI Appeals

Although you may represent yourself at any level, retaining a qualified Montana disability attorney can greatly improve your odds. Experienced counsel will:

• Analyze the technical basis of denial and develop tailored medical evidence.

• Cross-examine vocational experts to challenge transferable skills findings.

• Prepare you to testify clearly about your limitations, pain, and daily activities.

• Ensure every appeal is filed on time and conforms to complex regulatory requirements.

Fee arrangements: Under 42 U.S.C. § 406(a), attorney fees are withheld from past-due benefits and paid directly by SSA, so you owe nothing up front.

Local Resources & Next Steps

Montana SSA Field Offices

Billings Social Security Office 2900 4th Ave N, Room 100 Billings, MT 59101 Great Falls Social Security Office 2008 23rd St S Great Falls, MT 59405 Helena Social Security Office 10 W 15th St, Suite 1100 Helena, MT 59626 Missoula Social Security Office 610 North Wyoming St, Suite 110 Butte, MT 59701 (serves Missoula by appointment)

Medical Providers Familiar with SSDI Documentation

• Benefis Health System – Comprehensive neurological and orthopedic services in Great Falls.

• Billings Clinic – Regional Level II trauma center with multiple specialty clinics.

• Providence St. Patrick Hospital – Leading cardiology and oncology care in Missoula.

Vocational and Independent Living Support

Montana Vocational Rehabilitation & Blind Services Montana Statewide Independent Living Council

Contact Information for the Appeals Council and Federal Court

SSA Appeals Council 5107 Leesburg Pike, Falls Church, VA 22041-3255 U.S. District Court – District of Montana James F. Battin U.S. Courthouse 2601 2nd Ave N, Billings, MT 59101

Conclusion

Facing an SSDI denial is discouraging, but it is not the end of the road. Federal regulations give you multiple chances to prove your disability, and Montana offers a network of legal, medical, and vocational resources to bolster your claim. Act quickly, gather complete medical evidence, and consider partnering with a seasoned Montana disability attorney to maximize your likelihood of success.

Legal Disclaimer: This guide is for informational purposes only and does not constitute legal advice. Consult a licensed Montana attorney 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.