Why did I get Denied on my Florida Disability Request for Reconsideration?

As a former disability examiner and in my involvement in claimant representation, I've come across thousands of individuals who were angry, irritated, and perplexed over the fact that, after being denied on their disability application, they were denied yet again, for a second time, on their request for reconsideration appeal.

Typically, if I was speaking to the claimant who had just been denied on the "recon", my response would be something akin to "It's nothing to worry about. Most cases get denied at that level as well. We simply need to file your next appeal, the request for a disability hearing".

It's true, of course. The great majority of social security reconsideration appeals in Florida get turned down as well. And when the subject came up, I typically told claimants to simply expect that the reconsideration appeal we were filing would "probably get denied", that there was nothing out of the ordinary about it, and as soon as it occurred, we would file for a hearing.

However, WHY is it so common for the request for reconsideration to get denied? After all, if over 80 percent of all reconsideration appeals get denied, what's the point of even filing them?

Well, there's a very valid reason for filing a request for reconsideration. And that reason is that a claimant cannot request a hearing before an administrative law judge until they are denied on a reconsideration beforehand. So, a good way to look at the reconsideration appeal step is that it is simply a stepping stone, a necessary hurdle to get through before a hearing can even be requested.

As to why the reconsideration is so routinely denied, here's my observation of it. When your case is evaluated at the state disability agency in Florida (the agency that makes medical determinations for the social security administration --- this agency is usually known in most states as DDS, or disability determination services), it basically goes through the exact same process that it did the first time. That is, the case is assigned to a disability examiner (I used to be one) and the claimant's case is reviewed in order to determine whether or not the claim will, based on the medical and vocational information available, point to a residual functional capacity rating that will satisfy the social security administration definition of disability.

The only thing that really changes between the evaluation of the original disability application and the reconsideration that different disability examiners handle each step. However, what happens in the processing of the case is exactly the same. And considering the fact that the processing of a disability application and the processing of a reconsideration appeal are typically only separated by a few weeks, it wouldn't really make much sense for the state disability agency (DDS) to make radically different decisions on reconsiderations than were made on initial disability applications.

In fact, if a large percentage of reconsideration appeals were approved, it would bring into question why it was that a case could be easily denied in, say, January, only to be later approved in April on an appeal.

The truth, unfortunately, is that individuals who file for disability don't really get a fair chance of appealing the disability denial on the first appeal, the reconsideration. This is because, as I stated, it is the same agency making the decision the second time around.

In the Social Security Disability system, really, fairness enters into the process at the disability hearing level. Why? Because the state disability agency (DDS) is completely left out of the process. And more than that, applicants actually have a chance to meet the decision maker in their case (a federal judge) and also have their disability attorney (or non-attorney representative) represent their case and present a rationale as to why they should be approved to receive 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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