Social Security Reconsideration Appeal in California - what makes it different from the Disability Application?

What makes this first disability appeal different from the application?

Answer: not a whole lot. Reconsiderations constitute the first appeal that is available to individuals who file for Social Security Disability or SSI disability benefits.

How is a reconsideration handled or conducted? In brief, it goes like this: if a claimant who has been denied on an application for disability benefits in California files a request for reconsideration within the required time period (you are given sixty days plus an additional five days for mailing time for a total of 65 days), then their file will be assigned to a new disability examiner. This examiner will be someone who specializes in reconsiderations, but, nonetheless, does the job in exactly the same manner as the initial claim examiner who preceded him. That is, medical evidence will be gathered as needed and an evaluation based on this evidence will be performed.

Reconsiderations are denied at a significantly higher rate than initial claims. But this should not be surprising if you consider how it would look if reconsiderations were more often approved than they currently are. For the most part, it would be a repudiation of denials that occurred at the initial claim level only several weeks earlier. It would be tantamount to saying "We made a mistake when we denied you on your application three weeks ago. Now we think you qualify for disability". Of course, that will never happen and the likelihood will be that reconsiderations will always have a high rate of denial as long as the agency that conducts first appeals is the same agency that processes initial disability claims.

Should you request a reconsideration if your application for disability gets denied? Yes, most certainly. But you should do it with this in mind. Even though only about 15 percent of reconsiderations get approved, you still want to file a reconsideration because this puts you on the road to getting a disability hearing before an ALJ (administrative law judge) scheduled. In other words, you are not allowed to request a disability hearing until your reconsideration gets denied (and, as we said, most, unfortunately, do).

What are your chances of winning disability at a hearing? Far better than at a reconsideration. Roughly half of all cases that are heard by judges at hearings are approved.

The only real downside to disability hearings is how incredibly long it can take to get a hearing scheduled. But it is for this reason that you should not waste any time in requesting a hearing (or a reconsideration for that matter).

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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