SSDI Denial Appeal Guide for Burbank, Texas

Introduction: Why This Guide Matters to Burbank, Texas Residents

If you live in or around Burbank, Texas—an established neighborhood in south-central San Antonio—you are served by the same Social Security field offices and hearing locations that handle thousands of disability applications each year in Bexar County. According to FY 2022 data published by the Social Security Administration (SSA), nearly 67 percent of initial SSDI applications nationwide are denied. In Texas specifically, the allowance rate at the initial level hovered around 38 percent, which means roughly six out of ten Texans must enter the appeals process to secure the benefits they need. Because most denials are ultimately overturned only after one or more levels of appeal, understanding the exact steps—and local resources available in Burbank—is critical.

This 2,500-word guide walks you through the federal regulations, deadlines, and practical strategies that can help you protect your rights. We favor the claimant’s perspective while remaining strictly factual and citing only authoritative sources such as the Social Security Act, the Code of Federal Regulations (20 CFR), and published SSA data.

Understanding Your SSDI Rights

The Legal Definition of Disability

Under Social Security Act §223(d) and 20 CFR 404.1505, you must show that you have a medically determinable impairment expected to last at least 12 months (or result in death) and that it prevents you from engaging in substantial gainful activity (SGA).

Work Credit Requirements

SSDI is an insurance program. You generally need 20 quarters of coverage earned in the past 40 quarters, though younger workers may qualify with fewer credits (20 CFR 404.130). A single quarter is earned by wages or self-employment income of $1,640 in 2023; the figure is indexed annually.

Your Due-Process Rights

• The right to review your entire claims file (20 CFR 404.913).

• The right to submit new medical and vocational evidence at each appeal stage (20 CFR 404.935).

• The right to representation by an attorney or qualified non-attorney (20 CFR 404.1705).

• The right to obtain a written decision that explains the reasons for denial (20 CFR 404.961).

Common Reasons SSA Denies SSDI Claims

Knowing why claims are denied helps you avoid repeat mistakes during your appeal.

• Insufficient Medical Evidence – The SSA often states that records do not show functional limitations severe enough under 20 CFR 404.1520(a)(4)(ii).

• Failure to Follow Prescribed Treatment – Under 20 CFR 404.1530, the SSA can deny claims if you do not follow recommended treatment without good cause.

• Income Above SGA Levels – If you earn more than the SGA threshold ($1,470 per month in 2023 for non-blind claimants), SSA must deny the claim at Step 1 of the sequential evaluation.

• Drug or Alcohol Materiality – 20 CFR 404.1535 requires denial if drug or alcohol use is a contributing factor material to disability.

• Insufficient Work Credits – Applicants who have not worked long enough under covered employment cannot qualify for SSDI regardless of medical status.

Federal Legal Protections & Regulations Every Burbank Claimant Should Know

60-Day Appeal Deadlines

Federal statutes impose strict timelines. You generally have 60 days from the date you receive the denial letter (presumed received within five days after mailing) to request the next appeal stage (20 CFR 404.909 and 404.933).

Four Sequential Appeal Levels

• Reconsideration – A fresh review by a different Disability Determination Services (DDS) examiner (20 CFR 404.909).

• Administrative Law Judge (ALJ) Hearing – A live or video hearing before an ALJ; you may present witnesses (20 CFR 404.929-404.961).

• Appeals Council Review – A written review in Falls Church, VA unless a local, in-person appearance is granted (20 CFR 404.967-404.984).

• Federal District Court – A civil action under 42 U.S.C. §405(g); for Burbank residents, the filing ordinarily occurs in the U.S. District Court for the Western District of Texas, San Antonio Division.

Good-Cause Extensions

If you miss a deadline, you may request an extension for “good cause” as defined in 20 CFR 404.911. Examples include serious illness, mental incapacity, or lost mail.

Attorney Fee Limits

Federal law caps contingent fees at 25 percent of past-due benefits or $7,200, whichever is less (effective Nov 30 2022; see SSA Notice of Final Rule, 87 Fed. Reg. 65,503). The SSA directly withholds and pays approved fees, giving claimants clarity and protection.

Steps to Take After an SSDI Denial

1. Review the Denial Letter Closely

The SSA’s explanation section cites medical exhibits and vocational findings (RFC, past relevant work). Note the specific weaknesses flagged and whether they involve missing evidence, duration, or SGA.

