SSI vs SSDI: Denial Appeal Guide for Tennessee, Tennessee

Introduction: Why SSDI Appeals Matter to Tennesseans

Tennessee’s nearly 7 million residents include more than 950,000 people living with a disability, according to the U.S. Census Bureau. If you are one of them and can no longer work full-time, Social Security Disability Insurance (SSDI) may be a lifeline. Unfortunately, the Social Security Administration (SSA) initially denies roughly two out of every three SSDI applications filed nationwide. Tennesseans are no exception. This guide explains—step by step—how to protect your rights, why denials happen, and what you can do to strengthen your appeal under federal law. While we slightly favor the claimant’s perspective, every statement that follows is grounded in authoritative sources such as the Social Security Act, the Code of Federal Regulations, and SSA Program Operations Manual System (POMS).

Understanding Your SSDI Rights in Tennessee

How SSDI Differs from SSI

Although this article focuses on SSDI denials and appeals, many Tennessee residents confuse Supplemental Security Income (SSI) with Social Security Disability Insurance (SSDI). The biggest differences are:

• Funding source: SSDI is funded by payroll taxes under Title II of the Social Security Act; SSI is a need-based program funded by general tax revenues under Title XVI.

• Work history: SSDI requires that you earned enough quarters of coverage through FICA contributions (20 C.F.R. § 404.130). SSI does not.

• Income/asset limits: SSI imposes strict resource limits; SSDI does not, but it does limit substantial gainful activity (20 C.F.R. § 404.1571).

Knowing which program you applied for is essential, because each has a separate set of technical requirements. This guide zeroes in on SSDI, but many appeal steps overlap with SSI as well.

The Five-Step Sequential Evaluation Process

The SSA decides every SSDI case using the five-step sequential evaluation outlined in 20 C.F.R. §§ 404.1520 & 416.920. In short, the agency asks:

• Are you working above substantial gainful activity (SGA)?

• Is your impairment ‘severe’ under SSA rules?

• Does it meet or equal a Listing of Impairments criterion?

• Can you perform any past relevant work?

• Can you adjust to other work in the national economy?

An error at any of these stages can trigger an unjust denial. Tennesseans have the same federal protections as claimants in every other state, but local vocational data and medical evidence often tip the scales.

Common Reasons SSA Denies SSDI Claims

SSA denial letters (form SSA-LRFD) usually cite one of the following grounds:

• Medical evidence is insufficient to prove a severe or listing-level impairment.

• Non-medical technical issues such as lack of work credits or failure to cooperate with requests for records.

• Residual functional capacity (RFC) finding indicating you can still perform past relevant work or other jobs identified by a vocational expert.

• Substantial gainful activity (SGA) if your earnings exceeded the monthly threshold ($1,550 for non-blind claimants in 2024).

• Missed consultative examination (CE) appointments.

Because these decisions rely heavily on paperwork, even a minor clerical mistake—such as mislabeling MRI results—can derail an otherwise strong claim.

Federal Legal Protections & Regulations You Need to Know

Key Statutes and Regulations

The backbone of every SSDI appeal is federal law. The most frequently cited authorities include:

• Social Security Act § 205(b) – Guarantees the right to a hearing after a denial.

• 20 C.F.R. § 404.900 et seq. – Lays out the four-step administrative appeal process.

• 20 C.F.R. §§ 404.1512 & 404.1513 – Define the claimant’s and SSA’s responsibility to develop the medical record.

• 42 U.S.C. § 405(g) – Grants federal courts jurisdiction to review final SSA decisions.

Under these rules, Tennessee claimants have a constitutional due-process right to present evidence, confront adverse findings, and obtain written decisions at every stage.

Statute of Limitations for Appeals

You have 60 days from the date you receive a denial notice to appeal to the next level (20 C.F.R. § 404.909(a)(1)). The SSA presumes you receive the notice five days after mailing, but you can rebut that presumption with proof of late delivery.

Steps to Take After an SSDI Denial

Tennessee residents must follow the same federal four-step path as everyone else, but local hearing backlogs and venue rules can influence timing.

1. Request for Reconsideration

File SSA-561 and form SSA-3441-BK within 60 days. In Tennessee, reconsideration decisions generally take 2–4 months. Be sure to:

• Submit new medical evidence from treating physicians at Vanderbilt University Medical Center, UT Medical Center, or other local providers.

• Identify any listing-level impairments in the Blue Book.

2. Administrative Law Judge (ALJ) Hearing

If reconsideration fails, request an ALJ hearing via form HA-501. Hearings for Tennessee claims are scheduled at:

• Nashville ODAR, 6840 Carothers Pkwy, Franklin, TN 37067

• Knoxville ODAR, 800 S. Gay St., Knoxville, TN 37929

• Chattanooga ODAR, 1232 Premier Dr., Chattanooga, TN 37421

You may testify in person, by video, or—if justified—by telephone. A vocational expert (VE) will likely appear. Cross-examining the VE about job erosion in Tennessee’s labor market can be pivotal.

3. Appeals Council Review

An unfavorable ALJ decision can be appealed within 60 days to the Appeals Council in Falls Church, Virginia. You must explain specific legal errors or present new and material evidence under 20 C.F.R. § 404.970.

4. Federal District Court

If the Appeals Council denies review or issues an adverse decision, you have 60 days to file a civil action in the U.S. District Court for the Eastern, Middle, or Western District of Tennessee (42 U.S.C. § 405(g)). No new evidence is admitted; the court reviews the administrative record for substantial evidence and legal errors.

When to Seek Legal Help for SSDI Appeals

While you can represent yourself at every administrative level, data from the SSA Office of the Inspector General shows that claimants represented by an attorney win benefits at a significantly higher rate. Here’s why:

• Case development: Attorneys know how to obtain medical source statements that satisfy SSA’s treating-physician rule (20 C.F.R. § 404.1520c).

• Procedural compliance: Missing a 60-day deadline can force you to start over, costing months or years of benefits.

• Cross-examination skills: Effective questioning of vocational and medical experts can expose flaws in SSA findings.

Fees are capped at 25% of past-due benefits or $7,200 (as of November 2022), whichever is less, under 42 U.S.C. § 406(a)(2)(A).

Local Resources & Next Steps for Tennessee Claimants

SSA Field Offices

Below are the three busiest Social Security field offices in Tennessee. You can file appeals, drop off evidence, or update contact information at any branch:

• Nashville Social Security Office – 120 Athens Way, Nashville, TN 37228

• Memphis Social Security Office – 3602 Austin Peay Hwy, Memphis, TN 38128

• Knoxville Social Security Office – 9031 Cross Park Dr, Knoxville, TN 37923

Medical Facilities Familiar with SSA Documentation

• Vanderbilt University Medical Center – Nashville

• Erlanger Health System – Chattanooga

• University of Tennessee Medical Center – Knoxville

Providing records from these facilities can expedite SSA’s consultative exams because they are already on electronic record with Disability Determination Services (DDS) in Nashville.

Legal Aid and Advocacy Groups

Legal Aid Society of Middle Tennessee & the Cumberlands Tennessee Alliance for Legal Services Disability Rights Tennessee

Authoritative External References

20 C.F.R. § 404.1520 – Sequential Evaluation Process SSA Appeals Information Social Security Act § 205(b) Tennessee Board of Professional Responsibility (Attorney Licensing)

Legal Disclaimer

This guide provides general information for Tennessee residents and is not legal advice. Laws and regulations change. Always consult a licensed Tennessee attorney for advice about your specific SSDI case.

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