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What is a Social Security Request for Reconsideration?

By   /  November 11, 2012  /  83 Comments

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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  • Published: 3 years ago on November 11, 2012
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  • Last Modified: May 27, 2014 @ 1:16 pm
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83 Comments

  1. Megan says:

    When my husband’s claim was denied, he decided to get a lawyer that specializes in MS to file his appeal. He just got a letter from the judge stating that his appeal request was about 2 weeks late from the deadline. He was told by the lawyers that he just needed to wait to hear from them when the hearing date will be set. Do judges accept late appeals when the lawyer filed the paperwork late?

    • Kay Derochie says:

      Dear Megan,

      I suggest that your husband discuss his options with his attorney. Your husband might be able to file a formal request to have the late appeal accepted saying that he had no way of knowing that the attorney was missing the filing date until he received the judge’s letter, so he could not have known that he needed to step in and file it himself.

      Sincerely,
      Kay

  2. Jill says:

    I need advice on how long a request for reconsideration can take. We filed my request on November 15 and still haven’t heard anything. They did have to request additional medical records, which I imagine is adding to the delay. However, is 7 months a long time to make a decision for a request for reconsideration? Everything I’ve read online says it only takes about 2-3 months. Is the longer wait a positive sign? Thank you for your help!

    • Kay Derochie says:

      Dear Jill,

      I suggest that you call the Disability Determination Services (DDS) and ask the claims examiner whether he or she is waiting for anything from you or your medical providers. If not, ask her what is needed for DDS to complete the reconsideration review and how long it will be. Politely point out that it has been seven months since you appealed. If you don’t have a decision in a month, call back and ask to speak to a supervisor.

      Sincerely,
      Kay

  3. SOAR Case Mgr says:

    I am a non-atty rep who files SSDI/SSI claims for homeless, whom are severe mentally ill. During an initial stage, our client scored low on the SLUMS. Because he often cannot even remember his case mgr’s name (4 letters) and other cognitive issues, I submitted the low test score document to DDS and requested that they order Weschler and Trails A & B, cognitive/neuro testing. If I’ve provided “proof”, they’ve always ordered it in the past, and that dr usually nailed my claim for me.

    Today, however, I received a call from the DDS Director who said it was inappropriate for me to request such testing. ?? I had been taught by 3 former DDS mgr’s that if I submitted proof of a cognitive problem, they had to order and pay for the testing. Otherwise, it is their neglect in obtaining ALL of the info before making a decision. Is there something new I don’t know about? It’s June 2015.

    • Kay Derochie says:

      Dear SOAR Case Mgr.,

      I apologize for the length of time it has taken me to respond. I had to do a bit of research.

      My understanding is that it is within the discretion of the SSA Regional Office via DDS to order any consultative examination or test if it will add to the full development of a claim. But, if one is not ordered, then the only recourse is to make an on-the-record motion to an Administrative Law Judge to order said test. But, it is up to the discretion of the judge. If a test is not ordered, then one can always argue a reversible error to the Appeals Council. When the claim is not yet at the hearing level, all you can do is make the written request–whether they think it is appropriate or not–and at least go on record as having done so.

      Sincerely,
      Kay

  4. Alice says:

    I really need advise is there a advisor online?

    • Kay Derochie says:

      Dear Alice,

      Communication on this site is conducted through this forum, which is not “real” time.

      Sincerely,
      Kay

      • Alice says:

        Hello Kay, my son has been diagnoised with adhd , my son was denied so I am appealing it the social security case worker sent me a reconsideration form to appeal it, they had denied him in less than 2months. What are chances of my son getting approved through a reconsideration appeal?

        • Alice says:

          His only 4years old going on 5 this month, what should we expect from a recondideration appeal, his syciatrist had to up his dose 3times already it doesn’t seem to help him. He also takes medicine to sleep his syciatrist prescribed him.

        • Kay Derochie says:

          Dear Alice,

          Your appeal has a better chance of approval if you have new information or evidence to submit and/or if you have a knowledgeable Social Security attorney focus the appeal on essential points. You can reach a good Social Security attorney by completing the online form on this page to request a free Benefits Evaluation from Disability Advisor. When you hire a Social Security attorney, you do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from the retroactive award at the time they send your back pay to you. So, it’s all very easy and risk-free.

