The difference between an Application for disability and a Social Security Reconsideration?

Someone recently submitted this question: "What is the difference between a disability application and the reconsideration? Are they the same thing? Answer: they are definitely not the same thing, though they are handled in an almost identical manner.

The application for disability is where the whole process of filing for SSD or filing for SSI--or both if your claim is concurrent--begins. If you've gone through this extended process, then you know that your case will be worked on by a disability examiner and that individual will do the job of going through your medical records and examining your work history. They will review your past work to determine if the physical and/or mental limitations that you have as a result of your condition (or conditions) makes it impossible for you to engage in work activity.

You may also (if this was done on your particular case) may be aware of the fact that, during the course of processing your claim, the examiner may find it necessary to contact you through the mail, or by phone, to get additional clarifying information about your work history, or to discuss what your range of normal daily activities is, or to ask you more questions about your doctors or the treatment you have received.

The process that is conducted on a request for reconsideration appeal is largely the same. This is because the disability evaluation process is simply what it is, and, therefore, is essentially handled the same regardless of the level of your claim.

The process is, of course, conducted a bit differently at a social security hearing where a judge is charged with making the disability determination, but this is largely due to several reasons:

A) Neither the judge nor the hearing office will gather records for the case (once the case moves beyond the reconsideration appeal stage, the social security administration no longer does development on a case, though the judge may decide to send a claimant to a consultative medical exam if this is considered necessary)

B) The claimant will appear before the judge, usually with disability representation in the form of a disability lawyer or non-attorney claimant's representative.

The focus of the hearing is, to some extent, to address what has happened at previous levels of the system (disability application and reconsideration). However, since the claimant and his attorney are allowed to present additional medical evidence, information regarding the work history, and also to present an argument for approving the claim, the actual process of making the decision is still the same.

For those who are unaware of the process, it basically boils down to determining if the claimant's condition satisfies the criteria of an impairment that is listed in the Social security list of impairments, i.e. the blue book. If the claimant does not have a listing level impairment, then the decision will be based on what mental and physical functional limitations the claimant has, and, secondly, whether or not those limitations are strong enough to prevent the person from doing work activity.

To go back to the original question, however, there are few substantial differences between an application for disability and a reconsideration appeal. Here are the most apparent differences:

1. Reconsideration appeals generally take less time for a decision to be made.

2. Reconsideration appeals are generally denied at an even higher rate (87 percent denial rate on reconsiderations versus 70 percent denial rate on disability applications).

3. A reconsideration is handled by a different disability examiner than the examiner who made the decision on the disability application.

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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