Disability Reconsideration: Appealing a Denied Claim
The vast majority of claims for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) disability are denied at the initial claim stage. The Social Security Administration (SSA) typically denies disability claims for the following reasons:
- Claimant's disability isn't severe or isn't expected to last 12 or more months.
- Claimant can perform his or her usual type of work or other type of work.
- Claimant's disability is the result of alcohol or drug addiction.
- Claimant provided insufficient medical evidence.
- Claimant failed to cooperate or didn't adhere to the prescribed medical treatment.
- Claimant resumed gainful work before the disability could be proven.
If the SSA has denied your claim for disability benefits, don't despair. You have the right to appeal the decision. The initial phase of appealing a claim for disability is a request for reconsideration. As its name implies, reconsideration is another look at your initial claim. Claimants often make the mistake of starting over with a new claim when their initial claim is denied, but filing for a reconsideration is generally more effective.
New Evidence Rebutting the Denied Disability Claim
One of the most effective ways to challenge a denied disability claim is to file a request for reconsideration that includes new evidence rebutting the SSA's findings. A brief statement from your doctor simply stating that you are disabled and cannot work will likely be deemed by the SSA as conclusory and generally won't help your case. On the other hand, a well-written doctor's report supported by convincing medical evidence can help overturn a denied disability claim. Your doctor's medical report generally should contain the following information:
- Medical history
- Laboratory findings
- Clinical findings
- Medical diagnosis
- Medical treatment prescribed with response and prognosis
Your doctor should include a statement regarding your ability to perform work-related activities, which among other things may include hearing, talking, walking, standing, sitting, traveling along with carrying, lifting, and handling objects. In addition, your doctor's statement should include what you can do despite your disability. Finally, if your impairment is a mental disability, your doctor's statement should evaluate your ability to remember, understand, and carry out instructions along with your ability to respond appropriately to your supervisor, co-workers, and pressures in the workplace.
How to File the Request for Reconsideration
Generally, you have 60 days from the date you received the SSA's letter to file your request for reconsideration. The SSA presumes you received its letter five days after the date on the letter, unless you can show you received it later. Late reconsideration requests generally are rejected. If you miss the deadline, you'll typically have to file a brand new claim. However, in certain circumstances, the SSA may allow an untimely appeal if a "good cause" exception applies.
If the SSA denied your disability claim for medical reasons, you can request a reconsideration through the SSA's online disability appeal tool. Alternatively, you can file your request for reconsideration by completing the following three forms:
- Request for Reconsideration (Form SSA-561)
- Disability Report - Appeal (Form SSA-3441)
- Authorization to Disclose Information to the Social Security Administration (Form SSA-827)
You should mail or take your completed signed forms along with any new evidence to your local SSA office. If you don't know the address, you can look up the SSA office address online or call 1-800-772-1213 for assistance.
Because the SSA sometimes loses documents, it's important to make copies of everything you provide to the SSA. Moreover, you shouldn't expect an immediate reconsideration decision. Depending on your SSA office, a decision generally will be issued in three to five months.
My Reconsideration Was Denied. What Now?
Unfortunately, only a small percentage of disability claims are approved upon reconsideration. Consequently, you shouldn't be surprised if this initial appeals phase results in another denial. However, the good news is that you can appeal the reconsideration decision. There are three additional levels for appealing your claim. The first of which, an Administrative Law Judge hearing, has a much higher approval rate.
To help you prepare for your hearing, you may want to review "What Happens at a Disability Hearing?" and "Preparing for Your Social Security Disability Hearing."