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What is a Social Security Request for Reconsideration?

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Learn how to appeal a denied disability claim with a Social Security Request for Reconsideration and how a lawyer can help you win.

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Watch the Video: "What is a Social Security Request for Reconsideration?"

Filing Your Social Security Request for Reconsideration

If your initial disability claim is denied, the first appeal you can file is a Social Security Request for Reconsideration. When you file a Request for Reconsideration, you will be asked to complete a reconsideration request form and to provide information about any changes in your health and any work you have done since you filed your claim. You will also be asked the reasons why you think the denial determination is wrong. This means that you will need to understand why Social Security denied your initial claim, so that you can effectively prove your case and be approved.

Refuting Social Security’s Reasons for Denial

Sometimes a person’s claim is denied because Social Security says the disability won’t last for twelve months. In that case, a reconsideration claiming that disability will continue for twelve months can result in an approval simply because, by the time the reconsideration is processed, twelve months will have passed and current medical information will show that disability continues.

At other times, how DDS arrived at their decision is not as clear. You have the right to obtain a copy of, and review, your claim file, including the determination memos. Social Security can, however, at its discretion, decline to release your medical records and doctor’s reports, including any consultative examination reports, directly to you. They will, however, release them to an attorney who represents you or, in some cases, to your physician. It could be helpful to have a lawyer who is experienced with Social Security Disability review your claim file to determine what is needed to win the appeal. See our article “How Can a Social Security Disability Lawyer Help Me Get Social Security Benefits?” for more information on how an attorney can help your case.

Sixty-day Deadline to Appeal

There is a time limit for filing a Social Security Request for Reconsideration. You must file your appeal within sixty days of receiving your denial letter. Social Security allows five days from the date on the letter for delivery. This means that Social Security must receive your reconsideration request within sixty-five days of the date on the denial letter. Filing the appeal on time is very important because if you fail to do so, you will most likely lose your right to appeal. It is only very rarely that Social Security allows a late appeal, and then only because the claimant couldn’t respond sooner because of very severe limitations, such as an extended hospital or nursing home stay.

The Reconsideration Review and Appealing Again

Physicians and claims examiners at the Disability Determination Services who were not involved with your initial claim will review your Request for Reconsideration. If your disability claim is denied at the reconsideration appeals level, you can appeal again by requesting a hearing. For more information about the Social Security disability appeals process in general and hearings in particular, please see our articles “I Was Denied Social Security Disability. What Can I Do?” and “What is a Social Security Disability Hearing, and What Can I Expect When I Request a Disability Hearing?”

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26 Comments

  1. LarryYoung says:

    I can not get DDS to look at the nedical record stating that my preop c5c6 cervical fusion was done because of instability the preop says the same thing meaning the operation was not successful in stablizing c5c6 vertabrea meaning I will have limitations and pain for the rest of my life be cause once they do this operation they will never and thats it no more so im stuck and have not recieved a dime in bemefits since I broke my neck in june 2005.This is wrong I shoild not have to fight for my constitutional writes when I have ben fighting for my life.

    • Kay Derochie says:

      Dear Larry,

      Am I correct in assuming that you meant to say that your preop and postop reports said the same thing, thus showing no improvement.

      I am not sure what you mean when you say that you cannot get DDS to look at your medical records. Do you mean they won’t request the? If so, you can get the records and submit them to DDS yourself. If you mean that it appears DDS is insufficiently considering the information in the reports, it might be helpful to have your physician write an interpretive report that includes a statement of your current limitations.

      Best regards,

      Kay

  2. Dennis says:

    I have been denied twice by SSDI (Tennessee) and now I learn my case has been sent to Denver. Is this just due to a large backlog? I was told this isn’t for an Administrative Hearing so what could it be? Any reason I should feel optimistic? Tennessee approval rates are among the lowest.

    • Kay Derochie says:

      Dear Dennis,

      Hearings are sometimes reassigned to other geographic areas to find a judge who is free. Because you have been told that the transfer is not for a hearing, I suggest that you contact the person or office that notified you and ask for an explanation of what is being done in Denver and what you can expect next.

