There are two ways to respond to a denied disability claim: you can appeal it, or ask the Social Security Administration to reopen it. Either way, you may end up with benefits AND backpay.
Appealing a Denied Disability Claim
Most states have a four-step appeals process:
- Request for Reconsideration. You must file this within 60 days of the denial. Be aware that some states have eliminated this step and that the SSA denies most requests.
- Request for a Hearing. You must make your request to be heard by an administration law judge (ALJ) within 60 days. Most cases that get approved for benefits are approved by an ALJ.
- The Appeals Council lets you fight an ALJ denial, as long as you appeal within 60 days. There are three possible outcomes. The AC can: (a) refuse to hear your claim; (b) disagree with the ALJ, awarding you benefits; or (c) bounce your claim back to the ALJ and tell them to review it, which may or may not result in benefits.
- The Federal Appeal. Your final option. First, you must submit a short, detailed document called a “brief,” explaining why all the earlier decisions in your case were wrong. You especially need legal help here, because federal briefs are hard to write and must follow complicated requirements most non-lawyers can’t meet.
Reopening Your Claim
This is your only option for fighting a denied disability claim if you choose not to appeal or miss the deadline. This actually involves opening a new claim related to the old one. Suppose you have severe hemophilia and can’t safely work in most environments. A related claim might result from a disabling injury sustained because you had no choice but to work anyway after your first claim was denied.
You can only reopen a denied claim while disabled, and there are limits you must follow. If the old claim is less than a year old, you can reopen it for any reason. If the claim is 1-4 years old, you can reopen it only if there’s new evidence or the old claim has an obvious “error on the face” on the part of the ALJ. You can open an older claim only if:
- someone committed fraud or left out important information;
- your benefits were miscalculated; or
- an error on the face needs correction.
Reasons to Reopen Your Claim
If you’re approved, you’ll get back-payments of benefits going back to your first application date, even if it was years ago. Social Security Disability (SSDI) may also add more “retroactive benefits” dating back to the day you first became disabled. Altogether, this can amount to many thousands of dollars.
Reasons NOT to Reopen Your Claim
It’s easier and better to appeal a denied disability claim instead of reopening it, because:
- You may have to wait more than two years for a final decision.
- The SSA can decide not to reopen your claim if (a) they think it doesn’t meet the deadline requirements; (b) they decide the new claim isn’t related to the old one; or (c) the old claim fails the evidential or error tests listed above. If they don’t reopen the claim, you won’t get backpay even if you get benefits for the new claim.
- An ALJ can deny your claim just because it was denied before. They’re supposed to review the case all the way back to the very beginning, but may assume it was denied for a good reason and deny it again without checking. Again, you get no backpay.
Get an Experienced Attorney to Handle Your Denied Disability Claim
If you’re sick or hurt and can’t work, don’t give up. Get Hermann Law Group on your side. Call 1-888-504-3413 for help with your denied disability claim.