SSA Attorney Guide: SSDI Appeals in Nevada, Nevada

SSDI Denials and Appeals in Nevada, Nevada: A Claimant-Focused Legal Guide

If your Social Security Disability Insurance (SSDI) claim was denied in Nevada, you are not alone—and you have the right to appeal. This guide explains how SSDI appeals work under federal law, what deadlines apply, and how to navigate the process from reconsideration through federal court. It also includes Nevada-specific context and practical steps to strengthen your case. While every claim is different, claimants in Clark County (Las Vegas), Washoe County (Reno), and throughout Nevada face the same federal standards and timelines. If you are searching for help with an SSDI denial appeal Nevada Nevada claim, this resource is designed to be a clear, factual starting point.

SSDI is a federal insurance program for workers who paid Social Security taxes and can no longer perform substantial gainful activity due to a medically determinable impairment expected to last at least 12 months or result in death. Initial denials are common, but federal regulations provide a structured appeal process. With careful attention to deadlines, evidence, and the sequence of appeals, many claimants ultimately obtain benefits. This guide slightly favors protecting claimant rights while remaining strictly evidence-based, citing controlling federal regulations and statutes.

Below, you’ll learn your rights under the Social Security Act and the Code of Federal Regulations (CFR), common reasons for denials, how to respond after a denial, when to seek representation, and where to find local Nevada resources.

Understanding Your SSDI Rights

Who qualifies for SSDI

To qualify for SSDI, you must be “insured” and disabled as defined by federal law:

• Insured status and work credits: You must have enough work credits and be “insured” at the time you became disabled. See 20 C.F.R. § 404.130 and related provisions.
• Definition of disability: For adults, disability means the inability to engage in substantial gainful activity (SGA) due to a medically determinable impairment expected to last at least 12 months or result in death. See Social Security Act § 223(d), 42 U.S.C. § 423(d).

Your procedural rights during an SSDI claim

• Right to appeal and to a hearing: You can appeal an adverse determination and request a hearing before an Administrative Law Judge (ALJ). See Social Security Act § 205(b), 42 U.S.C. § 405(b); 20 C.F.R. § 404.900(a)(1)–(3).
• Right to representation: You may appoint a representative, including an attorney, to assist you at all stages. See 20 C.F.R. § 404.1705.
• Right to review and submit evidence: You may request your file and submit medical and nonmedical evidence. At the hearing, you may review the evidence, present witnesses, and question witnesses. See 20 C.F.R. § 404.950.
• Right to submit evidence before the hearing: Evidence should generally be submitted no later than five business days before the hearing. See 20 C.F.R. § 404.935.
• Right to a decision with reasons: ALJs must base decisions on the record and give reasons. See 20 C.F.R. § 404.953.

How the SSA evaluates medical and vocational issues

SSA uses a five-step sequential evaluation process to decide disability. See 20 C.F.R. § 404.1520:

• SGA: Are you working at the level of substantial gainful activity? If yes, generally not disabled. See 20 C.F.R. § 404.1572 (definition of SGA); SGA dollar amounts are set annually by SSA.
• Severity: Do you have a severe impairment or combination of impairments? See 20 C.F.R. § 404.1520(c).
• Listings: Does your impairment meet or equal a Listing? See 20 C.F.R. pt. 404, subpt. P, app. 1 (the “Listings”).
• Past relevant work: What is your residual functional capacity (RFC), and can you perform your past relevant work? See 20 C.F.R. §§ 404.1545, 404.1560(b).
• Other work: Considering your RFC, age, education, and work experience, can you do other work existing in significant numbers in the national economy? See 20 C.F.R. §§ 404.1560(c), 404.1563–.1569; Medical-Vocational Guidelines at 20 C.F.R. pt. 404, subpt. P, app. 2.

SSA considers symptoms along with objective medical evidence and evaluates consistency with the record. See 20 C.F.R. § 404.1529. SSA also considers the combined effect of all your impairments. See 20 C.F.R. § 404.1523.

Common Reasons SSA Denies SSDI Claims

Lack of insured status or insufficient work credits

Even with serious health conditions, you must be insured under Title II rules to qualify. Claims are commonly denied when the claimant’s “date last insured” (DLI) is before the established disability onset date or when work credits are insufficient. See 20 C.F.R. § 404.130.

