Do you feel frustrated after receiving a denial on your Social Security claim? The reconsideration process is your chance to challenge that decision and provide the evidence you need to move your case forward. However, appealing a denial without help can feel overwhelming. That’s where a knowledgeable disability lawyer comes in.
Disability Advocates Group helps people in Los Angeles present stronger cases during the reconsideration phase. We can gather critical documents, meet important deadlines, and communicate with Social Security on your behalf. Contact us today for a free consultation and learn how we can help you during the reconsideration process.
Common Reasons for Social Security Claim Denials
The Social Security Administration (SSA) evaluates claims based on strict eligibility requirements and evidence. Many claims result in denials for reasons that often surprise applicants. According to the SSA’s own data, only 21 percent of first-time disability claims are approved. Below are some frequent causes of Social Security claim denials:
- Insufficient Medical Evidence: The SSA denies claims when medical records do not clearly show that a disability significantly limits the claimant’s ability to work.
- Failure to Follow Prescribed Treatment: If a claimant does not follow their provider’s recommended treatment plan without a valid reason, the SSA may deny the claim.
- Earning More Than the Allowed Limit: If an applicant earns too much income, the SSA will consider them able to engage in substantial work and deny the disability claim.
- Failure to Cooperate with the SSA: The SSA can deny a claim if the applicant does not respond to requests for additional information or submit necessary documents.
- Insufficient Work Credits: Many claims fail because applicants do not have enough work credits, which depend on employment history and earnings.
- Temporary or Short-Term Conditions: The SSA denies claims when applicants’ medical conditions are not expected to last at least 12 months or result in death.
- Substance Abuse Contributing to the Disability: If substance abuse significantly contributes to the medical condition causing the disability, the SSA may deny the claim.
- Missed Deadlines for Filing: The SSA denies claims when applicants fail to submit their applications, requested forms, or appeals within the required timeframes.
- Lack of Recent Treatment or Medical Care: The SSA might deny a claim if the applicant has not sought recent medical care for their condition.
Overview of the Reconsideration Process
If the SSA denies your initial application for disability benefits, you can request a reconsideration. The reconsideration process is the first step in appealing a denied claim. During this phase, a new examiner who did not participate in your initial claim decision will review your case independently. In this review, the examiner will consider all evidence you submitted during the initial application and any new evidence you provide.
There are two main types of reconsideration requests. The first is for medical determinations, which involve claims related to disability eligibility. These requests focus on medical evidence, work history, and the severity of the disability. The second type involves non-medical determinations, such as disputes about overpayments or income limits.
How to Request Reconsideration
You must submit a written appeal within 60 days of receiving your denial notice to request reconsideration. The SSA provides multiple ways to file your request. The quickest option is filing online through the SSA website, where you can complete and submit the necessary forms electronically. Alternatively, you can download the required forms, such as the Request for Reconsideration (Form SSA-561), and mail or fax them to your local Social Security office. You can also visit a local office to complete the process in person.
A lawyer can help you prepare a strong reconsideration request. They can identify weaknesses in your original application, gather additional evidence, and ensure your appeal meets all procedural requirements. Your attorney can also communicate with the SSA on your behalf to reduce the stress of managing deadlines and paperwork.
What Happens During Reconsideration
During reconsideration, the SSA facilitates a thorough and independent review of your claim. A new disability examiner and, if applicable, a medical or psychological consultant will consider your original application materials and any new documents you submit.
For medical reconsiderations, the Disability Determination Services (DDS) in California handles the case. They may contact your doctors for additional information or request that you attend a consultative examination. For non-medical reconsiderations, SSA employees at your local office or payment center will review your file. They might ask for more information about your finances or eligibility factors.
The reconsideration process typically takes several weeks to a few months, depending on the complexity of the case and the availability of additional evidence. You will receive a written decision explaining the outcome. If you disagree with the decision, you can proceed to the next step in the appeals process.
Potential Outcomes of Reconsideration
The reconsideration phase can result in three main outcomes. First, the SSA may reverse the initial denial and approve your claim, after which you will start receiving benefits.
Second, the SSA might affirm the original decision, which means upholding the denial. If this happens, you can appeal further by requesting a hearing before an administrative law judge (ALJ). If you disagree with the ALJ’s decision, you can request a review with the SSA Appeals Council. If the Appeals Council does not rule in your favor, you can proceed with the final stage of the appeals process by taking your case to a federal district court.
Third, the SSA may partially approve your claim. For instance, they might agree with certain parts of your application but not others. In this situation, you can choose to accept the decision or move forward with an appeal.
Contact a Social Security Lawyer Now
Don’t let a claim denial stop you from getting the benefits you need. Disability Advocates Group can help you through the reconsideration process with confidence. Contact us today for a free initial consultation to get the support you deserve.
