Denied on a Social Security Disability Claim in New York

If you have filed a

Filing a new claim because you hope to get a different result if a different
disability examiner reviews you claim is also not a good idea. The state agency that decides all initial applications for Social Security, usually called the Disability Determination Services (DDS) agency, tends to have an insitutional culture of denial. Submitting the same claim to the same agency is likely to result in yet another denial, and waste months of your time (it takes about 3 to 4 months to receive a decision on a claim).

If you are denied for SSD or SSI, your first step should be to immediately appeal. This first appeal, a request for reconsideration, must be filed within 60 days (plus 5 days grace for mailing) from the date stamped in the upper right corner of your notice of denial. If you miss the deadline you will probably have to file a new claim, a bad idea as previously stated.

Is your claim more likely to be approved as a result of a reconsideration appeal? Not really. Reconsideration appeals are also decided by DDS, the same agency that made the initial denial. The exception here could be if you have any new medical evidence to add to the record such as medical test results, reports from ER visits, etc. Only about 11% of all reconsideration appeals are successful.

You're probably wondering, at this point, why you should bother to appeal at all. The reason for going through the disability appeals process is that it keeps your claim advancing through the system to the second level of appeal, the disability hearing. Disability hearings take place before a federal administrative law judge. Statistically, ALJs are far more likely to approve applications for SSD and SSI than the disability examiners employed by DDS.

In short, the disability hearing presents a claimant with his best chance of winning benefits, particularly when represented by a disability attorney or non-attorney rep. About 60% of those who attend a disability hearing with legal representation are approved.

If you are denied for disability, does it ever make sense to file a new claim rather than an appeal? Only if your denial was based on non-medical criteria; for instance, if you made too much money to qualify for disability benefits at the time you first filed but your monthly income has since decreased, or if your reconsideration appeal was denied because you missed a deadline, or, in the case of those filing for SSI, if the value of your total assets was too high (to qualify for SSI you must demonstrate financial need, with assets totaling not more than $2,000 excluding your home and one car).

In all other instances it is better to appeal than file a new claim, and filing an appeal is exactly what you should do if you are denied for disability.

At each level of appeal, a claimant has a better chance of winning benefits than he would if he either gave up entirely or skipped the appeals process in favor of filing the same claim again with DDS. At hearings, claimants who have been previously denied at the application and reconsideration appeal levels tend to have up to a sixty percent of being awarded benefits, particularly when representation is involved and when a well-reasoned and well-documented case is presented before a judge.

Note: The reconsideration appeal is currently suspended in the state of New York as New York is one of 10 prototype states testing the removal of this appeal step. Reconsideration may be reinstated at some point. However, at this time, a denied claimant should request, and prepare, for a disability hearing to be conducted in front of a federal administrative law judge.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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