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SSDI and Request for Reconsideration

SSDI and Request for Reconsideration

Although millions of Americans receive monthly benefits through the Social Security Disability Insurance (SSDI) program every year, the process to obtain those benefits is not easy. Most people’s claims are denied initially. Then how do so many people ultimately obtain benefits? Because of the rigorous and thorough appeals process.

The SSDI appeals process contains four phases: 1) request for reconsideration; 2) hearing with an Administrative Law Judge (ALJ); 3) review by the Appeals Council, and 4) review in Federal Court. Here, we discuss the first level of the appeals process, the request for reconsideration.

Social Security Administration (SSA) will send you a letter that explains the rationale behind its decision to deny your claim. The Administration could deny you for medical or non-medical reasons. If you were denied for medical reasons, it is because SSA either does not believe you are disabled, or it believes that you are disabled but that your condition is not severe or long-lasting enough to qualify you for benefits. SSA will tell you which medical records it considered when evaluating your claim.

A denial for non-medical reasons could be because you were already denied a different kind of benefit or you did not work long enough to qualify for SSDI benefits. Regardless of whether you were denied for medical or non-medical reasons, you can file your request for reconsideration online or by using Form SSA-561. You usually have 60 days after you receive the notice of decision to appeal; if you miss that window, you will have to start over with a new claim.

Reconsideration involves a complete review of your claim by someone who did not participate in the initial review of your claim. The examiner will look at all evidence you have submitted with your original claim along with any additional evidence you have provided since then.

Some people incorrectly assume that it is better to file a completely new claim than appeal the first one. The logic behind that is flawed because your second claim will likely be denied for the same reason(s) the first one was. Instead, it is better to correct the gaps SSA noted in your claim when they rejected you the first time to ensure that your claim grows more robust as it progresses through the appeals stages.

To ensure you have the best possible request for reconsideration, go over your denial letter carefully to see what you might have left out in your initial application inadvertently. Fill out all forms completely, submit new medical records, ask your treating physicians to write letters of support for your disability claim, and consider working with an attorney who is familiar with the process and can help you present yourself in the best possible light.

Unfortunately, the people who review your claim in reconsideration are bound by the same rules as the people who denied your claim initially; as a result, about 85% of claims are denied at the reconsideration stage. However, once you appeal that decision, your chances of getting approved for benefits at the hearing stage increase dramatically, especially if you work with an experienced Social Security Disability lawyer.