          Sincerely,
          Kay

  5. Anna Tuccillo says:

    I was diagnosed with bipolar and others along with serve anxiety. I have been on disability since 2002 and diagnosed with bi polar at the age of 20. I have lost plenty of jobs due to my bipolar illness and have been in the hospitals. I work part time and just recently went over my Gainful Amount that I can make according to disability in 2013 and 2014. The Social Security administration stopped my benefits and I called up Social Security in my town for help, they decided that I start a new application over again and it would not take that long. But I was not taking medication at the end of 2014, I stopped because the last doctor I saw was trying to make me take medication that I did not feel was working for me, I felt sick, headaches, stomach issues, making me slur and all. I have been on almost all meds through my life. He then said there is nothing I can do for you and let me go, I told him but don’t I need the medication? I then left and found a therapist after that I have been seeing her. Bipolar symptoms never disappear. I am in the process of renewing benefits.. .Will they see that I was not taking medication and deny me. I also was in the hospital in 2012. I am in the process of calling up a psychiatrist to go back on meds for anxiety and bi polar meds as of tomorrow. I have been trying natural medication to help. The new application was filled out last week. I really need to be put on medication all symptoms are recurring. Maybe there are some new medication that will agree with me. Will they deny my benefits because of that? Hope this makes sense, scared and depressed.

    Thanks

    • Kay Derochie says:

      Dear Anna,

      It sounds as if more than thirty-six months has passed since you completed your nine-month Trial Work Period and that your benefit were terminated in the first month after that that you performed substantial gainful activity (SGA.) If that is the case you are eligible to apply for Expedited Reinstatement, which is a faster process than a regular new claim. If Expedited Reinstatement was not mentioned to you, contact your local office and ask that your claim be flagged for that.

      Sincerely,
      Kay

      • Anna Tuccillo says:

        If I do sign up for Expedited Reinstatement, would I be getting my full amount that I have been receiving from Social Security or will it be less then that? Would it not be better to open up a new claim? IF I do open up a new claim how long will that take (s/s told me around four months) and what are my consequences?

        Also thanks for your replies.

        Anna

        • Kay Derochie says:

          Dear Anna,

          You will receive the same amount as you were receiving previously if you use the Expedited Reinstatement.

          Opening a new claim might give you a new trial work period, though I am not sure about that because either way–Expedited Reinstatement or a new claim within five years of the closure of the old claim–there is no five-month unpaid waiting period.

          On an average a new claim takes longer than a review for Expedited Reinstatement. It might be helpful to discuss the options with your Social Security claims representative.

          Sincerely,
          Kay

      • Pam says:

        I filed for social security disability reconsideration 6 10 15 along with my appeal I sent in medical evidence which included mri,xray,copd test results a letter from my dr with all my diagnoses and treatments he stated i could not work at this time1 week later they sent me a authorization to disclose information form I filled it out and mailed it back in then today they called went over my limitations and ask if anything got worst since April I told her yes have severe copd and neuropathy which was in the recent medical records I just had done she kept referring to April I said one test was done in may one in June so yes things have got worst she then proceeded and at the end of the call,she said they would send for medical records from such and such places which is the places where I had went recent so my question is why would they have to send for that when I already sent it in and she said she got it I will be 50 in 12 days i,hope my age will,help,also thanks in,advance for all your help

        • Pam says:

          Also she asked if there was anything that has changed since April I kept saying yes I sent in the medical evidence she kept saying yes I got those but has anything changed since april (which is when my case was denied)so why is she referring back to that when I sent in evidence and also she asked about the facilities I have been so she could send for the record I forgot to tell them about the hospital where I had all my kidney surgeries starting in 2008 so I guess I’m asking why does she have to send for records when I sent them in and also should I call them and add the other hospital and next question I will be 50 in 10 days is that close enough for the to put me in the 50-54 age bracket thanks so much for all advice

          • Kay Derochie says:

            Dear Pam,

            Please see my previous response. Yes, do submit the information about the hospital you forgot to mention and provide the month and year of the surgeries and type of surgeries if possible.

            Sincerely,
            Kay

        • Kay Derochie says:

          Dear Pam,

          The disability claims examiner may need to be see all the records and not just the ones you selected. Given the questions about dates, the examiner may be trying to determine whether you became disabled when you claimed or at some later date.

