If you get denied on a disability application do you have to file a new application?

For the approximately 70 percent of individuals who get denied at the disability application step but decide to continue on through appeals, the disability process will usually involve the following:

1. An initial filing (the application, which the claimant has already gone through).

2. A request for reconsideration appeal (basically, a second look at the claim if the disability application is denied, as well as the opportunity to have additional evidence reviewed by the reconsideration examiner if there is new information).

3. A a hearing before an administrative law judge (requested when reconsideration appeals are denied).

Should you immediately file a new application if your current application is denied? In nearly all cases no. You should file a request for reconsideration, the first appeal. In a small percentage of cases, a claim will be denied for a non-medical reason, such as the claimant working at or above the allowable limit for earned income (SGA limit).

In those cases, the claim will have received a technical denial at the Social Security office and will not even have been assigned to a disability examiner for processing. Or the issue of being over the income limit will have been discovered by the disability examiner, the result being that the case is "denied for SGA". In either situation, there is no point in filing an appeal and the claimant may wish to file a new claim provided that they are no longer working, or their earnings have dropped below the SGA limit.

In nearly all other situations, however, a person who has been denied will wish to file a request for reconsideration appeal, not file a new claim--simply because there will be no point in filing a new claim since it will be likely to be denied again.

While the reconsideration appeal is also likely to be denied, once a claimant goes through the reconsideration phase, they can request a hearing where the odds of approval rise substantially.

Filing an appeal after being denied

If you learn that you have been denied for disability benefits, either under the title II Social Security Disability or title 16 SSI disability program, you will receive a notice of denial that contains an explanation of your appeal rights.

At anytime within 65 days of your disability denial notice date (this includes 60 days for the actual appeal time plus an additional five days of mail time which the social security administration will allow you), you have the right to file an appeal.

It is not uncommon for appeals to be missed. In some cases, this is due to a simple error on the part of the claimant. In other instances, this is because the appeal paperwork was never received by the claimant from the social security office, or was mailed back to the social security office and never received there. This, of course, illustrates the high value of doing followups on any paperwork that has either been requested or mailed out.

Note: It sometimes occurs that the time period for submitting an appeal expires because the claimant never became aware that their case was denied in the first place. Again, this points to the need for occasional follow-ups on the status of a case.

If you intended to file an appeal following the denial of your disability application, but missed the appeal deadline, you have two choices. You can file a new disability application with the social security administration or you may request that good cause be given for your late appeal filing.

If the Social Security Administration determines good cause, then your disability claim will be appealed to the next level. If good cause cannot be given, then you will have to file a new application for Social Security Disability or SSI disability benefits.

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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