      Sincerely,

      Kay

    • brett says:

      they r doing me the same way

  3. John Getty says:

    My wife(26) suffered an AVM(aneurysm) almost 3 years ago. She was on disability with her job. She applied for long term disability and was apparently denied(not sure why) I believe she should file for social security disability.
    She worked for Cigna as a claims manager. After she recovered from the aneurysm she worked part time along with partial disability for about a year and a half. Then went back to full time after it ran out.
    They company was amazing during it all. They eventually dropped her down because she couldn’t pass all the psyche evaluations to be a claims manager because of her speech/memory problems. They did keep her at the same pay rate though doing some lower jobs. Anyway, the job became very hard for her. She was not able to keep up with multi-tasking and the memory problems affected her work. The stress accompanying this ended up not being worth it so she quit the job about 5 months after going back to full time.

    I know she cannot work at the same level she was at before this all happened. Isn’t she allowed to get some disability for this? Or is it an all or nothing type thing? She hasn’t worked in 4 or 5 months, not that she can’t, but I know the speech and memory problems have a lot to do with it.

    Thanks in advance.

    • Kay Derochie says:

      Dear John,

      At age 26, to be eligible for Social Security (SSD) or Supplemental Security Income (SSI), your wife has to be unable to perform substantial gainful activity (SGA) in any occupation she could has the skills to perform absent her medical limitations. SGA earnings guideline is usually $1,070 gross monthly. It is hard to tell whether you are right, that your wife could work in some occupation. Although your wife quit her last job, your remarks indicate that she resigned because she couldn’t keep up with the duties. This means she has been unsuccessful in two occupations since the aneurysm.

      It usually takes an expensive, comprehensive neuropsychological evaluation to determine the extent and exact nature of a person’s cognitive deficits. Your wife might discuss with her physician the possibility of such an evaluation. She might also contact the your state’s Department of Vocational Rehabilitation to see whether they can provide testing and vocational assessment. They may be able to identify occupations your wife can perform with her background and limitations or even provide some job training for those occupations.

      If these investigations indicate that she is unable to work, she could then apply for Social Security Disability. If she applies within seventeen months of when she ceased work the second time, she will not lose any potential retroactive benefits. And, of course, if she thinks she is unable to work, there is nothing keeping her from applying now. Whenever she might apply, I suggest that, in addition to statements and records from her medical providers, she provide statements from her supervisors regarding the performance problems she had.

      One last thought, she might be eligible for a new period of short-term disability on the same policy that covered her before.

      Sincerely,

      Kay

  4. Kim says:

    My daughter has epilepsy and was denied SSI due to insufficient records, at the time that I applied for her we thought that she had some autoimmune problems as well. When I appeal, I will be claiming just the epilepsy and accompanying effects of it, for example, memory loss, changes in cognitive and psychological issues. Will this present a problem in your opinion? We live in Texas, she cannot attend school because she cannot function well for 8 hours a day. She has been “home bound” since October 2013. She just had cognitive testing done and has a profound memory problem. I assume I should include all of this info with my appeal? I am also trying to get her Neurologist to write a letter on her behalf which he said he would do but has an issue saying it will continue for over a year. It’s already been going on over a year, how do I convince him to just write the letter?

    Signed
    Frustrated Mom

    • Kay Derochie says:

      Dear Kim,

      In your appeal, t is okay to say that the autoimmune problem has been ruled out. Yes, do include all the information about being unable to attend school. Use the ter”home boun.” only if she really doesn’t go out with you to the store or anywhere else. Also, include copies of the cognitive test reports. As far as the letter from the doctor, he can just discuss what has happened in the past and her condition now. He does not need to comment on the future.