          Sincerely,
          Kay

  6. Lori Howard says:

    I received my SSD denial and requested a reconsideration, I basically questioned their decision and threw it back at them because it was a contradiction of words, they claim I am disabled ( spinal and cervical bi lateral stenosis with nerve root compression) but my age and education determined I could do ” light work”
    My response was: I cannot use my education ( Healthcare) for other light work because it is specific to one field. My doctor the only one I could afford in my area ( he was referred by hospital) was absolutely awful and didn’t take notes or listen to me he was also unethical charging me to come into office to fill out disability paper had he taken notes he wouldn’t have needed me there although he probably would have still charged me. I also told disability due to my lack of not being able to work for the last year I couldn’t afford specialist and such.
    I got a letter today from the reconsideration examiner requesting I go to see their doctor, not a problem but my question is do these appointments help or hinder these decisions I realize SSD says they don’t approve or deny based on the docs decision although I find that hard to believe. Thanks so much

    • Kay Derochie says:

      Dear Lori,

      You were denied previously because you were determined to have transferable skills to do other types of work. The current consultative examination report will be considered together with the other information in your claim file when a decision is made. Because your own doctor’s records and reports were apparently weak as related to your claim, the upcoming examination will be an important piece of evidence.

      Sincerely,
      Kay

  7. shareca says:

    WOULD YOU KNOW HOW LONG IT’S GOING TO TAKE FOR THEM TO MAKE A DECISION?

  8. shareca says:

    THANKS! WELL SAID….

  9. shareca says:

    HELLO!
    MY CHILD RECEIVE SSD UNDER THE FATHERS DISABILITY. I RECEIVED A LETTER OF A OVERPAYMENT AND THEY STOPPED HER PAYMENTS WITHOUT A 30 DAY NOICE. I APPEALED IT BUT IS CORRECTLY WAITING ON THE PAPER WORK IN THE MAIL. THE LETTER DONT STATE WHY AND HOW SHE WAS OVER PAID. MY QUESTION IS CAN THEY JUST STOP HER PAYMENTS WITHOUT A 30 DAY NOICE AND I APPEALED IT? IT HAS TO BE A MISTAKE ON THE SSA WITH THE CALCULATIONS. I DONT KNOW WHAT TO DO.

    • shareca says:

      WHILE THE APPEAL IS IN PROCESS WILL THEY GIVE BACK HER PAYMENTS OR MAYBE I WILL RECEIVE SOME TAPE OF PAYMENT LATER IN THIS MONTH? BUT FOR WHAT THERE TELLING ME IS SHE NOT GOING TO RECEIVE A PAYMENT FOR MAY. AND I RECEIVED THE LETTER ON THE 20TH OF THIS MONTH.

      • Kay Derochie says:

        Dear Shareca,

        Please see my response to your first posting. If you are having trouble understanding the correspondence you are getting, you can take it to your Social Security office and ask for an explanation of the letters and an answer to your questions about future benefits.

        Sincerely,
        Kay

    • Kay Derochie says:

      Dear Shareca,

      The first thing to do is to find out why your daughter is overpaid. You have to know why in order to know if you disagree with the recalculation (assuming the overpayment has to due with calculations) and, therefore, disagree with the fact of the overpayment. If you find that you do not disagree with the fact of the overpayment, you can request waiver of collection of the overpayment based on the overpayment not being your fault and your not being able to afford to repay. If future benefits are being withheld to collect the overpayment, another option is to request partial monthly withholding.

      Sincerely,
      Kay

      • shareca says:

        THANK YOU. I DID VISIT A OFFICE TODAY AND THEY SAID THATS ITS NOT POSTED IN THE COMPUTERS ON WHY AND HOW SHE WAS OVER PAID. BUT THEY GAVE ME A OVERPAYMENT WAIVER TODAY AND I SENT IT OFF WITH PROOF OF MY INCOME AN EXPENSES. BUT I ALREADY HAD PUT IN FOR A APPEAL. WHICH SHE BE INTHE MAIL IN A FEW DAYS. IT JUST DOESN’T MAKE SENSE FOR THEM TO STOP PAYMENTS WITHOUT 30DAYS. BUT I WAS TOLD THAT I WILL RECEIVE HER BENEFIT PROLLY A LIL LATE SINCE I PUT IN FOR A APPEAL PLUS WAIVER TODAY.

