Reconsideration Explained

A disability attorney is important in helping applicants for disability benefits understand each and every stage of the application process. Typically this process begins with the initial application period. If an application is denied, the second stage is Reconsideration. Upon further denial, the third stage involves Requesting a Hearing before an Administrative Law Judge (ALJ). While a few states like New York have eliminated the reconsideration stage, Kentucky has not.  In my own limited experience, Reconsideration has an abysmal approval rate.  I am not sure what real benefit exists to the claimant.

Not only is the representation of a disability attorney important when initially applying for benefits, but such representation becomes crucial when the applicant is initially denied benefits and files a “Request for Reconsideration,” since this is the first appeal available to applicants that have been denied. Claimants should state the issue being appealed  (is it medical, is it technical, ….) and their reason for disagreement with the SSA’s determination. Claimants may also choose, depending upon the circumstances, whether they want a case review, informal conference, or formal conference.

A request for a Reconsideration must be made within sixty (60) days of the notice of denial. In certain cases where a redetermination of ongoing eligibility for benefits is concerned, you do have the 60 day appellate wondonw.  However, in certain limited cases, if an appeal (Reconsideration or Reqeust for Hearing) is made in writing within 10 days of the denial (or within 10 days  after receipt of the notice if you can affirmatively prove WHEN you got it), and you request benefit continuation, any payment that SSA is currently making will continue until the reconsideration determination, provided a claimant continues to meet all other SSI eligibility requirements.  READ THE SSA NOTICE VERY CAREFULLY FOR THESE CASES.  OPEN SSA MAIL THE SAME DAY (and save the envelope it came in).  In any event, for the run of the mill tpyical appeal, with a  Reconsideration, a different SSA examiner will review your case and determine if you are disabled. However, as the qualifications for disability under the Reconsideration process are the same, a claimant may once again be denied. Approval rates are low at the Recon level, varying from 8% to 20%, depending upon where you live in the United States. Nationally the rate hovers at about 8-10 %.

As to an approval, there are several ways to win.  Having a Listing level impairment is a quick way to win.  However, the Listings depict fairly severe conditions-meeting them is rather hard. Most claims don’t meet the medical requirements of a Listing in the SSA’s Listings of Impairments.  There are also compassionate allwoances.  If you have the diagnosis and the medical proof, this is a fast track way to win.   Go online at ssa.gov or Google”compassionate Allowance” to see if your condition is once that the SSA will consider.

Still others may receive an approval based upon what we call a medical-vocational allowance (the GRID regualtions).  The GRID uses age, education and your RFC to fit a claimant onto a table, and the table directs the  outcome (win or lose).  In the case of a medical-vocational allowance, the examiner reviews the medical records, determines the claimant’s physical and/or  mental functional limitations, and then concludes whether or not they retain the ability to return to their past job.  If you meet your burden of pproof, the SSA then considers your age, edication and job skills and then consider your case on the GRID (this is what we call a Step 5 analysis).  The GRID is most useful for claimant at age 50 or older.

Yes, this is confusing.  It gets hypertechnical quickly.  If you have any questions or concerns about any kind of disability case, including Social Security Disability, long-term disability, short-term disability, state retirement and workers’ compensation, call the Sullivan Law Office today! Call 888-587-0228 or visit us online.Reconsideration Explained

2016-09-28T17:41:49+00:00