Reopening a Social Security Disability Claim
Reopening an earlier disability claim can get your more money in backpay benefits.
Social Security pays benefits back to the date of the application when it approves a disability claim (and for SSDI, even further back, to the date of disability onset). Many disability claimants (applicants) whose claims are initially denied end up pursuing those claims through multiple appeals, and since those appeals take time, the claimants usually receive sizeable backpay awards when they finally win their disability cases.
Why You Want to Reopen an Earlier Disability Claim
Because Social Security pays benefits back to the date of the original application or beyond, it is always in a claimant's interest to get an older claim reopened and joined to a new claim, since the backpay award will be larger. This situation arises when a claimant denied SSDI or SSI benefits doesn't request reconsideration or request a hearing by the appeal deadline, and the denial of the old claim becomes final. If the claimant later applies for SSD or SSI again, he or she should hire a lawyer to reopen the first claim because, if the claimant is successful, he or she can receive benefits back to the date of the first application.
Only Related and Overlapping Claims Can Be Reopened
A prior disability claim needs to be related to the current disability claim (for instance, an initial claim for herniated disc and a second claim for herniated disc and spinal stenosis). Social Security will not reopen a prior claim that is based on a disability that is unrelated to the current claim.
In addition, the onset date of your disability on your second claim must be within the timeframe covered by your first application.
Finally, Social Security will generally only reopen a claim that was incorrectly decided the first time around (more on this below).
How to Reopen a Disability Claim
Social Security has not created a particular form or process for claimants who want to reopen a claim. To reopen a claim, you must file a new application for disability and ask Social Security to reopen your old claim. You must also tell Social Security in your second application that the onset date of your disability was within the timeframe covered by your first application (or for SSDI, within 17 months of the initial application).
When a Prior Claim Can Be Reopened
Whether Social Security can reopen a prior claim depends on how old it is.
Prior Claim Less Than a Year Old
A prior SSD or SSI claim that became final after Disability Determination Services (DDS) or an administrative law judge made an initial determination can be reopened within 12 months of the date of the decision for any reason. After 12 months has passed, it becomes more difficult to reopen a claim.
Prior Claim Two to Four Years Old
The rules for reopening claims more than 12 months old are different for SSI and SSD, but in either case, it's a difficult thing to do. Social Security can reopen a SSD claim within four years if it finds good cause to reopen the old claim, and Social Security can reopen an SSI claim within two years if it finds that there is good cause to reopen the claim.
For both SSI and SSD, good cause is defined as having new and material evidence about the claim, finding a clerical error in the way benefits were calculated, or when the written DDS decision shows error "on its face."
New and material evidence. Something is new and material if the prior decision maker did not consider it, and it would have changed the decision.
Error on the face. A decision shows error on its face when the error is obvious and clearly resulted in an incorrect decision. An example is a decision citing a medical report that belonged to someone other than the claimant.
Prior Claim More Than Four Years Old
Social Security will reopen a case that has been closed for more than four years only for a few very specific and rare reasons. SSI claims can be reopened at any time if there was fraud or similar fault. Examples are when someone knowingly made false statements or left out information that can affect the outcome of the decision.
SSD claims can be reopened at any time if there was fraud or similar fault, but also to correct a mistake in computing benefits, to correct an error that is evident on the face of the written decision, or for a few other unusual reasons, like if the denial was based on a criminal conviction that was later overturned.
Who Can Reopen a Claim
A claim denied by DDS can be reopened by a claims examiner at DDS, an administrative law judge, or the Disability Appeals Council. A claim denied by an administrative law judge (ALJ) can be reopened only by an ALJ or the Appeals Council (so the claimant would need to raise the issue of reopening at the second ALJ hearing or with the Appeals Council). A claim denied by the Appeals Council can only be reopened by the Appeals Council.
Denial of a Request to Reopen a Claim
A denial of a request to reopen a prior claim cannot be appealed. Social Security only allows appeals of certain kinds of decisions -- “initial determinations” -- and a denial of a request to reopen is not considered an initial determination.
Getting a Lawyer to Help Reopen a Claim
Because you only have one chance to get it right, it makes sense to hire a lawyer to get a prior claim reopened. A disability lawyer can make sure your new application is relevant to the prior application and has the proper disability onset date, can make the request to reopen a claim for you, and can argue why new evidence should be considered or why there was a clear mistake in the initial decision (or why there is good cause to reopen the claim, if it's been more than a year since you first applied). To find a disability lawyer in your area, use our disability attorney locator.