        • Kay Derochie says:

          Dear Shareca,

          The government has no obligation to pay benefits that are not due so a “thirty-day notice” is not required. The local office can request an explanation of the calculation of the overpayment from the payment center.

          Sincerely,
          Kay

          • shareca says:

            THANKS ALOT FOR YOUR HELP AND MAKING IT EASY FOR ME TO UNDERSTAND. IS A APPEAL THE SAME AS A WAIVER BECAUSE I HAVENT RECEIVED ANYTHING IN THE MAIL TO SIGN FOR THE APPEAL. ONLY A WAIVER FOR OVERPAYMENT

          • Kay Derochie says:

            Dear Shareca,

            An appeal is saying that you are not overpaid or the amount of the overpayment is wrong. An appeal asks the Social Security to correct the mistake so that there is a smaller overpayment or no overpayment. A request for waiver does not disagree with the overpayment; it just asks that you not have to repay the overpaid money.

            Sincerely,
            Kay

  10. Lisa says:

    I first applied for disability in April of 2013 for chronic obstructed kidney, pulmonary embolism, hematoma, and liver mass. I was initially denied the first time. I appealed for the reconsideration and went to their doctor in which he said he didn’t have enough vocational information about my past jobs. I was denied September 2014. I appealed that decision and was granted a hearing on April 2 and I called today and they said that it was denied because of my initial application. Since I first applied I have been diagnosed with lupus, chronic anemia, fibromyalgie, arthritis, vitamin B deficiency by a rheumatologist. Also my right kidney is gone. I haven’t received the letter yet but I’m wondering should I file a new applications with the new diagnosis. I was diagnosed recently with carpal tunnel by an orthropedic. The Vocational Expert said I couldn’t do my previous jobs and their were no jobs in the nation that I can do and I was still denied. Help please

    • Kay Derochie says:

      Dear Lisa,

      It is very unusual that you would be given notice of denial over the phone, especially with a reason given. I suggest that you wait for the letter to see the exact reasons for the denial. At that time, you can consult with a Social Security attorney to get advice on whether to file an Appeals Council review or a new claim and how to formulate the appeal if you decide to go that route. Either way, I recommend that you request a copy of your claim file to help you prepare the appeal or the new claim. If you file a new claim, be sure to list all your illnesses including those for which you originally applied and get an attorney for the the first appeal if you are denied.

      Sincerely,
      Kay

      Sincerely,
      Kay

  11. Mrs. Jackson says:

    I was denied SSI. FOR MY 9 YEAR OLD DAUGHTER. SHE HAS ADHD AND MOOD DISORDERS. SHE WAS DENIED BECUZ DDS DIDNT HAVE ENOUGH MEDICAL INFORMATION. SHE WAS ON A WAITING LIST TO SEE THE CHILD PSYCHOLOGIST IN OUR AREA. SHE STARTED SEEING THE DOCTOR IN MARCH WHEN HER TIME CAME UP. SHE IS NOW ON MEDS AND SEEING THE DOCTOR ON A REGULAR BASE. MEDS ARE CONSTANTLY CHANGING AND MORE AND MORE REFERRALS FROM SCHOOL AND FREQUENT CALLS FROM TEACHER. I APPEALLED TODAY. WILL DDS CONSIDER MY NEW INFORMATION NOW

    • Kay Derochie says:

      Dear Mrs. Jackson,

      The DDS will consider all documentation that you submitted. If your daughter is approved, approval and benefits may begin on the date of original application or on the date that she has medical records sufficient to prove disability,

      Sincerely,
      Kay

  12. Januice says:

    Hello,

    My mother was denied SSDI twice. Today she received a letter that stated she meets approval for benefits, but no money. How is this? Could this be due to my father’s income? If so his income is depleted due to the amount of bills they have from my mother’s medical conditions. Is there anything else we can do? Can she appeal if she’s been approved, but denied at the same time? Please help!

    • Kay Derochie says:

      Dear Januice,

      If your mother actually applied for SSDI (Social Security Disability) as you say and not SSI (Supplemental Security Income), your father’s income will not affect her benefits. When you say “no money,” do you mean that the letter says she is not eligible for benefits or just that the letter doesn’t mention money? A medical approval letter from the judge after a hearing does not include any information about payment amounts. The medically approved claim goes to the payment center for benefit calculation and release of payment.

