Good Excuses for Filing a Late Disability Appeal

The Social Security Administration (SSA) has deadlines—usually, 60 days after you've received a denial—that you need to meet when you file an appeal for disability benefits. If you've missed an appeal deadline, you'll generally have to start your application all over again. But if you have a good excuse for missing the deadline, you can continue with your application even though you filed the appeal late.

Good Excuses for Missing an Appeal Deadline

In Social Security lingo, having a good excuse for missing a deadline is called "good cause." Good cause encompasses a wide range of serious situations. Factors the SSA will consider when determining if you had good cause to miss a deadline include:

• whether the SSA or CMS (Centers for Medicare & Medicaid Services) gave you confusing, incorrect, or incomplete information about filing your appeal
• whether you understood what you needed to do
• whether you had a physical, mental, educational, or language limitation that kept you from filing your appeal on time, or
• any circumstances that kept you from filing on time.

Examples of Good Cause for Filing a Late Appeal

Social Security has published some examples of circumstances where a disability claimant has good cause for a late appeal. If your reason for filing late isn't on the list, the SSA can still find that you have good cause, but any acceptable excuses have to be pretty important.

Filing a Late Appeal Due to Medical or Health Problems

Social Security often takes health factors into consideration when deciding whether you had good cause for a late filing. Examples include:

• You were so sick when the appeal was due that neither you nor a friend or family member could have contacted the SSA to file the appeal. You'll need to show that you were very sick—for example, by submitting records from an extended hospital visit—or the agency can find that you or somebody else could have submitted the appeal on time.
• Your medical condition (physical or mental) prevented you from understanding that you needed to file an appeal by the deadline (a traumatic brain injury, for example).
• You had a death or serious illness in your immediate family.

Filing a Late Appeal Due to Missing or Destroyed Records

Social Security understands that obtaining records can be a challenging process. Reasons where the SSA will find good cause because you couldn't get needed records on time include:

• You were actively looking for evidence to support your claim—like filling out medical records request forms and following up with your doctors—but you didn't ask for an extension before the appeal deadline passed.
• Relevant records that you needed for the appeal were destroyed by a fire or other accident close to the appeal deadline. (For example, your house containing the denial notice flooded a week before the filing was due.)

Filing a Late Appeal Due to Communication Errors

As a government agency, the Social Security Administration needs to follow certain rules when it comes to informing you about the disability appeals process. SSA mistakes in communication that lead to you missing the appeal deadline can be considered good cause, including:

• The SSA or CMS gave you incorrect or confusing information about appealing your claim. You'll need to provide a signed statement to the SSA explaining how, when, and where you got the misleading information.
• You never received a denial notice. For example, if you moved and told the SSA about your address change, but they still mailed the notice to your old address and you never got it, the agency will likely find good cause for your late appeal.
• You sent your appeal to another government agency (like the Veterans Administration) within the time limit because you didn't know that the appeal needed to be sent to the SSA, and the other agency didn't forward your request until after the deadline.
• You sent in a request for an appeal (and have a copy of it) but Social Security says it never received your request.
• You didn't understand the instructions because you're not fluent in English.
• You (or your lawyer) asked the SSA to provide additional information about why the agency denied your application before the appeal deadline passed. (In this case, the SSA will automatically find good cause for late filings submitted between 30-60 days after the agency responded to your inquiry, depending on the level of appeal.)

If you filed late because of other unusual or unavoidable circumstances, and you couldn't reasonably be expected to have met the deadline, Social Security can find good cause for your late appeal.

Procedure for Filing Good Cause for a Late Appeal

Social Security will only accept requests to find good cause for a late appeal in writing. You can use the agency's Form 795, Statement of Claimant, to explain your good cause reason or you can send a letter explaining the late filing.

Where Do You Send Your Late Filing Appeal Form?

Submit the completed form or letter at the same time you file your appeal request. Make sure you file the appropriate request for the level of appeal you're seeking.

• If you're late appealing an initial denial, send your good cause statement with your request for reconsideration.
• If you're late appealing a denial from reconsideration, send your good cause statement with your request for hearing by an administrative law judge (ALJ).
• If you're late appealing an unfavorable decision from an ALJ, send your good cause statement with your request for review of the hearing decision.
• If you're late appealing a denial of review by the Appeals Council, send your good cause statement when you file your complaint in federal district court.

When Do You Need to Send the Late Filing Form?

The SSA will review your request to accept a late appeal no matter how long ago the deadline was, but the later your appeal is, the harder it will be for you to show good cause for your delay. For example, if you had a heart attack and were in the hospital for two weeks around the time of your appeal deadline, the SSA is unlikely to find that you have good cause for filing a year late.

What If the SSA Finds You Don't Have a Good Excuse for Missing a Deadline?

If Social Security finds that you don't have good cause for a late appeal, you'll have to begin a new application at the initial level. But sometimes the agency will consider the date you submit your written request for the late appeal to be a protective filing date for your next disability application. Having an earlier protective filing date means that you might be entitled to more in back pay if the SSA ultimately finds that you qualify for benefits.

_{Updated August 23, 2022}