Earnings above substantial gainful activity (SGA)

Working and earning above SGA can lead to a denial at Step 1. SGA levels are set annually by SSA and differ for blind and non-blind individuals. See 20 C.F.R. § 404.1572; consult SSA’s SGA page for current amounts.

Insufficient medical evidence or gaps in treatment

SSA requires objective medical evidence from acceptable medical sources. Missing records, sporadic treatment, or declining consultative exams can result in denials. See 20 C.F.R. §§ 404.1502 (definitions), 404.1512 (evidence submission), 404.1519a (consultative examinations).

Impairment not severe enough or not lasting 12 months

At Step 2, SSA may find an impairment non-severe or not expected to last 12 continuous months, resulting in denial. See 20 C.F.R. § 404.1520(a)(4)(ii), (c).

Does not meet or equal a Listing

At Step 3, denials often state that the impairment does not meet or medically equal a Listing. If so, the analysis continues to RFC and vocational steps. See 20 C.F.R. pt. 404, subpt. P, app. 1; § 404.1526 (medical equivalence).

RFC supports ability to do past or other work

SSA can deny at Steps 4 or 5 if it finds you can perform your past work or other work in the national economy. Vocational factors (age, education, transferable skills) and exertional/non-exertional limitations are crucial. See 20 C.F.R. §§ 404.1545, 404.1560–.1569; app. 2 (the “grids”).

Other technical reasons

• Failure to cooperate (e.g., not providing requested evidence). See 20 C.F.R. § 404.1512.
• Failure to follow prescribed treatment without good cause. See 20 C.F.R. § 404.1530.
• Drug or alcohol materiality: If substance use is material to disability, benefits may be denied. See 20 C.F.R. § 404.1535.

Federal Legal Protections & Regulations You Can Use

Key statutes

• Definition of disability: Social Security Act § 223(d), 42 U.S.C. § 423(d).
• Hearing rights: Social Security Act § 205(b), 42 U.S.C. § 405(b).
• Judicial review: Social Security Act § 205(g), 42 U.S.C. § 405(g) (file civil action in federal district court within 60 days of Appeals Council notice; see also 20 C.F.R. § 422.210).

Appeals framework and deadlines

• Administrative review process: Reconsideration, ALJ hearing, Appeals Council, then federal court. See 20 C.F.R. § 404.900(a).
• Reconsideration deadline: Generally 60 days after you receive the notice; SSA presumes you receive it 5 days after the date on the notice unless you show otherwise. See 20 C.F.R. §§ 404.909(a)(1), 404.901.
• ALJ hearing request deadline: Generally 60 days from receipt of the reconsideration determination. See 20 C.F.R. § 404.933(b).
• Appeals Council request deadline: Generally 60 days from receipt of the ALJ decision. See 20 C.F.R. § 404.968(a).
• Federal court filing: Generally within 60 days of receiving the Appeals Council’s denial or decision. See 42 U.S.C. § 405(g); 20 C.F.R. § 422.210(c).
• Good cause for late filing: SSA may extend time for good cause. See 20 C.F.R. § 404.911.

Evidence rules that protect claimants

• Submitting evidence before hearing: Provide evidence at least 5 business days before the hearing (with limited exceptions). See 20 C.F.R. § 404.935.
• Appeals Council evidence: The Appeals Council may consider additional evidence only if it is new, material, relates to the period on or before the ALJ decision, and there is a reasonable probability it would change the outcome; you must generally show good cause for not submitting it earlier. See 20 C.F.R. § 404.970(a)(5), (b).

Reopening past decisions

In some circumstances, SSA can reopen a final determination: within 12 months for any reason, and within four years for good cause for Title II (SSDI) claims. See 20 C.F.R. § 404.988. Reopening has specific requirements and is separate from appealing within 60 days.

Steps to Take After an SSDI Denial in Nevada

1) Read the denial notice carefully

Your notice explains whether the denial is technical (e.g., insured status) or medical. Note the date on the notice and the appeal deadline. SSA presumes you receive the notice five days after its date unless you can show you received it later. See 20 C.F.R. § 404.901.

