SSDI Denial Appeal Guide for Marathon, Texas

Introduction: Navigating SSDI Denials in Marathon, Texas

With fewer than 500 residents, Marathon, Texas sits on U.S. Highway 90 in Brewster County—hours from the nearest metro area but only 40 miles from Big Bend National Park. That remoteness can make a Social Security Disability Insurance (SSDI) denial feel even more daunting. Claimants must juggle federal deadlines, extensive paperwork, and travel to out-of-town offices while coping with serious medical conditions. This comprehensive guide explains what Marathon applicants need to know after receiving a denial notice, which federal rules protect them, and how to leverage local resources—slightly favoring the claimant while remaining strictly factual.

Whether you filed at the Alpine Social Security office or online, a denial is not the end of the road. Nearly two-thirds of initial SSDI applications nationwide are refused, according to the Social Security Administration (SSA). However, many denials are overturned on appeal when timely evidence and advocacy are presented. Understanding your rights under federal law is the first step toward that reversal.

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Understanding Your SSDI Rights

The Insurance You Paid For

SSDI is a federal insurance program funded by payroll taxes under Title II of the Social Security Act. If you have earned sufficient quarters of coverage, you are insured against long-term loss of income due to a medically determinable impairment expected to last at least 12 months or result in death. The statute guarantees several core rights:

• The Right to File a Claim without charge (42 U.S.C. § 423).

• The Right to Written Notice explaining any adverse decision (20 C.F.R. § 404.904).

• The Right to Appeal through a four-level administrative process and, if necessary, federal court review under 42 U.S.C. § 405(g).

• The Right to Representation by an attorney or qualified non-attorney representative. Fees are capped and must be approved by SSA (20 C.F.R. § 404.1720).

Because Texas lawyers are licensed by the State Bar of Texas, any attorney representing you must be in good standing with that body and comply with SSA’s fee-approval rules. You never pay an upfront retainer; approved fees are generally 25% of past-due benefits, up to the federal cap ($7,200 in 2023).

The Five-Step Disability Analysis

SSA adjudicators follow the sequential evaluation in 20 C.F.R. §§ 404.1520 and 416.920:

• Substantial Gainful Activity (SGA)—Are you earning over the monthly SGA threshold?

• Severity—Does your medically determinable impairment significantly limit work activities?

Listing of Impairments—Does your condition meet or equal a Listing in the SSA Blue Book?

• Past Relevant Work—Can you perform any of your prior jobs?

• Other Work—Considering age, education, and residual functional capacity (RFC), can you adjust to other work in the national economy?

Knowing where your claim faltered within this analysis helps you target evidence on appeal.

Common Reasons SSA Denies SSDI Claims

According to SSA’s own data, initial denial rates hover around 65%. The most frequent grounds are:

• Medical Insufficiency—lack of objective tests, specialist notes, or consistent treatment records.

• Work Activity Above SGA—earning more than $1,470 per month (non-blind, 2023 rates).

• Non-Severity—impairment deemed not severe under 20 C.F.R. § 404.1521.

• Failure to Cooperate—missing consultative exams or ignoring SSA requests.

• Insufficient Work Credits—especially for younger applicants or those with inconsistent employment.

In rural communities like Marathon, gaps in specialist care can translate into thin medical files. Telehealth notes, hospital discharge summaries from Big Bend Regional Medical Center (Alpine), and Veterans Affairs records (if applicable) can help fill those gaps on appeal.

Federal Legal Protections & Regulations

Appeal Timeline and Regulatory Authority

Denial letters reference your right to appeal within 60 days of receipt, presumed to be five days after mailing (20 C.F.R. § 404.909). Missing that deadline usually forfeits further review unless you prove good cause (20 C.F.R. § 404.911).

The appeals framework is codified in 20 C.F.R. § 404.900:

• Reconsideration

• Administrative Law Judge (ALJ) Hearing

• Appeals Council Review

• Federal District Court under 42 U.S.C. § 405(g)

Each stage has its own evidentiary rules, but you can submit new evidence until five business days before your ALJ hearing (20 C.F.R. § 404.935). Courts have enforced those deadlines strictly—see Brewster v. Kijakazi, 859 F. App’x 24 (5th Cir. 2021).

