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SSDI appeal: What are my options if I missed the deadline?
Millions of workers apply for disability benefits each year. The SSA denies an estimated 65% of all first-time applications, forcing many applicants to appeal their disability denials.
Social Security Disability Insurance (SSDI) is available to disabled workers who can prove that they have a severe mental or physical health condition that will last 12 continuous months. Applicants must also have worked and paid employment taxes, generating sufficient income to earn work credits and be considered “insured” for benefits. Applicants with short-term conditions or those who have not worked and earned enough work credits will automatically be denied SSDI benefits.
Claimants have a limited time to file their appeal
If your SSDI application has been denied, you have 60 days from the date of the denial to file your first appeal. In most states, the first appeal is called a reconsideration. The reconsideration allows another disability examiner to review your application and make another disability determination. The same criterion is used by the second examiner as the first. For this reason, 80% of reconsiderations are denied a second time.
Claimants who receive a second SSDI denial have 60 days from the date of the reconsideration denial to file another appeal and request a hearing before an administrative law judge. Unfortunately, there are hundreds of thousands of cases waiting to be heard by judges, and it can take months or years to have a hearing scheduled.
Finally, if the case is denied at the hearing level, the claimant can appeal to the Appeals Council to have their case reviewed a third time. The Appeals Council has several options: they can review the case and make a new decision, refuse to hear the case, or remand it back to the lower court.
What if I missed the SSDI appeal deadline?
So what are your options if you missed the deadline to appeal at any stage in the SSDI appeals process? In most cases you will have to start the process again from the very beginning. But there are specific reasons the SSA may be willing to waive the deadline for and let you continue with the appeal. Specific reasons listed by the SSA include the following:
- Serious illness
You had a serious health condition, you were unconscious, or you were hospitalized and were unable to contact the SSA.
- Evidence for your case was destroyed
Crucial information for your claim was destroyed due to unforeseen events such as a storm, tornado or fire.
- Family emergency
You have suffered a serious loss such as a death in your immediate family.
Other reasons the SSA may be willing to make exceptions to the appeal deadlines and offer you an extension include pending inquiries, lack of notice, personal difficulties due to mental or physical health conditions, or lost mail (you must show proof that you were never notified). Talk to the Social Security Administration if you have questions about your options.
Benefits of filing an appeal
It is not unusual for some disability applicants to file their Social Security Disability application over and over again hoping that someday it will be approved. Assuming you meet the nonmedical requirements for SSDI, this strategy could be successful, but generally you would need to present more medical information to support your claim that you are disabled and cannot work.
If you do not have more supporting medical information and nothing else about your case has changed, filing multiple applications generally does not help. The examiners will simply keep denying your claim.
Most claimants will improve their chances of winning benefits by filing an appeal after the first SSDI denial. Filing an appeal gets you one step closer to an administrative hearing which is your best chance to win benefits. It also does not restart the application date, which means your back benefits continue to accrue while you wait. Finally, it can eliminate unnecessary wait times and moves you further through the appeals process.
Missed the SSDI deadline, what now?
If you have missed the SSDI appeals deadline, you have several options. As mentioned above, you may be allowed to ask for a waiver from the SSA. If they grant the waiver, you can continue with your appeal.
If the SSA decides not to grant the waiver, you may have to simply apply again. Although this is a hassle, you will understand more about the process the second time. Why not ensure that you have sufficient medical information to win your case? For example, if the SSA said you could retrain for new work, you may want to request a residual functional capacity form from your doctor. This form is a great addition to your claim because it can specifically identify limitations about your ability to work.
Another option is to try to go back to work. Many disability applicants are not disabled, according to the definition offered by the SSA. Maybe this is the perfect time to go back to school or get technical training to see if you can do a different job.