SSI vs SSDI Denial Guide – North Dakota, ND

Introduction: Facing an SSDI Denial in North Dakota

According to the Social Security Administration (SSA), more than half of initial Social Security Disability Insurance (SSDI) applications are denied nationwide. North Dakota residents are no exception. Whether you live in Fargo, Bismarck, Grand Forks, or a rural community along the Missouri River, an SSDI denial can jeopardize the financial stability you depend on while unable to work. This comprehensive guide explains the difference between SSI vs. SSDI, why claims get denied, and—most importantly—your legal options for appealing in North Dakota. We rely exclusively on authoritative sources, including the Social Security Act, the Code of Federal Regulations (CFR), and published federal court decisions, to give you an evidence-based roadmap tailored to North Dakota claimants.

Understanding Your SSDI Rights

SSI vs. SSDI: Why the Distinction Matters

The SSA offers two primary disability benefit programs:

Social Security Disability Insurance (SSDI) provides benefits to workers who have paid enough FICA taxes and meet the SSA’s definition of disability under Section 223 of the Social Security Act. Supplemental Security Income (SSI) is a need-based program for low-income individuals, codified at Section 1611 of the Social Security Act.

While the medical definition of disability is nearly identical for both programs, SSDI focuses on work history, whereas SSI evaluates financial need. This guide centers on SSDI denials and appeals, but many North Dakotans apply for both programs simultaneously.

Key Eligibility Criteria for SSDI

• You must have earned enough quarters of coverage (work credits) based on age, per 20 C.F.R. § 404.130.

• Your condition must meet the SSA’s strict definition of disability found at 20 C.F.R. § 404.1505: an impairment expected to last at least 12 months or result in death, preventing substantial gainful activity (SGA).

• You must prove the onset of disability occurred while you were insured under the SSDI program.

If the SSA concludes any of these requirements are missing, you will receive a written “Notice of Disapproved Claim.”

Common Reasons SSA Denies SSDI Claims

The SSA’s denial rationale is typically summarized in the notice you receive. The most frequent reasons include:

Insufficient Medical Evidence Medical records must demonstrate functional limitations. In North Dakota’s rural areas, gaps in treatment from clinic shortages (for example, in McKenzie County) may be misconstrued as lack of severity. Failure to Meet Duration Requirement Under 20 C.F.R. § 404.1509, your impairment must last—or be expected to last—12 consecutive months. Earnings Above SGA If your average monthly earnings exceed the SGA threshold ($1,550 for non-blind claimants in 2024), a technical denial can be issued. Non-Compliance With Treatment The SSA can deny a claim under 20 C.F.R. § 404.1530 if you fail, without good cause, to follow prescribed treatment that could restore your ability to work. Past Work or Other Work Determinations At Step 4 or 5 of the sequential evaluation in 20 C.F.R. § 404.1520, the SSA may find you can perform past relevant work or adjust to other work in the national economy.

Federal Legal Protections & Regulations

The SSA must follow federal law when evaluating and deciding your disability claim. Two cornerstone regulations protect claimant rights:

• 20 C.F.R. § 404.1520 — Sets out the five-step sequential evaluation the SSA must apply. Compliance is mandatory for every adjudicator from initial level through federal court.

• 20 C.F.R. § 404.1512 — Establishes SSA’s duty to develop the claimant’s full medical record. You are not required to prove your case alone.

In addition, the Administrative Procedure Act (5 U.S.C. §§ 551-559) guarantees due process at SSA hearings. Numerous federal court opinions—for example, Thomas v. Colvin, 881 F.3d 656 (8th Cir. 2018)—have reversed denials when the SSA misapplies vocational testimony or disregards treating-physician opinions. North Dakota falls within the Eighth Circuit, and its precedent controls appeals to the U.S. District Court for the District of North Dakota.

Steps to Take After an SSDI Denial

1. Read Your Denial Letter Carefully

The SSA must list the medical and vocational reasons for denial, as well as your appeal rights. Mark the 60-day deadline to request reconsideration (20 C.F.R. § 404.909). Missing this deadline usually requires starting over unless you can show good cause.

2. File a Request for Reconsideration

Most North Dakotans file online via SSA’s Appeal Portal, but you can also file at your local SSA office:

Fargo SSA Field Office 657 2nd Ave N, Room 320, Fargo, ND 58102 Bismarck SSA Field Office 4207 Boulder Ridge Rd, Suite 100, Bismarck, ND 58503

Average reconsideration processing time in North Dakota is approximately four months. The disability examiner reviews any new evidence you submit.

3. Request an Administrative Law Judge (ALJ) Hearing

If reconsideration is denied, you have 60 days to request a hearing before an ALJ under 20 C.F.R. § 404.933. North Dakotans are typically assigned to the Fargo Hearing Office, though video hearings may be scheduled if distance is an issue.

4. Submit Additional Evidence

Under 20 C.F.R. § 404.935, you must submit all written evidence at least five business days before the hearing, or show good cause for late submission. Common supplemental evidence includes:

• Updated MRI or CT scans from Sanford Medical Center Fargo

• Functional capacity evaluations from CHI St. Alexius Health in Bismarck

• Vocational assessments documenting inability to perform past oil-field work common in Williston

5. Appeals Council Review

If the ALJ denies your claim, you may request Appeals Council review within 60 days (20 C.F.R. § 404.968). The Appeals Council in Falls Church, Virginia, can affirm, remand, or reverse the ALJ decision.

6. Federal Court Action

The final administrative step is filing a civil action in the U.S. District Court for the District of North Dakota within 60 days of the Appeals Council denial, per 42 U.S.C. § 405(g). Federal judges review the administrative record for legal error or lack of substantial evidence.

When to Seek Legal Help for SSDI Appeals

While self-representation is allowed, SSA statistics show claimants represented by attorneys or qualified non-attorney representatives have significantly higher win rates. North Dakota licensing rules require attorneys to be admitted to the State Bar Association of North Dakota (SBAND). Out-of-state lawyers must file a pro hac vice motion under North Dakota Rule of Court 3.1 to appear in a specific case.

Key moments to involve counsel:

• Before submitting reconsideration to identify missing medical evidence.

• During ALJ hearing preparation—attorneys can cross-examine vocational experts.

• When appealing to federal court—complex briefing standards apply.

Local Resources & Next Steps

Medical Providers Familiar With Disability Documentation

• Sanford Health Fargo – largest tertiary care center in the state.

• Altru Health System in Grand Forks – specializes in neurological disorders.

• Trinity Health Minot – orthopedic and pain management clinics.

Vocational & Community Resources

North Dakota Vocational Rehabilitation – may fund functional capacity evaluations. Legal Services of North Dakota – limited representation for low-income claimants.

• ND Job Service – labor market data to rebut “other work” findings.

Statistical Snapshot

SSA’s 2023 data show approximately 13,000 disabled workers in North Dakota receive SSDI, with an average monthly benefit of $1,464—slightly below the national average. Understanding this context underscores why maximizing your appeal is critical.

Federal Deadlines at a Glance

• Request for Reconsideration: 60 days from date you receive denial (assumed 5 days after mailing).

• ALJ Hearing Request: 60 days after reconsideration denial.

• Appeals Council Review: 60 days after ALJ decision.

• Federal Court: 60 days after Appeals Council denial.

Legal Disclaimer

This guide is for informational purposes only and does not constitute legal advice. You should consult a licensed North Dakota attorney about your specific SSDI claim.

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.