If you are unable to work due to a disability, then you may be eligible for Social Security disability benefits. The Social Security Administration (SSA) offers two kinds of disability benefits: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Depending on your situation, you may qualify for one or both types of benefits.
Unfortunately, the SSA rarely approves benefits based on an initial application. On average, just 22% of applicants are awarded disability benefits at this stage. Fortunately, there are four levels of appeal after a denial, starting with filing a request for reconsideration.
If your disability reconsideration is denied, then you can proceed to the next step: requesting a hearing with an administrative law judge (ALJ). If you need to appeal a denial, our law firm can help. Bross & Frankel represents people with disabilities throughout New Jersey and Pennsylvania, helping them get the benefits that they are entitled to under the law.
Understanding the Reconsideration Process
If your initial application for disability benefits is denied, then the notice of decision from the SSA will have included information about your right to appeal. The first step in the process is reconsideration.
Reconsideration is a complete review of your disability claim by someone who was not involved in the initial determination. The same office that handled your initial claim for Social Security disability will perform the reconsideration review, but a different examiner will look at your case.
There are two types of reconsideration requests. If your Social Security disability claim was denied for medical reasons, then you can file a request for medical reconsideration. If your initial application was denied for non-medical reasons – such as income or resources – then you can request a non-medical reconsideration. Both types of requests for reconsideration can be filed online.
During the reconsideration process, the SSA examiner will look at all original evidence submitted with your application, plus any new evidence that you present with your request for reconsideration. This examiner is bound by the same rules as the person who reviewed your initial application. For this reason, unless you provide new evidence to support your claim (such as updated medical records), the chances of succeeding are low.
Denials at the reconsideration stage are common. In 2017, the SSA approved just 9.3% of all requests for reconsideration for disability benefits. There are certain steps that you can take to improve the odds of winning disability reconsideration.
First, the appeal must be filed on time. A request for reconsideration must be filed with the Social Security Administration within 60 days from the date listed on the denial letter. The sooner that you file your claim, the sooner you will receive a decision.
Second, you must file the correct paperwork. This includes Form SSA-561 (Request for Reconsideration), a Reconsideration Disability Report (to submit new evidence), and an Authorization to Disclose Information to the SSA (a medical release form). If you don’t file these forms, then your request for Social Security disability reconsideration may be denied.
Third, you should obtain and submit supporting evidence. One of the main reasons that the SSA denies claims is due to a lack of evidence. Without additional evidence to support your application, the Disability Determination Services (DDS) office will not have enough information to overrule the initial denial.
The type of evidence will depend on why your initial claim for disability benefits was denied. If it was denied because the Social Security claims examiner did not find that you were disabled, then you will need to submit additional medical evidence. If it was denied for non-medical reasons, then you may need to submit other types of evidence at the reconsideration level.
Fourth, ask a treating physician to fill out a residual functional capacity (RFC) assessment for you. This form is different from your other medical records, in that it specifically addresses how your medical condition affects your ability to engage in substantial gainful activity (SGA). A disability benefits attorney can help you find a doctor who can perform an RFC for you.
Fifth, review your initial application to determine if you left out any important information. Correcting these mistakes can increase the likelihood of getting the initial decision overturned on reconsideration.
On average, it takes between three and five months to complete the Social Security disability reconsideration process. Once you have received your disability determination, you will be able to decide whether you should file an appeal.
One of the best ways to improve the likelihood of winning reconsideration is to work with a disability lawyer who has significant experience handling Social Security disability claims. They will understand what the SSA needs in order to approve your application – and will put together a strong case for your benefits claim to be approved at the reconsideration level.
What Comes After Reconsideration Is Denied?
If your request for reconsideration is denied, then you will need to move to the next step of the appeals process: filing a request for a hearing with an administrative law judge (ALJ). You can request this hearing online through SSA’s website or by filing form HA-501, Request for Hearing By Administrative Law Judge. A request for an appeal must be made within 60 days of the notice of the reconsideration determination.
Once your request has been filed with the SSA, then a hearing will be scheduled. Typically, this hearing will be scheduled within 75 miles of your home. It may be held via video at one of Social Security’s hearing sites, in person at a Social Security hearing office, or from your preferred location. If you are represented by an attorney, they may host your hearing in a conference room at their office for your convenience.
The SSA will send you a packet of information that explains the ALJ hearing process. To expedite your hearing, make sure that you complete and return all forms as soon as possible. This will help to get your hearing scheduled more quickly so that you can get before a judge and get a decision on your claim.
Any new evidence that you want to submit, such as medical records, must be sent to the hearing office by mail or fax at least 5 business days before the scheduled hearing. Your lawyer can work with you to gather evidence and to submit it to the SSA in advance of your hearing.
