Reconsideration of a Social Security Disability denial- what does it involve?

Filing a Request for Reconsideration

If you wish to still pursue your disability claim after your initial disability application has been denied, it is a fairly simple procedure.

1. You can file the appeal online at the social security administration website.

2. You can contact your disability lawyer if you are represented and that individual's office will submit the appeal paperwork for you to the nearest social security office, most likely the same one that you filed your initial claim at. After the lawyer completes the appeal, they will mail you a copy of the appeal for your records and keep a copy for their own file.

This has the added benefit of not only keeping all parties on "the same page"; it also serves to prove to SSA that the appeal was submitted in a timely fashion if, for some reason, they do not receive their copy of the appeal (or simply lose it, which is not an uncommon occurrence).

3. Lastly, if you are not represented, you can contact the nearest social security office and advise them of your desire to appeal your claim denial. That will put them on notice to send out the correct appeal paperwork to you.

Remember, if your disability claim (Social Security Disability or SSI) has been denied you will have sixty days to file an appeal. Note: You will have received a notice of denial with the date of the denial stamped in the upper right corner on the first page. This is the date to count the 60 days from.

This, of course, does not mean that you should mail the appeal in on the last day. The appeal actually has to be received by the end of the appeal period, so you shouldn't waste time in doing this.

Being Late on the Reconsideration Appeal (or any type of appeal filed with SSA)

If the Social Security Administration does not receive the disability appeal from you within the established appeal period (sixty days from the date of your denial), your request for reconsideration may not be granted...unless one of two things happens.

1. "Good cause" for a late filing is granted (such as a verifiable medical or family emergency) -- or

2. It can be proven that you did not receive the notice of denial and, therefore, did not have the opportunity to appeal (this also falls under good cause); this is why keeping copies of everything that is sent to SSA is a good idea and this is exactly why a disability attorney will usually keep a copy of anything that involves the case -- or

3. It can be proven that the social security office did, in fact, receive the submitted appeal. It does occasionally happen, meaning situations in which the claimant and their attorney insist that the appeal was sent in timely and the social security office later discovers the submitted paperwork tucked away in a file or on someone's desk.

If you are not granted good cause for a late appeal, or the social security office cannot find their copy of what you believe they really received, you will have to begin the Social Security Disability process again by filing a new disability application with social security. In other words, you will have to start all over again.

Whether you have a disability attorney or not, to avoid a late filing of a request for reconsideration, if you receive a Social Security denial letter immediately contact your local Social Security office or the toll free number 1-800-772-1213 and request an appeal.

You may also visit the Social Security office and get the proper paperwork or you may request that the appropriate forms be mailed to you.

Of course, once again, if you are represented by an attorney, you can contact your attorney and have them file the request for reconsideration for you.

What happens on the Request for Reconsideration Appeal

A reconsideration is fundamentally the same as a disability application. A disability examiner (a different examiner than the first one) will review the medical evidence. If the claimant is an adult, the examiner will also review the individual's work history to see if there are jobs to which the person can return, or job skills that will allow them to do some type of other work.

If the claimant is a child, the examiner will review the claimant's school records and educational achievement scores, in addition to IQ testing.

Procedurally, there is no difference between the process involved in deciding the outcome of a reconsideration appeal versus a disability application.

However, there are two distinctions that can be made between disability applications and reconsiderations:

1. Reconsiderations have an even higher rate of denial. While applications are denied at roughly a 70 percent rate, approximately 87 percent of reconsiderations are denied.

2. Reconsiderations are usually decided faster because most of the evidence has been gathered by the disability examiner who worked on the initial claim.

What is the true usefulness of the reconsideration appeal, and should a claimant even bother to file this appeal? Every claimant who has the opportunity should file a request for reconsideration because there still remains a possibility of being approved at this level.

More importantly, though, after a reconsideration has been denied, a claimant can request a disability hearing. And it is at this level where previously denied claimants typically have the best chance of being awarded 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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