2) Decide your appeal level and deadline

• Initial denial → Reconsideration: 60 days from receipt. See 20 C.F.R. § 404.909(a).
• Reconsideration denial → ALJ hearing: 60 days from receipt. See 20 C.F.R. § 404.933(b).
• Unfavorable ALJ decision → Appeals Council: 60 days from receipt. See 20 C.F.R. § 404.968(a).
• Appeals Council denial → Federal court: 60 days from receipt. See 42 U.S.C. § 405(g); 20 C.F.R. § 422.210(c).

If you miss a deadline, request an extension and explain why—SSA can accept late appeals for “good cause.” See 20 C.F.R. § 404.911.

3) File your appeal online or at your local SSA office

Many Nevada claimants find it fastest to appeal online through SSA’s official portal. You can also file by mail or in person at a Nevada SSA field office. Use the SSA Office Locator to find the correct office serving your address.

4) Gather and submit medical evidence

• Objective records: Hospital records, imaging, labs, surgery reports, mental health treatment notes, and specialist records.
• Longitudinal treatment: Evidence showing how your condition persists over time can be persuasive.
• Functional impact: Records that document your specific work-related limitations are critical to RFC findings (e.g., sitting/standing limits, lifting limits, cognitive limitations).
• Follow evidence rules: Submit evidence as early as possible; for hearings, comply with the five-day rule or show good cause. See 20 C.F.R. § 404.935.

5) Cooperate with SSA and attend exams

If SSA schedules a consultative exam, make every reasonable effort to attend; missing an exam may lead to denial for insufficient evidence. See 20 C.F.R. § 404.1518 (failure to attend consultative examination) and § 404.1519a.

6) Prepare for the ALJ hearing

Hearings can be in person, by video, or by telephone. Before the hearing, review your file, identify missing records, and consider submitting a written statement clarifying your symptoms and functional limitations. At the hearing, you have the right to present evidence and question witnesses. See 20 C.F.R. § 404.950.

7) Understand Appeals Council review

The Appeals Council reviews ALJ decisions for legal error, abuse of discretion, unsupported findings, or new and material evidence that could change the outcome, subject to the rules in 20 C.F.R. § 404.970. If the Appeals Council denies review, you may file a civil action in the U.S. District Court for the District of Nevada under 42 U.S.C. § 405(g).

8) Consider federal court

In a federal court appeal, you challenge the Commissioner’s final decision based on the administrative record. The court reviews for legal error and whether substantial evidence supports the decision. The action is typically filed in the U.S. District Court for the District of Nevada. See 42 U.S.C. § 405(g).

When to Seek Legal Help for SSDI Appeals

Why representation can help

SSDI appeals hinge on evidence, regulatory standards, and precise deadlines. An experienced representative can identify missing records, develop functional evidence, prepare you for testimony, comply with submission rules, and frame arguments under 20 C.F.R. §§ 404.1520, 404.1529, 404.1560, and related provisions. Many claimants benefit from having an advocate present at hearings and during Appeals Council review.

Who may represent you

SSA allows representation by attorneys licensed in a U.S. jurisdiction and by certain qualified non-attorney representatives. See 20 C.F.R. § 404.1705. If you want legal advice governed by Nevada law or plan to file a civil action in the District of Nevada, consult an attorney licensed in Nevada.

Fees and approval

SSA must approve representative fees. Under 42 U.S.C. § 406(a) and 20 C.F.R. §§ 404.1720–.1730, fees are generally limited to a percentage of past-due benefits, subject to SSA’s fee cap then in effect, and must be approved through SSA’s fee agreement or fee petition process.

Local Resources & Next Steps for Nevada Claimants

Finding your local SSA field office

Nevada residents can locate their nearest Social Security field office (including offices serving Las Vegas and Reno) using SSA’s official Office Locator. Field offices accept applications, appeals, and documentation and can answer questions about your claim status.

