Friday, May 11, 2007

Reconsideration Appeal - what makes it different from the Disability Application

I thought I'd address this question because I've been asked about it before in the past and I've come across it several times in forums that are either devoted to the discussion of disability issues or the discussion of a particular medical impairment.

Answer: not a whole lot. Reconsiderations constitute the first appeal that is available to individuals who file for social security disability or SSI disability benefits (excluding individuals who live in the SSA boston region, where the DSI program has replaced "reconsideration" with "federal review"----I don't comment that much on federal review because it is very debatable as to whether or not DSI, aka Disability Service Improvement, will transfer to the rest of the country or simply be phased out as a failed experiment).

How is a reconsideration handled or conducted? In brief, it goes like this: if a claimant who has been denied on an application for disability benefits files a request for reconsideration within the required time period (you are given sixty days plus an additional five days for mailing time for a total of 65 days), then their file will be assigned to a new disability examiner. This examiner will be someone who specializes in reconsiderations, but, nonetheless, does the job in exactly the same manner as the initial claim examiner who preceded him. That is, medical evidence will be gathered as needed and an evaluation based on this evidence will be performed.

Reconsiderations are denied at a significantly higher rate than initial claims. But this should not be surprising if you consider how it would look if reconsiderations were more often approved than they currently are. For the most part, it would be a repudiation of denials that occurred at the initial claim level only several weeks earlier. It would be tantamount to saying "We made a mistake when we denied you on your application three weeks ago. Now we think you qualify for disability". Of course, that will never happen and the likelihood will be that first appeals (reconsiderations) will always have a high rate of denial as long as the agency that conducts first appeals is the same agency that processes initial disability claims.

Should you request a reconsideration if your application for disability gets denied? Yes, most certainly. But you should do it with this in mind. Even though only about 15 percent of reconsiderations get approved, you still want to file a reconsideration because this puts you on the road to getting a disability hearing before an ALJ (administrative law judge) scheduled. In other words, you are not allowed to request a disability hearing until your reconsideration gets denied (and, as we said, most, unfortunately, do).

What are your chances of winning disability at a hearing? Far better than at a reconsideration. Roughly half of all cases that are heard by judges at hearings are approved.

The only real downside to disability hearings is how incredibly long it can take to get a hearing scheduled. But it is for this reason that you should not waste any time in requesting a hearing (or a reconsideration for that matter).

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Apply for disability
Approved for disability
Social Security Disability Appeal