My Claim Was Initially Denied. What’s Next? Social Security Request For Reconsideration

After the State Agency decides you are not disabled, you will receive a letter saying you are not eligible for disability.  After a page of standardized language, your notice may list on the second page what medical evidence the judge had reviewed.  But sometimes they list everything and sometimes they list nothing – a staffing issue again.  I look at the list of what they had mostly to see if what we submitted is even mentioned but since a denial is the normal result, the most important factors to me are that they issued a decision and that it is dated.  We have 60 days to appeal but on occasion there isn’t even a date which means it had not even been finalized but went out anyway. 

Claimants are often surprised when I say I don’t really care why they denied you if it is a routine denial – I’ve seen variations of the same denial language thousands of times.  Sometimes you are denied for other reasons and then you have to look carefully.  They may say you didn’t work long enough to be eligible for benefits.  If that is so and if it is accurate, you may not be eligible though often enough you don’t meet the current eligibility but you did in the past and you might have to prove an earlier onset.  Sometimes you have worked recently but have not filed your return yet.  If so, sometimes you can now do so and with the extra credits make yourself eligible. 

You must have worked enough years over your lifetime and especially in the ten years before you were disabled to be eligible.  These rules are different for SSD than for SSI since SSI cases do not require proof of work.  Your work and the FICA taxes taken out of your paycheck make you eligible for benefits.  You pay for SSD out of your FICA taxes just as you pay for retirement out of your FICA taxes.  SSD is  an “entitlement” program – you are entitled to benefits since you both paid your FICA taxes each week out of your paycheck and you have proven that you cannot work right now.  But as I said, such denials like this or other special reasons are relatively unusual.  The normal denial says you are not disabled enough for disability. 

How much time do I have to appeal?

Your initial denial letter will tell you that you have been denied and if you want to appeal, you must do so within 60 days.  60 days is a common deadline for Social Security cases.  There are lots of ways to appeal.  The Social Security Administration (SSA) will list some of them on the denial including doing an appeal through the internet or by the U.S. Post Office mail (but I would make sure you have some proof of the mailing). 

If you fail to apply on time you have to start all over again and in some states you lose forever the period of time up to the date of the denial.  There are some exceptions to the 60 day appeal such as you didn’t get the notice as you moved or your mail was stolen or you were hospitalized and could not get to it.  But there is no excuse for not appealing timely if you got the notice within a few days of the date on the denial.  If in doubt appeal – you can always withdraw it later if you are not eligible or if your doctors refuse to cooperate. 

What is the Reconsideration Stage?

Reconsideration is the Second Stage in the process. The Reconsideration stage is exactly what it sounds like – you are asking the government to reconsider the decision to deny you.  Reconsideration has long been considered a phony step, one designed basically to discourage you, to make you give up from fighting the government.  In response to Congressional anger at the length of time it was taking to get a case processed, as an experiment, Reconsideration was abolished for many years in 29 states.  

Experiments in the SSA don’t go on for 6 weeks or even 6 months but go on for years.  The bureaucracy becomes reluctant to ever end an experiment, so we had this “experiment” going on for years in some states but not in others.  Most people practicing in this field and many in Congress felt there was no point of this second paper stage, that by and large the State Agency merely affirmed what it had done the first time. 

In my experience, if you had a second new disability, you might be found disabled based upon that second impairment in combination with the first one but seemingly 95% of the time unless you had some dramatic new evidence Reconsideration was a rubber stamp of the first Initial Denial.  Going through Reconsideration would add 3 or 6 months to the process which was long enough already.  But you could not skip it.

The Commissioner appointed by Trump reinstated this second step in the 29 states that had abolished it almost immediately upon being confirmed.  His purpose seemed to be to make the process longer.  That Commissioner certainly could not be considered a friend of the disabled nor of the retired .  Some commentators felt he did not genuinely believe in the Social Security system.   So Reconsideration was reinstated for what seems to be the wrong reasons – to make the process longer so that people would get more discouraged and drop out.

 It seems to have worked because the number of people applying who drop out at reconsideration is not insignificant.  A lot of people who are unrepresented drop out.  People who are represented who know that this stage has always been traditionally a phony paper stage merely wait for the denial and apply for the hearing.  But unsophisticated or unrepresented claimants often wait six months or so and reapply which has consequences.  But it brings a hardship to claimants who have been without any money coming in for months already – adding another 4-6 months is simply cruel. 

However, to the Social Security Administration’s credit, I have seen more Reconsideration grants now than I used to see so it is possible they have made Reconsideration a serious step.  Again, it hasn’t been long enough to know.  I don’t know what the new Commissioner will do because President Biden hasn’t nominated a Commissioner.  The agency is being run by an Acting Commissioner who everyone feels has almost no authority to do anything.  So the disability program right now seems to be running itself without any serious supervision, without guidance, and as articles in the papers such as the recent one in the Washington Post point out that the management of this vital program is terrible. 

So to sum up, after you are denied you cannot skip a step.  Reconsideration is the second step.  It is a paper step like the first stage.  No one interviews you and you do not testify.  The grant rate as with the initial stage varies state by state.

After Reconsideration is the most crucial stage in the proceedings – the hearing stage.  I will discuss that in the next article.

Get The Right Representation For Your Request For Reconsideration

At Binder & Binder®, the Social Security Disability Advocates, we will file your claim carefully and professionally. We handle cases at all levels, including Reconsideration. Call us at 1-800-4-BINDER (1-800-424-6337) or complete our online contact form to get started.