Hearing locations and scheduling

SSDI hearings for Nevada claimants are administered by SSA’s Office of Hearings Operations (OHO). Hearings may be scheduled for in-person, video, or telephone formats depending on SSA’s scheduling and your preferences. You will receive a Notice of Hearing in advance explaining the time, format, and submission deadlines. Comply with the five-business-day evidence rule or explain good cause for late submissions under 20 C.F.R. § 404.935.

Federal court in Nevada

If you exhaust administrative remedies and seek judicial review, file your civil action in the U.S. District Court for the District of Nevada within 60 days of receiving the Appeals Council decision. See 42 U.S.C. § 405(g); 20 C.F.R. § 422.210(c). Federal court filing procedures are governed by the Federal Rules of Civil Procedure and local court rules.

Practical tips tailored to Nevada claimants

• Track deadlines meticulously: Use the date on your SSA notice and add five days for mailing receipt unless you can prove a different date. See 20 C.F.R. § 404.901.
• Use online services when possible: Online appeals are efficient for many Nevada residents, especially in rural areas far from field offices.
• Supply complete records: Ensure SSA receives comprehensive medical documentation from all your providers. If you are treated by multiple clinics or specialists, list each one clearly with dates of service.
• Explain work attempts: If you tried to work but could not sustain it, document the dates, duties, and reasons you stopped. SSA distinguishes between unsuccessful work attempts and SGA.

Detailed Overview of Each Appeal Level

Reconsideration

After an initial denial, submit a request for reconsideration within 60 days of receipt. See 20 C.F.R. § 404.909(a). A different adjudicator at the state disability determination service (DDS) reviews your file and any new evidence. Provide updated medical records and a clear statement of changes since the initial decision.

Hearing before an Administrative Law Judge (ALJ)

If reconsideration is denied, request a hearing within 60 days. See 20 C.F.R. § 404.933(b). Hearings are non-adversarial. The ALJ may hear testimony from you and, where applicable, vocational and medical experts. You can submit a pre-hearing brief citing relevant regulations (for example, how your impairments meet a Listing or why your RFC precludes past and other work under the Medical-Vocational Guidelines). At the hearing, you have the right to examine the evidence, present witnesses, and question any expert witnesses. See 20 C.F.R. § 404.950.

Submit evidence at least five business days before the hearing or show good cause for later submission (e.g., records not previously available despite due diligence). See 20 C.F.R. § 404.935. After the hearing, the ALJ issues a written decision with findings of fact and reasons. See 20 C.F.R. § 404.953.

Appeals Council (AC)

File your request for review within 60 days of receiving the ALJ’s decision. See 20 C.F.R. § 404.968(a). The AC may deny review, remand, or issue its own decision. It considers whether the ALJ erred on the law, abused discretion, made findings unsupported by substantial evidence, or whether new, material, and time-relevant evidence creates a reasonable probability of a different outcome, with good cause for late submission. See 20 C.F.R. § 404.970(a)(1)–(5), (b).

Federal court

If the AC denies review or issues an unfavorable decision, you may file a civil action in the U.S. District Court for the District of Nevada within 60 days of receipt. See 42 U.S.C. § 405(g); 20 C.F.R. § 422.210(c). The court reviews the administrative record to determine if the Commissioner’s decision is supported by substantial evidence and free of legal error. Possible outcomes include remand for further proceedings or, less commonly, reversal with an award of benefits.

Strengthening Your Nevada SSDI Appeal: Evidence and Strategy

Medical evidence

• Objective testing: Imaging, lab values, EEGs, EMGs, pulmonary tests, and standardized cognitive assessments can corroborate impairments.
• Treating source opinions: Detailed functional assessments can inform the RFC. SSA evaluates persuasiveness based on supportability and consistency with the record. See 20 C.F.R. § 404.1520c.
• Continuity of care: Records across months and years help establish the 12-month duration requirement and the day-to-day impact of your impairments.

Functional and vocational proof

• Specific limitations: Document sitting/standing tolerances, lifting/carrying limits, need for unscheduled breaks, off-task time, and attendance issues. These details bear directly on Steps 4 and 5.
• Past relevant work analysis: Clarify the physical and mental demands of your past jobs (exertional level, skill level). See 20 C.F.R. § 404.1560(b).
• Age, education, and skills: The Medical-Vocational Guidelines may favor older workers with limited education and non-transferable skills. See 20 C.F.R. pt. 404, subpt. P, app. 2.