During the hearing, the ALJ will explain the issues in your case. They will then question you and any witnesses that you bring to the hearing, such as your doctor or a family member. The ALJ may also ask a medical expert or a vocational expert to testify. If you are represented by an attorney, then they will have an opportunity to make arguments and question witnesses.
An ALJ hearing is less formal than a trial in a courtroom. However, it is still a legal proceeding. You will be under oath or affirmation when testifying and the hearing will be recorded. The ALJ will listen to all of the testimony and consider any evidence submitted.
After the hearing, the ALJ will issue a decision, which will be mailed to both you and your attorney. If you disagree with the decision, then you can file a request for review by the Social Security Appeals Council. The final step in the appeals process is to seek federal court review by filing a civil lawsuit in a federal district court.
Through every step of the process, from the initial application through a federal court review, having a skilled disability benefits lawyer to represent you can increase the likelihood of getting your disability claim approved. The Social Security disability process is complicated, and failing to follow the rules or submit the correct evidence can make it difficult – or even impossible – to get your application approved at any level.
Starting with a free claim review, a disability attorney will be a strong advocate for you. They will explain the process and what types of evidence you will need for a successful claim. When filing an initial application, they will ensure that every form is filled out and filed properly and that all medical records and other evidence are completed. They will also work with you to find medical professionals who can provide the type of evidence that you need for your claim.
If your application is denied, your lawyer will gather additional evidence and file the appropriate paperwork to request reconsideration. They will closely examine the basis for a denial, and develop arguments designed to overcome the denial. Throughout the appeal process, they will reach out to medical providers and other experts to put together the strongest possible claim.
While the Social Security disability process can be challenging, it is possible to be approved for benefits at the initial determination level with the help of a seasoned disability benefits attorney. Whether you are just starting to apply for benefits or have already been denied, we can help. Our law firm will fight for your right to disability benefits, at any stage of the process.
Why Should I File for Reconsideration?
After receiving a denial on your initial claim for disability benefits, you may be tempted to just start the process over again. Doing this can affect your right to back pay. If you are ultimately awarded benefits, then you will receive back pay dating to your initial claim. That is why you should file a request for reconsideration instead of starting a new application.
To win a reconsideration, you will need to submit new evidence to overcome the initial denial. Bross & Frankel can help you with this process. Give our law firm a call to schedule a free claim review with a member of our team.
Why Was My Request for Reconsideration Denied?
There are many reasons that a request for reconsideration may be denied by the SSA. Most often, the reason is that you did not submit new evidence that is sufficient to overturn the initial determination. Remember: the disability examiner is bound to the same rules during the reconsideration stage as they were during the initial application. If you don’t provide evidence or information that meets the legal standard for benefits, then your request for reconsideration will be denied.
The best way to improve the odds of having your reconsideration request approved is by working with an experienced disability benefits lawyer. In New Jersey and Pennsylvania, reach out to Bross & Frankel to schedule a free initial consultation about your claim.
What Is the Difference Between Reconsideration and an Appeal?
A reconsideration request is the first step in the Social Security disability appeals process. It is a type of appeal, but it essentially involves the same process as the initial application, with a disability examiner analyzing your application and supporting evidence. During the later stages of appeal, the process may include hearing testimony from witnesses and formal legal arguments.
For purposes of Social Security disability, you must follow the steps of the appeals process – starting with a request for reconsideration. If you need assistance appealing a denial of disability benefits, contact Bross & Frankel to schedule a free claim review.
Filing for Disability Benefits? Call Us First.
When you’re dealing with a physical or mental health condition that makes it hard to work, the thought of applying for disability benefits may be overwhelming. Our law office can help. Each day, we put our skill and knowledge to work to help people with disabilities get approved at the initial determination level and at each stage of the appeal process.
At Bross & Frankel, we are dedicated to helping disability claimants get approved for Social Security benefits. With decades of combined experience, we understand what it takes to get disability benefits claims approved. To learn more about how we can help or to schedule a free consultation with a New Jersey disability attorney, give us a call at 866-859-1061 or fill out our online contact form.
Rich Frankel is the managing partner of Bross & Frankel. He is a member of the New Jersey and Pennsylvania bars. He has focused exclusively on disability and social security benefits since 2005.
Mr. Frankel joined what is now Bross & Frankel after having watched his father struggle with disability, fighting a lengthy illness. Mr. Frankel founded the firm’s veteran’s law practice and substantially grew the social security disability practice, focusing Bross & Frankel’s ability to fight for all of the disability benefits available to his clients.
Mr. Frankel additionally fights for clients in court, obtaining frequent victories in Social Security appeals and against insurance companies in Federal court.