They Stamped “Denied” on your Application for Benefits - why you must demand a claim review immediately
Have you received a letter from Social Security stating that your claim for disability benefits has been denied? If so, you have only sixty (60) days from the date you received this “notice of disapproved claim” to file your appeal. Here’s what you need to know about filing a timely appeal.
First, keep in mind that Social Security uses the United States mail to notify claimants about claim decisions. You will not get a phone call, fax or email to advise you that your claim has been approved or denied.
When you file your claim, SSA will mail you a letter stating that your claim has been entered into their system and that an adjudicator (claims adjuster) will be gathering information to evaluate your claim.
If you don’t receive a written acknowledgment from SSA within 10 to 15 days after you file that your case has been opened, you should call SSA at 800-772-1213 to confirm that your case has been opened and that they have a valid mailing address for you.
Once your case is opened, SSA will assign an adjudicator to request medical and other records and to make a decision in your case. During the adjudication process you will receive several letters from the adjudicator. Here, too, if you receive no mail, you should pick up the phone and call to find out what is happening.
I advise my clients that a post office box is better than a street address to receive important mail. This is especially true if your mailbox is not secure or if you expect to move while your case is being decided. If a post office box is not an option, you can use a more “permanent” address of a parent, relative or friend to get your mail.
Generally, you will get a decision from Social Security around three (3) to five (5) months after you file your claim. If your denial notice gets lost in the mail, or if your mail get’s misplaced or stolen, you will have no recourse against Social Security.
I also advise my clients to save all correspondence received from Social Security along with the envelopes used to mail that correspondence. I have seen cases where letters are mailed 2 to 3 weeks after the date on the actual letter.
Your denial notice (Notice of Disapproved Claim) will be dated. Technically you have 60 days from your receipt of that letter to file your appeal. SSA will assume that you have received your letter within 5 (five) days from the date on the letter.
I advise my clients to file their appeals as soon as possible after receipt. A good idea would be to file your appeal no later than 60 days after the date on the denial notice. And remember that the 60 days includes weekends and holidays - it is not 60 “business days.”
If you don’t file a reconsideration appeal within 60 days from the date you receive your denial notice, your case will be closed and you will have to start over again if you want to pursue disability benefits.
Filing Your Appeal
If your application for disability benefits is denied, the appeal you need to file is called a Request for Reconsideration. You can file this reconsideration appeal online at https://www.ssa.gov/forms/ssa-561.html or you can download a paper copy of the Request for Reconsideration (Form SSA-561) and the Disability Report - Appeal (Form SSA-3441) and SSA Medical Authorization (Form SSA-827) and mail in your appeal to the address on the denial notice.
If you mail in your appeal, I would advise you to use registered mail, return receipt requested.
If you are running late and can’t use the online appeal procedure, I would physically visit your local Social Security office to hand file your appeal. You should always get a receipt.
I often get retained by clients to begin my representation at the reconsideration appeal stage. I file appeals electronically and once my name is associated with your file, we will both get mailed notices.
How to Fill Out Your Reconsideration Appeal
The stated purpose of the reconsideration appeal is to ask the SSA adjudicator to take a second look at your file and perhaps consider new evidence or a new medical impairment.
Statistically, less than 10% of reconsideration appeals are granted, meaning that the reconsideration stage of the disability decision making process is pretty much a waste of time. When I am filling out an appeal I look for the following:
- Did SSA consider all of your medical providers? The denial notice will identify the names of medical providers and dates of service for medical records considered in rendering your decision. If a particular medical provider was not on the denial notice, I’ll make sure to add it in the reconsideration appeal paperwork.
- Are there any new medical conditions? If so, I would definitely want to add any new condition to the reconsideration paperwork as many judges will not consider new conditions at hearings.
- Are there any other mistakes on the initial denial notice? If so, these should be corrected using the Reconsideration Appeal form.
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