Failing to File a Timely Appeal

Most SSDI applications are denied in the initial stages of decision-making. Some states have a denial rate of up to 70%, meaning that most applicants will be forced into the appeal process. You must appeal to the SSA within 60 days of your denial to be reconsidered. There are many steps to the appeal process if your first one is denied. Each one has a window that you must stay in to be able to successfully file. If you accidentally miss the deadline, you have some recourse to seek if you act quickly. Failing to file an appeal at all can be more complicated. Either way, seeking an attorney if you are denied is a good idea to increase the chances of a successful appeal. 

Failing to File On Time

This is a common mistake. Sometimes life gets in the way of the application, especially for people seeking help to support themselves through their disability. You have a limited time window to appeal your SSDI application, which is 60 days from when your application was denied. Most of the time, you will be forced to restart your application from scratch. This delays your benefits even further as you wait longer to submit a new application. However, there are times when you can get an extended time limit within reason. This is called a good cause extension. At the time of appeal, you should include your justification in writing on the form. There are many good reasons that you had to file your appeal late, including: 

• Failure to acquire evidence in time. Sometimes compiling a complete medical record is difficult and takes a lot of interaction and time to accomplish. Often your medical team is busy and may forget something in their notes or do not have enough time to dedicate much thought to your case. Some life events will completely disrupt your ability to find evidence, like moving homes, causing you to lose paperwork, or a fire or flood that destroys property. This is all-important to mention on the late appeal as the SSA will want to consider it. 
• Illness. If you were very ill when you had to file your appeal and could not ask for an extension, that’s a good reason why you couldn’t file in time. It’s also very likely to happen to a lot of people in this situation since they are all experiencing some form of disabling condition. 
• Confusion or delay caused by the SSA. The SSA must notify you that your application was denied. They will typically mail this to you, so if you never got the letter, you can notify the SSA that you were unaware of the denial and should have the timeline extended to reflect that. This could happen if they sent it to the wrong address and you have previously notified them of the change of address. Another reason your appeal could have been delayed is that you and/or your lawyer needed more information that you requested from the SSA and failed to get it to you in time for the appeal. It’s also possible that you sent the appeal to the wrong office or department, and its reception by SSA was delayed or incomplete.

There are many other good reasons that you filed an appeal late. Whatever the reason is, you must prove that it is true. Any phone records, doctor visits, emergency reports, or anything that shows you were stopped from filing the appeal on time. 

Failure to File an Appeal

It’s more straightforward if you have failed to file a claim entirely. You must reopen your claim if you have missed the window for appeal and you don’t have good cause to get an extension. Certain rules must be followed to put forward a reopened claim. At this point, it is at the SSS’s discretion whether you can reopen your claim, or if they will force you to start a new application (possibly on a related claim). 

To begin, two things must be true: the original decision on your claim was wrong, and your claim is still within the time limits of reconsideration. Technically, a claim may be reopened within 12 months of denial “for any reason.” However, this is not automatic and may be denied if there is no reason to change the decision. In good news, the Disability Determination Services (the section of the SSA that makes the initial application determination) will not consider revising your claim to take away your benefits unless they can prove that your disability did not or has ceased to exist. If you attempt to revisit a claim in the second year after the denial, you must present “good cause.” There are three ways to prove good cause in this step: new evidence is presented, an error was made in the first denial based on evidence, or a clerical error caused the denial. Unfortunately, a change in the administrative procedure or the law will not be a good cause here. If you are trying to reopen a claim that was denied in the last four years, you will need to show good cause exactly like you would if it had been two years since the denial. 

Once it has been over four years, it will be considered a revision “at any time.” There are very few reasons why you will be able to revise at this point. The Disability Determination Services (the section of the SSA that makes the initial application determination) only considers fraud or similar fault in this revision. If the evidence initially relied on for the decision was misrepresentative or fraudulent, they will reopen the claim. However, it can work both ways if they believe you knowingly relied on fraudulent information to create your claim, even if you have completed a Continuing Disability Review that found you were disabled. 

Filing a Related Claim

If you want to file a new claim, it must be related to the original one to reopen it. This may be a condition that is caused by the first disability that also makes you eligible for benefits. For example, you could have applied for SSDI for Multiple sclerosis. That claim was denied, so later on, you file a new claim when you develop muscle weakness or paralysis due to the MS. You will need to go through the entire application process again. However, this time you may find it easier with your previous experience. 

Get Help from an Attorney Today!

If you are facing an SSDI denial and have missed the appeal deadline, you can feel lost and confused about where to start. Information and knowledge is your best resource at this time. If you find yourself researching this issue before it arises, remember that you may be eligible for more backpay should you attempt to reopen a claim, but you are more likely to win an appeal than a revision. Always appeal a denial if possible. Sometimes you aren’t able to work within the appeal window, and you need to revisit or file a related claim. It’s a good idea to contact a lawyer if you have missed the opportunity to appeal since they can advise you on the best path to getting approved for SSDI. Contact us today to get the help you need today.