      Sincerely,
      Kay

  13. Gail LaBella says:

    I applied for SSI and SSDI after I fell from 3rd story roof shattering both ankles and breaking my back in several places. I’ve had numerous surgeries and now in a wheelchair for life. I was approved for the SSI without any problems but denied SSDI because I haven’t worked for at least 5 of the past 10 years. I’ve worked most of my life (I’m 51) except for the past 8 years because I got married and was a housewife. I got divorced shortly before my accident and was in the process of getting my business started again. I’m now single again , no children or family, just me. There is no way I can survive on SSI alone. Since I don’t meet that one eligibility requirement is there any way I can still get SSDI? There is no question I’m disabled, got approved for SSI and Medicaid with no problem. SSA says I can start receiving benefits when I reach retirement age but that doesn’t help me now. I was only married for 8 years so I can’t use my exhusbands employment, you must be married at least 10 years. I’ve lost my car, my home, everything and now I’m homeless because I can’t survive on $480 a month from SSI. Ive been staying with friends here and there but at some point I’m going to wear out my welcome. Any advice you can provide would be greatly appreciated!

    Thank you,

    Gail

    • Kay Derochie says:

      Dear Gail,

      You cannot receive Social Security Disability without being insured (without having enough work credits) on the date you became disabled. If you have not yet received your SSI back pay, you can use that money to rent yourself a small apartment or a room with kitchen privileges that you can afford to pay ongoing with $733 income. and thus begin to qualify for the maximum SSI of $733 a month beginning the second month after you start to pay your own shelter expenses.

      Usually back pay is paid in installments six months apart with the first installment being $2,199; however, if you need more than that amount to pay first and last months rent and rental and utility deposits and to get minimal furniture and basic cooking and bedding furnishing, you can make a written request to have more released (assuming you are eligible for more.)

      Sincerely,
      Kay

  14. Jill says:

    Hi, Kay. I asked you another question earlier and I apologize for the repeat question. I have bipolar 1 disorder with rapid cycling and/or mixed episodes, general anxiety disorder, seasonal affective disorder, social phobia, and arthritis in my hip and knees. I’ve recently been diagnosed with obsessive/compulsive disorder as well. My file is currently in the request for reconsideration phase and I’m working with an attorney. The SSA informed me that they requested additional records and received them on Februrary 12. I’m not sure what evidence has been submitted because I’m getting conflicting statements from my doctor and my attorney. Is there any way I can request the records from SSA to see exactly what has been submitted? Or do I have to work with my lawyer to do that? My doctor has not been very cooperative, although I do see her regularly because of medication adjustments. How would I go about getting the submitted medical records from her? I don’t want to make waves, but I really would like to see what she’s submitted. They act live everything’s a big secret, even though they are MY records and I’m paying a fortune in doctor’s bills.

    I was forced to retire from a $67,000 annual job and I sure didn’t do it for the fun of it. I just couldn’t work any more. So here I am on a very reduced income. What else can I do to win my request for reconsideration?

    Thank you.

    • Kay Derochie says:

      Dear Jill,

      Talk to your attorney about the fact that you are uncertain that your doctor has actually sent the records to Social Security. He or she can request a list of the records received and the dates covered by those records.

      As far as getting the records, you would probably have to sign a release and pay for them. Another way to get them is to have your attorney request a copy of your claim file to date. If your reconsideration is denied, you can request it yourself because you will not be represented until the request for hearing is filed.

      Sincerely,
      Kay

  15. gabriel says:

    Im filing for ssi for adhd depression anxiety. I have a long history of this all throughout my life . I was on ssdi as a child for being born with only one ear . The rules where changed long ago and i lost my ssdi at age 11 .. but what im here to ask is my current lawyer has taken my case but wants me to file on my own first its allmost like he is hopefull i get denied. So he can win on appeal. … why ? Is he trying to make the file to award time longer for a bigger lump sum

    • Kay Derochie says:

      Dear Gabriel,

      Many attorneys will help only after a denial. They are paid as a percentage of the back pay and if there is little or no back pay because of the unpaid five-month waiting period for Social Security Disability(SSDI) or only a few months of the relatively low SSI monthly benefit, they do not get adequately paid for their time.

