If your California disability appeal is denied, can you get another appeal?

The simple answer to this question is, yes, you can get another disability appeal if your first appeal is denied in California. The Social Security Disability appeal process is federal, standardized, and multi-level; therefore you may have another appeal for your Social Security Disability or SSI claim if you are denied on the first appeal.

In fact, it is more often the case than not that a claim will be approved on the second appeal rather than the first.

If your initial disability claim is denied in California you may file for a reconsideration of the denial, officially titled "request for reconsideration". The reconsideration process is identical to the application process in many ways. Your claim will be sent back to the state disability determination service responsible for Social Security Disability medical decisions (known as DDS or disability determination services).

At this agency, a second disability examiner will once again review the medical evidence in the file. For this reason, if you have had recent medical treatment, have gone to a new source of treatment, or had a change in your medical condition, this should be indicated by you or your representative (who may be a disability lawyer or a non-attorney disability representative, many of whom are former Social Security employees and disability examiners themselves).

If the "request for reconsideration" has been assigned to a new disability examiner fairly soon after the denial of the initial claim (you have two months to file the appeal but are advised to request the appeal as soon as you receive notice of being denied), there will be a reasonably good chance that there will be current medical record documentation in the file.

For Social Security Disability and SSI approvals to be made, there must be at least some current records to evaluate, "current" being defined as not older than 90 days. If there is no current documentation in the file, then the reconsideration examiner will need to request updated records from the claimant's treatment sources and this could significantly delay the decision on the reconsideration appeal.

Note: this is a perfectly good rationale for claimants to get their appeals submitted quickly, ideally the very next day after receiving a notice of denial. Doing so can sometimes help a case by avoiding the "aging out" of its medical evidence. Also, if there is no current evidence available, the chances are strong that you will be required to go to an independent consultative medical examination (referred to as a CE), which the Social Security Administration will schedule and pay for.

If your reconsideration appeal is denied

This happens roughly 87 percent of the time. If it happens to you, then you may appeal your claim with a request for a disability hearing. This appeal is initiated very similarly to how a request for reconsideration gets started. If you are represented by a disability attorney, you can have that individual submit your appeal paperwork for you.

Obviously, this is the easiest route to take. Typically, the attorney will send in the appeal and then conduct periodic followups on the status of the appeal as it is being worked on. If you are not represented, contact the social security administration and ask that appeal forms be mailed out to you (you have the option of filing appeals at the SSA website as well).

If you apply for a hearing, it may take a long number of months to be scheduled for a hearing date in California. This can range from six months to as long as two years depending on the hearing office that has jurisdiction for your case. The unusually long wait time is due to backlogs in the system. At some point, however, your case will be assigned to an administrative law judge who will review your disability claim.

This means that the ALJ will review your medical records and work history to learn about A) what your mental or physical limitations are and B) what your vocational work history reveals about your job skills and, thus, your ability (or inability) to do other tpes of work, assuming that your condition will prevent you from going back to one of your former jobs. After this analysis is conducted, the ALJ, or administrative law judge, will make a medical disability determination.

If your hearing appeal is denied

You may file an appeal to the Appeals Council, the third level of appeal in the SSD and SSI disability system. Relatively few disability claims are allowed at the Appeals Council level, however. The other alternative would be to file a new claim. Consultation with your representative at this point, of course, will be important.

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 SSD or SSI application or Appeal, go here.

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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