      Sincerely,

      Kay

  5. MRS>HILL says:

    I HAVE FILLED FOR SSI FOR MY SOM WHOM IS 9 I HAVE BEEN DENIED AND HAVE OBTAIN A RECONSIDERATION AS WELL AFTER MY FIRST DENIAL I OBTAIN A LAWER FOR MY RECONSIDERATION DURING MY CONSIDERATION DATE I AM A LITTLE CONFUSE MY CASE HAS BEEN GOING ON SINCE 2011 ,MY SON WAS SENT OUT FOR MEDICAL EXAMINATION TWICE THE FIRST ONE THE DOCTOR TRIED TO SAY THERE WASNT ANYTHING WRONG WITH MY SON HE GAVE SILLY ANSWER HE WAS UNABLE TO GET INFORMATION THAT WAS NEEDED AND HE WAS MOTERVATED TO DO POORLY HE RULED EVERYTHING OUT, WE WERE FILLING FOR ADHD AND SPEECH, WE HAD NOTES FROM TEACHERS DOCTORS EVEN THE SCHOOL PRINCIPAL SO THE JUDGE SENT US TO ANOTHER MENTAL DOCTOR IN THE NEW REPORT MY SON WAS DIAGNOSE WITH ADHD AND BORDERLINE INTELECTUAL FUCTIONING SHE ALSO WROTE HE WAS UNAWARE OF WHAT WAS GOING ON AND OUT OF THE SIX DOMAINS HE HAD FOUR AS MARKED IM CONFUSE BECAUSE THE NEGATIVE REPORT FROM THE FIRST EXAM IS WHO JOINED US BY VDEO CONFRENCE WHY? WHY NOT THE NEW EXAMINATION BEING IT HAD BEEN TWO YEARS AGO WHEN HIS WAS DONE VERSESTHE ONE TWO MONTHS AGO I HAD NEW SUPPORTIVE TEACHERS ,PRICIPAL, AND DOCTORS REPORTS, JUDGE SAYS HES CONFUSE HE WILL GO THROUGH EVERTHING AND ILL HAVE A DECISION IN A MONTH TO A MONTH AND A HALF WHAT WILL ILL BE WAITING FOR CONFUSED CONFUSED CONFUSED MOM! PLEASE HELP!

    • Kay Derochie says:

      Dear Mrs. Hill,

      You did well to point out that the expert who was called to be at the video hearing was not the one who conducted the most recent examination. It is good that the judge said that he would look at everything, which means he should she the report that supports your son’s limitations. If by chance, the claim is denied and the recent report is not adequately addressed in the denial letter, that would be grounds for an Appeal Council review.

      Sincerely,

      Kay

      • Mrs Hill says:

        Thanks Kay I needed to hear that
        I’m at my 30 day mark waiting! But no matter what I want go out without a fight for my son I’ll let you know hat happens ! My layer said if it is not approved it want sit on his desk five minutes before we go to the next step sincerely Mrs.Hil

  6. jane says:

    My Disability claim is in the reconsideration status, I already saw two of their doctors, I called yesterday they said a decision has been made as of 4/15 but they could not tell me the answer over phone for 5 days? Can you tell me what that would possibly mean? Approved or Denied?

    • Kay Derochie says:

      Dear Jane,

      For whatever reason, Social Security has the policy of not releasing a decision for five days. It may be to assure that the claim is not chosen for Quality Assurance review and the decision becomes final before revealing it. The wait is not a sign of approval or denial.

      Sincerely,

      Kay

  7. Larry Young says:

    I WAS IN A HIGH SPEED MVCOLLISION-JUNE-2005-Whent toba A.L.J.hearing in 2909-he put me on the spot and aked me why I was driving a a motorcycle with a broke neck-told him I had to sell it to survive-the whole time thinking he had the correct medical records he did not-i just found out after all the appeals waite time and my new app pending 2nd ALJ hearing that they never had the correct records-i signed 5 consent forms not only did they not have the write records my-x-lawyer was former gov.emoloyee.I have muskulerskeloter’pulmonary indemnia-hearingandvision impaitments along with A.D.H.D.I have ben to the E.R.three times due to reprocussions from open neck c5c6bone graft illac crest surgery eye and knee surgerys too.1st ALJ gave me unfavorable he said I could get a job as a ticket taker?I whant to give him and this state a ticket for making me feel like a piece of worm dirt after paying taxes my whole life .I become disabled and unable to be productive and get thrown under the bus-like I need any more injuries.Add deoression to my list-Can I contact the commisioner I
    Of social security-Or a congressmen?If I could somehow get a letter to the president he would listen.I ,have ben treated very creul and inhumane. I HAVE BEN LIED TO BYE BARIOUS GOV.EMPLOYES-Told I was waiting on the appeals council to review and approve for 2 yrs.I tried to file a civil action rule 4(c)of the rules of federal procedure states I could not file a civil action oending approval bye the appeals council.They denied my request to re open . Please help me with good news.

