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Social Security Disability Denial: Reconsideration Process, What You Need to Know

LaBovick Do I Need an Attorney to Apply for Social Security Disability

Unfortunately, social security disability denial is all too common after going through the application process and appearing before an administrative law judge. Although receiving a negative outcome is frustrating after waiting so long, hope is not lost. In fact, it’s not uncommon for those previously denied to eventually receive benefits. This article will explore the options available to you in the event of a social security disability denial.

Appealing a Social Security Disability Denial

First, if you are within 60 days of your hearing decision date, you do have the option to appeal the administrative law judge’s decision.

The instructions for submitting an appeal online are included with the judge’s Notice of Decision. If you choose to appeal the decision, the Appeals Council will review the entire file, including documents you completed for Social Security, medical records, earnings records, and the recording of the hearing.

The Appeals Council will determine whether the administrative law judge made a legal error when he or she decided on the case. If the Appeals Council finds that the judge did in fact make a legal error, they will send the case back for a new hearing with the same administrative law judge.

The Appeals Council will not reweigh the medical evidence; it will simply determine whether the judge did not properly follow one or more of Social Security’s regulations. Only about 20 percent of cases are sent back by the Appeals Council for a new hearing.

If the Appeals Council denies the appeal request, you have the option to file a federal court claim. The federal court will send the case back with instructions if they find that the judge and appeals council made a critical error in evaluating the case. There will then be a new hearing with the same administrative law judge.

Filing a New Claim for Social Security Disability Benefits

If you have missed the deadline to appeal, if your appeal was denied and you do not wish to go to federal court, or you simply do not want to proceed with appealing the judge’s decision, you may have the option to file a new claim for disability benefits.

One significant difference between filing an appeal and filing a new claim is that the date of disability, which Social Security calls the Alleged Onset Date, will need to change. This can affect the amount of past-due benefits you would be eligible to receive.

If you choose to file a new claim after a prior hearing decision, the earliest alleged onset date you will be able to choose is the day after the date of the administrative law judge’s unfavorable hearing decision. You will need to obtain new medical evidence to support your new claim.

This means that any medical records that were used to decide your previous unfavorable case will not be used to decide your new claim. Therefore, it is imperative if you choose to file a new claim that you continue to get updated treatment from your medical providers.

Even if your condition is considered to be permanent, it is important to continue to see a doctor so that his or her examination findings and comments regarding your long-term prognosis are documented clearly within your medical record.

What are the options to consider after social security disability denial: appealing or filing a new claim?

Appealing a Prior Hearing Decision

The advantage of appealing a prior hearing decision is that your original alleged onset date is preserved. This means that the medical records which were used in your initial hearing decision may be reevaluated if your case is sent back from the Appeals Council to the administrative law judge for a new judge. In addition, you maintain your original eligibility date for past-due benefits. Social Security will pay up to one year prior to the date that the claim was filed for SSDI benefits, depending upon the person’s alleged onset date. There is also a five month waiting period for benefits after the alleged onset date. By appealing the denial rather than filing a new claim, the person maintains eligibility for this higher level of past-due benefits.

Disadvantages of Appealing a Prior Hearing Decision

The Appeals Council typically only sends about 20 percent of cases back for a new hearing, and the judge may still deny the case at the new hearing. Typically, the same judge who presided over the first hearing will preside over the second one. If there are concerns about the particular judge and his or her overall approval ratings, it may be preferable to file a new application.

Filing a New Application for Benefits

If you choose to file a new application for benefits, it is important to confirm that your Date Last Insured is still current if you are filing a claim for SSDI benefits. In order to be eligible for SSDI benefits, you must prove you became disabled while you met “insured” status. Typically, one meets this requirement if they have worked and paid taxes on their earnings for at least five of the past 10 years. Therefore, if you have not worked for several years, it is important to check your date last insured. Social Security can provide you with this date either over the phone or by registering for their online portal.

Important Considerations When Filing a New Claim

The earliest alleged onset date you will be able to select is the date after your prior hearing decision, you will only be able to file a new claim if your date last insured has not expired.

Deciding whether to appeal a hearing decision or file a new claim can be difficult and warrants consultation with a skilled professional.

Seeking Legal Help

If you were denied at your previous hearing and your date last insured has not expired, do not give up hope – many people who were denied at their hearing go on to file a new application and be successfully approved for benefits. Our legal team at LaBovick Law Group has a wealth of experience with people in this exact situation. Give us a call at (561) 625-8400 for a free case evaluation.

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