Appealing a Social Security Disability Denial: The Reconsideration

How to appeal a denial with a Request for Reconsideration

The first appeal available to a Social Security Disability Insurance (SSDI) or SSI disability applicant who has been denied for benefits is the "reconsideration." In a reconsideration review (sometimes called a paper review), a different disability claims examiner at the DDS (Disability Determination Services) reviews your application and medical records with the help of a medical consultant.

In some states, the reconsideration step has been eliminated:

  • Alabama
  • Alaska
  • California (Los Angeles North and Los Angeles West Branches only)
  • Colorado
  • Louisiana
  • Michigan
  • Missouri
  • New Hampshire
  • New York, and
  • Pennsylvania.

In these states, an applicant who has been denied benefits can immediately request a disability hearing.

Deadline for Reconsideration Request

A failure to appeal within the 60-day time frame will result in an "untimely appeal," meaning that you would have to file a brand new SSD or SSI claim to be considered for disability benefits. Your Request for Reconsideration will simply be rejected. Failing to submit an appeal within the specified deadline is counter-productive and a waste of valuable time.

There are exceptions to this deadline, exceptions that fall under the umbrella of a concept referred to as "good cause" (meaning you had a good reason for missing the deadline). Such exceptions generally include illness, hospitalization, or other extenuating and plausible circumstances that might account for the late filing of a SSDI or SSI disability appeal. Often, Social Security claims representatives are somewhat lenient when it comes to the late filing of a reconsideration request, if the individual has a good reasonable reason for filing their request late.

Chances of Winning a Reconsideration

Overall, your chances of winning a reconsideration are quite low -- 85% of cases are denied on reconsideration review. Unless you've submitted new, convincing medical information or your condition has deteriorated, your claim will probably be denied again.

You will have a better chance for being awarded disability benefits (monthly amounts and backpay) at a hearing held before an administrative law judge (ALJ). However, an ALJ hearing can be requested only after the denial of a reconsideration appeal. Unfortunately, the reconsideration review is a necessary step in the appeals process you have to go through in order to get to an ALJ hearing.

Learn about how to request a reconsideration review.

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