Consistency and credibility

SSA evaluates the consistency of your statements with medical and other evidence. Provide detailed, accurate descriptions of symptoms, treatment side effects, and functional limits, and keep your testimony aligned with the medical record. See 20 C.F.R. § 404.1529.

Special Procedural Issues

Good cause for late evidence or appeals

SSA may accept late evidence or extend deadlines for good cause, such as circumstances beyond your control. See 20 C.F.R. §§ 404.911, 404.935(b).

Reopening and revising decisions

In limited situations, you may seek reopening of a prior final determination within 12 months for any reason, and within four years for good cause in SSDI cases. See 20 C.F.R. § 404.988. Reopening is separate from the standard appeal path and has specific criteria.

Failure to follow treatment

If your doctor prescribes treatment that could restore ability to work, failing to follow it without good cause can result in denial. SSA defines good cause narrowly (e.g., risk of significant harm). See 20 C.F.R. § 404.1530.

Nevada-Specific Context and How to Engage Locally

Serving Nevada’s major population centers

Most Nevada claimants live in and around Las Vegas (Clark County) and Reno (Washoe County), but SSA’s rules apply uniformly statewide. Whether you are in an urban center or a rural community, you can file and track your appeal online, by mail, or at a local field office.

Local SSA field offices and hearings

Use the SSA Office Locator to identify the correct Nevada office for your address. Bring government-issued identification when visiting. For hearings administered by SSA’s Office of Hearings Operations, you will receive detailed instructions regarding format (in person, video, or telephone) and evidence deadlines.

Federal court venue

If you pursue judicial review, your case is filed in the U.S. District Court for the District of Nevada pursuant to 42 U.S.C. § 405(g). Be mindful of the 60-day filing period after receiving the Appeals Council decision.

Frequently Asked Questions (Strictly Factual)

How long do I have to appeal?

Generally 60 days from the date you receive the notice at each administrative level—reconsideration, ALJ hearing, and Appeals Council. SSA presumes you receive the notice five days after its date unless you show otherwise. See 20 C.F.R. §§ 404.909(a)(1), 404.933(b), 404.968(a), 404.901. If you seek judicial review, you generally have 60 days from receipt of the Appeals Council notice. See 42 U.S.C. § 405(g); 20 C.F.R. § 422.210(c).

Can I work while appealing?

You may work, but earnings at or above SGA levels may affect your claim. SGA is defined at 20 C.F.R. § 404.1572, and SSA updates SGA dollar amounts annually. Consider how any work activity will be evaluated under the five-step process.

What if SSA requests a consultative exam?

Attend and cooperate. Missing an exam can lead to an unfavorable decision due to insufficient evidence. See 20 C.F.R. §§ 404.1518, 404.1519a.

Do I need a Nevada-licensed attorney?

SSA allows representation by attorneys licensed in a U.S. jurisdiction and qualified non-attorney representatives. See 20 C.F.R. § 404.1705. If you need advice governed by Nevada state law or plan to file in the District of Nevada, consult a Nevada-licensed attorney.

Authoritative Resources

SSA: How to Appeal a Decision20 C.F.R. § 404.900 et seq. (Administrative Review Process)42 U.S.C. § 405 (Hearings and Judicial Review)SSA Blue Book: Adult Listings of ImpairmentsSSA Office Locator (Find Your Nevada Field Office)

Action Checklist for Nevada Claimants

• Mark your appeal deadline (60 days from receipt) immediately upon opening the denial notice.
• File your appeal online or at your Nevada SSA field office without delay.
• Request and review your claims file; identify missing or recent records.
• Obtain and submit updated medical evidence that supports functional limitations relevant to work.
• Comply with the five-business-day evidence deadline before your hearing or explain good cause for late submissions.
• Prepare to explain past work, why you cannot return to it, and why other work is not feasible given your RFC, age, education, and skills.
• Consider representation to assist with evidence development and hearing strategy under the regulations.

Disclaimer

This guide provides general information for Nevada residents about SSDI denials and appeals. It is not legal advice. You should consult a licensed Nevada attorney about 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.