Requesting Reconsideration of an Application for SSDI in Maine and Elsewhere

Applying for benefits through the Social Security Disability Insurance (SSDI) program can be a time-consuming process, with long periods spent waiting for a response. The denial rate for initial applications is high, and sometimes as high as 70 percent of applications are denied, but a denial is not the end of the road. The next step in most states is to file a request for reconsideration, in which a different examiner with Disability Determination Services (DDS), part of the Social Security Administration (SSA), will review your application.DonkeyHotey [CC BY 2.0 (https://creativecommons.org/licenses/by/2.0/)], via Flickr

DDS offices in several states, including New Hampshire and New York, no longer offer reconsideration of SSDI claims. Applicants in those states must go directly to the next stage of review, which involves requesting a hearing before an administrative law judge (ALJ).

The Application Process:  A Review

The first stage of a SSDI claim is the application itself. You must show, to a DDS examiner’s satisfaction, that you are suffering from a condition that renders you unable to work, and that this disability is likely to persist for 12 months or longer, or result in death. An SSDI application requires a substantial amount of documentation, including medical records that indicate how your condition precludes you from working. A knowledgeable and experienced Social Security disability attorney can help you present your case in the best way possible.

Requesting Reconsideration

If you receive notice that your SSDI claim has been denied, you have 60 days to request reconsideration. If you miss the 60-day deadline, your appeal could be dismissed as untimely, and you will have to start over with a new SSDI application. You may file an appeal by submitting paper forms to the SSA, or you may submit the information online.  It is always advisable to have an experienced Social Security attorney assisting you with the appeals forms to ensure that questions are answered appropriately and that the appeal is filed timely.

Social Security’s online appeal form requests you to state the reason you believe the initial determination is incorrect. Here, a Social Security disability lawyer can help you identify the key issues that should be the focus of your appeal. Your lawyer will be able to best advise you what information and documentation may have been missing at the time of the initial filing that would have resulted in an unfavorable decision.  Likewise, they can assist you in gathering the additional evidence necessary to prove your claim.   The online report likewise will ask you for additional information regarding your condition(s) and treatment since you filed your claim, and it will ask you if there have been any changes to your conditions (for better or worse), any new condition(s) since you filed your claim, and any changes to your daily activities.  Each of these questions need to be answered carefully to ensure the proper impression is being provided to the SSA.   The advice of an experienced Social Security attorney can go a long way to ensuring that the answers to these questions don’t come back to haunt you at a later time because of a misunderstanding as to what the SSA was really looking for by way of the question.

Additional Information Required During the Reconsideration Process

Just as you must be available to answer questions while the SSA is processing your application, you must be able to provide supplemental information during reconsideration. DDS will have a different examiner review your original application, your request for reconsideration, and any new information or evidence you have provided. The examiner may request additional medical records, releases for certain medical providers, or other information about your condition.

Time Frames for Reconsideration

Reconsideration requests might not take as long to process as initial applications, or they can take even longer.  For example, the DDS office in Augusta, Maine is taking as long as five months or longer on certain cases, depending on whether the office itself or the examiner have a large backlog, or if there are examinations that need to be set up and kept with some of the state agency doctors, or if there is a substantial amount of additional medical documentation that needs to be secured from various medical doctors (especially if some of those doctors are delayed in responding to DDS requests).

The Next Step if Your Request for Reconsideration Is Denied

The denial rate for requests for reconsideration is also very high—even higher than the rate for SSDI initial application decisions.  The assistance of an experienced Social Security disability advocate can help you ensure that your application or appeal includes all of the information that SSA requires and that your case moves forward as quickly as possible.

If you receive notice of denial of your reconsideration request, the next step is to request a hearing before an Administrative Law Judge (ALJ).  This process allows you a De Novo (as of new) review of your claim with an Administrative Law Judge who has not been part of the agency’s prior determinations.  While this process provides you with an opportunity for an in-person hearing, many times our office is able to avoid the need for a hearing by way of presenting an argument brief (called an On the Record Request) well before the need to attend any scheduled hearing.

In some states, including New Hampshire, requesting an ALJ hearing is the next step after a denial of an initial application.

To get the advice and assistance you need with your SSDI claim, or to get your SSDI claim started right away, you can schedule a free consultation with the Law Offices of Russell J. Goldsmith by calling 1-800-773-8622.