Privacy and Anti-Discrimination Protections

SSA must handle your records under the Privacy Act of 1974 and cannot discriminate based on race, color, national origin, age, sex, or disability (Section 504 of the Rehabilitation Act). If you need Spanish-language notices—important for Marathon’s 60% Hispanic population—you can request translations from SSA free of charge.

Steps to Take After an SSDI Denial

1. Mark Your Calendar

Count 65 days from the date on the denial notice; that is your absolute last day to request Reconsideration. File earlier if possible.

2. Request Reconsideration

Submit Form SSA-561 and a Disability Report—Appeal (SSA-3441). You can deliver paper forms to the Alpine field office or file online via SSA’s appeals portal. Attach newly available evidence—e.g., updated MRI results from Midland Memorial Hospital or treatment notes from Permian Basin community clinics.

3. Develop Medical Evidence

Under 20 C.F.R. § 404.1512, you bear the primary burden of furnishing medical evidence. Strategies include:

• Ask providers for functional capacity evaluations (sitting, standing, lifting limits).

• Secure medical source statements on your inability to perform SGA.

• Keep a symptom diary to corroborate pain intensity and frequency.

4. Prepare for the ALJ Hearing

If reconsideration fails, request a hearing on Form HA-501. West Texas hearings for Brewster County are held by video or in person at the El Paso Office of Hearings Operations, 1545 Hawkins Blvd. When travel poses hardship, you can request a telephone or video hearing under SSA’s COVID-era protocols.

At the hearing, you may testify, question vocational experts, and present witnesses. ALJs are bound by HALLEX guidelines and Fifth Circuit precedent. A favorable ALJ decision reverses roughly half of denied claims nationwide.

5. Seek Appeals Council & Federal Review

If the ALJ denies, file Form HA-520 within 60 days. The Appeals Council in Falls Church, Virginia, may grant review, issue its own decision, remand, or deny. Exhausting administrative remedies preserves your right to file a civil action in the U.S. District Court for the Western District of Texas—Del Rio Division, the venue for Brewster County litigants.

When to Seek Legal Help for SSDI Appeals

A marathon disability attorney can:

• Analyze why SSA denied your claim and craft targeted evidence.

• Obtain opinion letters that satisfy 20 C.F.R. § 404.1527 weight factors.

• Cross-examine vocational experts on regional job numbers for remote West Texas.

• Ensure deadlines are met and procedural errors are preserved for judicial review.

Studies published in the Social Security Bulletin show claimants with representatives are nearly three times more likely to win at hearing. Because representation fees are contingency-based and capped, financially stressed claimants lose nothing by consulting counsel.

Local Resources & Next Steps

Key SSA Contact Points

Alpine SSA Field Office 300 Ridge St, Suite 100, Alpine, TX 79830 Phone: 866-563-9104 Hours: Mon–Fri 9 a.m.–4 p.m. (verify before traveling) El Paso OHO (Hearings) 1545 Hawkins Blvd, Suite 300, El Paso, TX 79925 Phone: 866-331-7129

Medical Providers Serving Marathon Claimants

• Big Bend Regional Medical Center – Alpine

• Permian Basin Community Centers – mental health services via telehealth

• Department of Veterans Affairs – Alpine VA Outreach Clinic (for eligible veterans)

Transportation Tips

The Presidio County Rural Transit District offers limited shuttle routes from Marathon to Alpine on designated days—important for attending consultative exams or hearings. Call 432-729-1957 for schedules.

Free & Low-Cost Legal Help

• Lone Star Legal Aid (serves West Texas via remote clinics)

• Texas Legal Services Center – statewide hotline: 800-622-2520

Conclusion

An SSDI denial is discouraging but far from final. By understanding the sequential evaluation, federal appeal deadlines, and local logistics unique to Marathon, you can turn a denial into an approval. Timely evidence, strategic representation, and perseverance are key.

Authoritative References

SSA Appeals Process (Official) 20 C.F.R. § 404.900 – Administrative Review Social Security Act § 205(g) HALLEX – ALJ Hearing Procedures

Disclaimer: This guide is for informational purposes only and does not constitute legal advice. Laws and regulations change. Consult a licensed Texas 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.