What can you do if you’ve missed an appeal deadline in your Social Security case? Most of the time, you will have to start again and file a new claim for disability benefits. However, in some cases, you may be able to get Social Security to accept your appeal even though you filed it late.
Good Cause for Missing an Appeal Deadline
Social Security will decide whether you had "good cause" for not filing your appeal in time. It will consider:
- whether there were any circumstances that kept you from filing on time.
- whether Social Security (or the Centers for Medicare or Medicaid Services, CMS) did anything that confused or misled you and resulted in your missing the deadline
- whether you understood what you needed to do, and
- whether you had a physical, mental, educational, or language limitation that kept you from filing a timely appeal.
Some Examples of Good Cause
Social Security has published some examples of circumstances where a disability claimant had good cause for a late appeal. If your reason for missing the deadline is not on this list, Social Security can still find that you have good cause. The examples just show how serious the situation has to be for Social Security to find that good cause exists. Social Security may find good cause in any of the following situations.
- You were very sick when the appeal was due and you could not have contacted Social Security yourself or through anyone else. You will need to show that you were seriously ill; otherwise Social Security will find that you could have submitted the appeal paperwork on time or asked someone to do it for you.
- There was a death or serious illness in your immediate family.
- Records that you needed for the appeal were destroyed by a fire or other accident. You will need to show that the records were destroyed close in time to the appeal deadline and that they were important to your meeting the deadline. For example, if your house burned down the week before your deadline and your denial notice was inside the house, you would have a strong argument that you had good cause for missing the deadline.
- You were actively looking for evidence to support your claim but failed to ask for an extension of time before the deadline passed.
- You or your lawyer asked Social Security for more information about its denial before the appeal deadline passed. You would have 60 days after Social Security gave you the additional information to file for reconsideration or for a hearing.
- Social Security or CMS gave you incorrect or confusing information about appealing your claim.
- You did not understand that you were required to file an appeal by the deadline or you were not able to appeal because of a physical or mental problem.
- You did not receive a denial notice. You will need proof that you never got the notice. For example, if Social Security mailed the notice to the wrong address, and you had notified them of the right address, then they might find good cause for your late appeal.
- You sent your appeal to another government agency within the time limit because you misunderstood that the appeal needed to be sent to Social Security, and the other agency did not forward your request until after the deadline.
- There were any other unusual or unavoidable circumstances, and you could not reasonably be expected to have met the deadline.
The later your appeal is, the harder it will usually be for you to show that you have good cause. For instance, if you had a heart attack and were in the hospital for two weeks around the time of your appeal deadline, that will not be good cause for you to file your appeal a year late.
How to Make a Request to Accept a Late Appeal
You must make your request to accept a late appeal in writing. Usually, you will submit your appeal form and then explain your good cause reason on the form or on a separate piece of paper that you submit at the same time.
Social Security has to accept your request to accept a late appeal for review no matter how late it is. Once you file your late appeal and good cause explanation, Social Security has an obligation to review your request and see whether you have a good reason for filing late. The agency might contact you to ask you for more information about your good cause argument.
Even if Social Security finds that you do not have good cause for a late appeal, it will sometimes consider the date you submit your written request for the late appeal to be a protective filing date for your next application for benefits. In that way, even though you can't preserve your original application date, you can at least establish the protective filing date for your next application.