    • Kay Derochie says:

      Dear Larry,

      If I understand correctly, you have been denied through the appeals process on your first clam and have another claim filed that is now pending. If that is correct, you should probably gather your own records to submit and also have a current physician make a statement regarding your capacity to do light or sedentary work. You have several different conditions and you need to have information that supports your limitations that come from each of those conditions. One question I have is whether your hearing and sight is good enough to do the type of work that was suggested.

      And a last thought, if you are unsuccessful with your claim or even while you are waiting for a decision, you might contact the Department of Vocational Rehabilitation of your state to see whether you could get job placement or job training services. They would first evaluate your ability to work and if they were unable to identify jobs you could do without training or were to refuse services because you are not able to work, you would have additional evidence to submit for your disability claim.

      Sincerely,

      Kay

  8. Martin E. Washington says:

    I’ve been waiting for the Socoal Security Benefit’s for nearly three year’s now. I’ve just been denied for the Request for review. My autttory for the case field a very good case for the brief. The first wrong thing The Administrative Law Jaw did was he appeared to have abused theri discretion in the original deciision what happened is that the Judge threw out all of the medical evidence of the case which stated that I could only work five hour’s a day. Instead the Administrative Judge who is not a doctor came up with his own solutions stating that I could work three two- hour’s a day shift knowningf that I’m 53 year’s old that know one would hear me at that age. The Administrative Law Jaw decision was not supported by any substantial evidence in this case! The next issue was the vocational expert at the very end of the trial stated that I could be only qualified by a cashier in which I’ve haven’t still worked for today. When I went to the Appeal Council for review the Administrative Law Jaw brought up another issue that wasn’t brought up in the original trial and the original vocational expert did even ask me about the question . First and for most I was never asked about Kaplan Career Instutie of Detroit. If I would have been asked I’ve would have said that I’ve have never received one cent from my exturnshiip-. It just truly upset’s me that I’ve going have to instead of asking for a second Appeals Counicl Action because it will take another two years. I will just have to sue the Social Security Admistration and take them to Federal Court. The only thing that this Adminstrative Law Jaw has on the Denied Request for Review was get this one There is a broad policy or procedural issue that may affect the public interest.

    Thank You:

    Martin E. Washington

  9. Gerald says:

    Okay. I have been denied back in april. I file for a reconsideration review. I was referred by doctor to a clinical treatment center for my mental illness. I diagnose with psychic disorders. And now i take medicine call tramzone, respridone, and paxil.now i seen their examiner. She diagnose me with just depression. She never said i need to see a counsel for futher treatment. But i have been getting my own paperwork together. And i also just had two surgery. I reasonly just had plates and srews remove out of my legs. But he couldn’t remove the main srew that’s in my joint. I have been incarcerated all my life in out the system.

    • Kay Derochie says:

      Dear Gerald,

      Submit everything you have gathered as soon as possible so it can be considered in the reconsideration review. If you have limitations due to the your leg or legs, be sure to mention those as well.

      Sincerely,

      Kay

  10. angela says:

    I am so confused with the reconsideration process in Tenn. I have clearly met impairment listing and all needed qualifications according to my attorney. Is there anything I can do to make sure my medical records are viewed correctly and get the correct decision. My case was assigned a caseworker a week ago. I just cannot understand what is taking so long

    • Kay Derochie says:

      Dear Angela,

      I suggest that you talk with your attorney and ask if there is anything you can add to the information given for your appeal.