      You can get a lot of information about filing a claim in the articles under the “Apply SSD” tab at the top of each page of this Disability Advisor website. There is also helpful information under the “Claims Process” tab on how claims are evaluated, which could help you form your arguments.

      Sincerely,
      Kay

  16. Fermen Lesdesma says:

    If i have been fighting disabilty for 5 yrs and just got denied by law judge and it says my disabilty onset date is going to expire dec 30,2014 can i still file appeal.

    • Kay Derochie says:

      Dear Fermen,

      Yes, you can appeal. If you are able to prove that your disability onset date was before December 31, 2014, you will be eligible for benefits.

      Sincerely,
      Kay

  17. Beverly Calvo says:

    Sadly, I cannot find a lawyer to help me because I do not take meds for my psychiatric diagnosis. They make me suicidal, aggressive and lethargic. This doesn’t seem to matter. And 3 disability lawyers told me they will not help if I am not on meds. I anticipate having to go on to a hearing. Any suggestions on how I can prove my claim without a lawyer assisting me? Any laws out there supporting/defending my right to not take meds without being labeled as non-compliant? Seems to me I have the right not to ingest anything that will cause me more harm.

    • Kay Derochie says:

      Dear Beverly,

      See my reply to your prior question. With regard the not taking medication, if you have had a bad response to the medications in the past, your medical records may document the problems and the reasons for not taking the meds. You could present those records to support you claim. If you have not done so already, I suggest that you discuss your claim with Disability Advisor. You do not have to pay any legal fees up front and you will pay attorney fees only if a Disability Advisor attorney accepts your case and you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from the retroactive award at the time it sends your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,
      Kay

  18. rRIGOT JOSEPH says:

    I am just received my denial letter stated that my medical evidence above ;HIGHT BLOOD PRESSURE , HIGH CHOLESTEROL, DIABETTE 2, PINCHED NERVE, LOWER BACK AND KIDNEY DISEASE SHOW SOME LIMITATATIONS TO YOUR ABILTILY TO PERFORM WORK RELATED ACTIVITIES, HOWEVER, THESE LIMITATIONS DO NOT PREVENT YOU FROM PERFORMING WORK YOU HAVE DONE IN THE PAST. I CALLED MY LAWYER, HE TOLD ME HE WOULD FILL FOR APPEAL. I DON’T KNOW IF I HAVE TO CALL SSA MYSELFLEF , LET THEM KNOW ABOUT MY PAST TREATMENT FROM MY PRIMARY DOCTOR WHICH WAS NOT MENTION ON MY DDS AND MY PRESENT TREATMENT ALSO. I AM CONFUSED I DON’T KNOW WHAT I SHOULD I DO. I DO TRUST MY LAWYER . BUT BY READING YOUR COMMENTS AND YOUR ADVICES. I NEED A SECOND OPINION ABOUT MY SITUATION. THE TWO DOCTORS THEY STATED IN MY DDS REPORT WAS NOT MY PRIMARY DOCTOR WHO WERE TREATING ME..

    • Kay Derochie says:

      Dear Joseph,

      I suggest that you talk with your attorney about everything you think was wrong about the decision so the attorney can address those issues when he files the appeal.

      Sincerely,
      Kay

  19. K Craig says:

    I am 22 years old and applied for SSDI Child Benefits (for myself under my fathers earnings record) for severe generalized anxiety disorder, panic disorder and social anxiety that started when I was 18 and keeps me in my house, has prevented me from driving and thus getting a drivers license, and causing me to have serious problems concentrating on anything or dealing with stress. Even being homebound I am eaten alive every day by anxiety even though I am on medication and go to a psychiatrist. I received mail today stating my claim was denied, because although my condition is “severe” it is not “severe enough”. My Adult Disability Form was never received by them even though I properly lined up the address on the envelope and mailed it out the morning after I received it… I am assuming it was lost in the mail somehow. I have some speculation that this is part of why I got denied and I am going to attempt to find a lawyer and start the first part of the appeal process tomorrow since today is Veterans Day. They only listed 3 sources of information and two were psychiatrists that I did not see for very long and one was a report from a family member. Do you think the Adult Disability Report has any real weight in the determination process? If so I hope I get a chance to either fill another one out during the appeal process or provide that additional information in some other way. I’m unemployed and home bound and my insurance runs out when I turn 26, so I feel like I am doomed.