2. Request Reconsideration Promptly

File SSA Form 561 and accompanying Form 3441 (Disability Report – Appeal). You may submit online via SSA’s secure appeals portal. Remember the 60-day clock.

3. Build a Complete Medical Record

• Obtain updated imaging studies, lab reports, and specialist notes.

• Request a Medical Source Statement (MSS) from each treating provider clarifying functional limitations.

• Document medication side effects, frequency of symptoms, and unscheduled work absences.

4. Track Vocational Evidence

Under 20 CFR 404.1560, the SSA assesses whether you can perform past relevant work or other work. A detailed job history and employer statements describing physical or cognitive demands can rebut SSA assumptions at Step 4 and Step 5.

5. Prepare for the ALJ Hearing

If reconsideration is denied—as happens to roughly 88 percent of claimants—request an ALJ hearing. In the San Antonio Hearing Office (ODAR), the median wait time was approximately 10 months in FY 2023 per SSA’s public statistics. Use this window to:

• Update evidence at least five business days before the hearing (20 CFR 404.935).

• Draft a pre-hearing brief summarizing how you meet a specific Listing (20 CFR Pt 404, Subpt P, Appx 1) or, alternatively, how vocational rules direct a finding of “disabled.”

• Consider subpoenas for treating physicians if their live testimony will strengthen the record.

6. Appeals Council & Federal Court

If you receive an unfavorable ALJ decision, you have two remaining venues. The Appeals Council often focuses on legal or procedural errors—e.g., failure to consider a treating physician opinion under 20 CFR 404.1520c. Federal court review is limited to whether the decision is supported by substantial evidence and whether correct legal standards were applied (Richardson v. Perales, 402 U.S. 389 (1971)).

When to Seek Legal Help for SSDI Appeals

Complex Medical or Vocational Profiles

If your impairment involves multiple body systems (e.g., diabetes with neuropathy and depression) or if you have skilled work that complicates Step 4, professional representation can be decisive. Attorneys often commission functional capacity evaluations or retain vocational experts not provided by SSA.

Prior Denials

Each new filing risks being denied for res judicata if you allege the same period of disability. An attorney can decide whether to appeal, reopen, or file a new application.

Statutory Fee Safety Net

Because fees are capped and contingent, hiring counsel rarely imposes upfront costs. Moreover, representatives may request direct payment from SSA only after the Appeals Council or court stage if past-due benefits become payable.

Local Resources & Next Steps for Burbank Residents

Nearest SSA Field Office

According to the SSA Office Locator (accessed June 2023), the primary field office serving ZIP codes in the Burbank neighborhood is:

Social Security Administration – San Antonio South

  3438 E Southcross Blvd

  San Antonio, TX 78223

  Phone: 800-772-1213 (national) | Local: 210-###-#### (see SSA letter for exact number)

Always verify hours on the SSA website before visiting, as schedules can change without notice.

Hearing Office (ODAR)

Disability hearings for Burbank claimants are generally held at:

Office of Hearings Operations – San Antonio

  727 E César E. Chávez Blvd, Suite 100

  San Antonio, TX 78206

Medical Providers Familiar with SSA Forms

Major hospitals that frequently provide records for disability cases include:

• University Hospital – 4502 Medical Dr, San Antonio, TX 78229

• Baptist Medical Center – 111 Dallas St, San Antonio, TX 78205

Be sure to request complete chart notes, imaging discs, and a physician-signed MSS.

Pro Bono & Low-Cost Assistance

Disability Rights Texas – Federally funded Protection & Advocacy agency; may handle complex SSDI matters. State Bar of Texas Lawyer Referral Service – Confirms attorney licensing and disciplinary history. SSA Form 1696 – Required to appoint any representative.

Additional community clinics—such as CentroMed and CommuniCare—can help uninsured claimants obtain ongoing treatment, which is vital for demonstrating 12-month duration.

The Bottom Line for Burbank Claimants

The SSDI appeals process is highly regulated, deadline-driven, and evidence-heavy. Yet federal data show that more than 50 percent of claimants who persist to an ALJ hearing ultimately win benefits. By understanding your rights under 20 CFR 404.900-404.999, gathering comprehensive medical proof, and—where needed—retaining a qualified burbank disability attorney, you greatly increase your chance of turning an initial denial into a successful award.

Legal Disclaimer: This article is for informational purposes only and does not constitute legal advice. Laws and regulations change; always consult a licensed Texas 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.