      Sincerely,
      Kay

  11. Kelly says:

    I am 42 until the 25th of this month, and have a few medical issues that keep me from doing gainful work. I started my case in early 2011 which carried on until I had my hearing in may of 2013. I received a decision in sept of 2013 (unfavorable) and appealed it. I had an attourney I believed to be doing their job in collecting my medical records. I was mistaken. I have suffered with pulmonary disease since birth. I was put under sun lamps to break up the stuff in my chest to help me breathe. I was also born with they named retroversion of the right hipbone, for which I wore braces on my legs. It was said that I would outgrow this abnormality I never did. At age 6 I tried for the first time to commit suicide. I suffered depression as long as I can remember, I also have violent black outs. I started having severe neck and shoulder pains at age 20 and was diagnosed with degenerative disease. I filed a case with workmans comp in 2005 I believe due to reinjury of an old injury from a wreck in 2001, which made my neck and shoulder worse. I ended up with buldging disc in my cervical spine, and radiating pains in my arms and legs. I was told then by the dr I was seeing that never again would I be able to do repetitive work with my upper extremeties again. Since then I have gotten to be in a worse state. my knees hurt all the time wether I walk sit stand. In march 2013 I was diagnosed with C.O.P.D, and sleep apnea. When I went to my hearing in may 2013 My attourney had none of my records that verified my statements although I gave him numbers, address’s, hospitals, and names. So of course with nothing backing me hardly it wasn’t helpful. The judge and some vocational something or other worker decided that there was one job I could do, ( Tag inserter) which is repetitive work with my upper extremeties. I filed an appeal and should hear back this month or next. I don’t know what is going to happen and I’m scared. I have a spot on my right lung, my knees are giving out, my head, neck and shoulders hurt daily, I can’t be in the heat to long because of my lungs, I pee in my pants all the time due to coughing. I need medical treatment and can’t get it… It’s taken me over an hour to type this because I can’t stay in one position too long. I am only 43 this month!!!!!!!!!!! My father was diagnosed with agent orange and I beleive my sisters and I inherited some of the effects from it. My attourney did tell me I needed to continue to get my condition documented, but please tell me how I am to do this with no car, no money for visits, much less prescriptions….. What can I do???

    • Kelly says:

      I forgot My first two denials were due to age and education, what good is that if I am falling apart, and when I am in severe pain good luck getting intelligents from me. I have been diagnosed as bipolar as well as all my other issues, I have what feels like ants crawling all over me and biting me at times. I believe auto immune disease or neuropothy, fybromyalgia, I do know I am tired of being in pain and its no wonder suicidal thoughts roam my pain racked brain. Stroke type blood pressure too. :) Its a wonderful life. Sorry

    • Kay Derochie says:

      Dear Kelly,

      I am responding to your three posts.

      If your appeal is denied, you can file a new application, claiming a date of disability after the date of the hearing denial letter. On the new application, you could list all your medical providers, their contact information, approximately range of when you saw them, the diagnoses you got from each and the treatment you got from each, and how the treatment did or didn’t help. You could make a statement that you don’t have the funds to obtain the medical records yourself and ask Social Security to obtain the records for your claim. (They may or may not get them all.) With regard to current care, you might check by telephone with your local social services off to find out whether there is a free clinic in your area. Free medications can sometimes be obtained from pharmaceutical companies; check the website http://www.needymeds.com. Lastly, you can call the Appeals Council office to find out whether they received the appeal and your letter.

      Sincerely,
      Kay

  12. G scott says:

    My husband has been diagnosed with PTSD steaming from a brutal attack he received back in 2007. He abstained some physical injures as well an had to have surgeries to somewhat fix that problem but mentally has never been the same an was diagnosed with PTSD. He applied for disability in 2007 an has been denied every year since. He has had the same lawyer an just recently in feb.of 2014 won his case in fed court to have another hearing, she said this might take up to another year. He has not worked since 2007. Being denied so many times what is the likely hood of ever being approved? An do they not consider PTSD as a disability? If approved how far back will he be paid? Thank you.

    • Kay Derochie says:

      Dear Ms. Scott,

      As long as the appeal is alive, there is a possibility that your husband’s claim will be approved. PTSD can be disabling depending on how severe it is. If he is approved and the current appeal is based on the 2007 application, benefits could go back to 2007.

      Sincerely,
      Kay

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