    • Kay Derochie says:

      Dear K.,

      It is your responsibility to submit another Adult Disability Report form with your appeal. If you kept a photocopy, then make a copy of it to attach to your appeal. If you don’t have a copy, get another from from Social Security and complete it thoroughly. It is important because it is your statement of why you can’t work. If you are denied again, request a hearing and obtain a Social Security attorney who can file a formal appeal of your claim denial. You do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge, and the Social Security Administration pays the attorney directly from your retroactive award at the time they send your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,
      Kay

  20. Beverly Vest says:

    I applied for disability in March of 2014, but been unable to work because of health problems since 2011. I just hated the idea of being considered disable so I waited in hopes my health would improve. Long story short it never has, actually it’s progressed. I applied was denied, applied for reconsideration was denied again.
    The denial stated” the medical evidence shows you do have the above conditions,(Fibromyaliga, Brain Damage, COPD, Blood disorder, Possible MS, Chronic Back problems, Chronic headaches, Third Stage Kidney disease, High blood pressure and High cholesterol) These are the conditions. Then it states ” you maintain the ability to perform some work like activities.” The evidence does not show any other condition which would significantly limit your ability to work. Additionally, any symptoms, such as pain, were considered in this claim. We do not have sufficient vocational information to determine whether you can perform any of your past relevant work. However, based on the evidence in file, we have determined that you can adjust to other work. However, it does not prevent doing lighter work. Based on your age (048 years and 08 months) education (12th grade), and past work experience. we have determined that your overall medical condition allows the performance of other work. At the top it stated ( We did not obtain any other evidence because we have enough information to fully evaluate this claim. This whole thing counterdicts itself. Any insight why I was denied after reconsideration with these medical problems?

    • Kay Derochie says:

      Dear Beverly,

      The letter does seem somewhat self-contradictory. In general, I can tell you that ordinarily the first factor that is evaluated is whether you can do past past. If you cannot, then you are evaluated to determine whether there is other work you can do. Individuals under age fifty must be unable to perform new occupations. The letter is essentially saying that they skipped the first evaluation because they were missing some vocational information about your past occupation(s), but it didn’t matter because you didn’t meet the second test.

      If you disagree with the decision, I recommend getting legal assistance from an attorney who is well versed in Social Security Disability law because disability based on multiple conditions is complicated and sometimes difficult to prove. You do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from your retroactive award at the time they send your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,
      Kay

  21. 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

  22. 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

  23. 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

  24. 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

  25. 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

    • Karen says:

      Martin – I sympathy with you, my husband was denied at the ALJ hearing and the Judge threw out the RFC filled out by his doctors which they stated he could not work and the disability would last over 12 months. Instead the ALJ judge agreed with the Social Security doctor whom my husband was sent to for an evaluation in March 2011 for 10 minutes (remember my husbands hearing with this Judge was August 2014). The Social Security Doctor said my husband could work a normal job but would “greatly benefit for extreme pain management”, this is the social security doctors own words nothing taken out of context, so the social security doctor pretty much said my husband can work and function normally at work but would need extreme pain management (ok does not make sense if he’s 100% ok and can work why would he need to see a pain doctor). It seemed that a decision was already made before the court hearing. Not sure, what they are doing but I do know many people are suffering dearly from this process. No one is given a choice to have Social Security and Medicare Taxes taken out your pay. But if you become disable and need that money to help pay bills (which this monthly amount is not much) you have to fight tooth and nail to get it and it’s your money, you paid in to this program and now when you need it, really need it, and you have doctors backing you up, they still say no, still not good enough reason. But if we the citizens of the USA told them no, we will not have Social Security and Medicare taxes taken out of our paycheck, they would do anything in there power to make sure they get paid, even if it meant you losing your house, having your wages garnish, assets sold, they the government, which includes Social Security will make sure they get paid and they will charge you late fees and interest. The process needs to be re-written big time, if anything us the people need to clean house, time to get the bad eggs out of office!

  26. 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

  27. 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

  28. 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

  29. 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

  30. 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

  31. 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

  32. 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

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