If your disability claim was denied, you may be eligible for an SSDI review.
Pennsylvania allows people with a disabling condition to receive benefits from SSDI, but many of these claims are denied.
A number of them may qualify for reopening and the decision appealed. However, you need to know what to do if you want to have your case reopened.
The best thing to do is to contact an experienced disability appeals attorney who can help you with the process.
Who is Eligible for SSDI?
A person may qualify for SSDI benefits if they meet specific requirements:
- They must be able to prove their injury is disabling
- They must prove they cannot fulfill their job duties as before the injury
- They must satisfy two earnings requirements tests
Once these requirements have been met, the disability benefits should receive approval. However, many claims receive a denial even if they meet requirements. Once someone is denied, they can request an appeal hearing before an Administrative Law Judge. It takes about an average of one year from the time of the request to the time of the hearing.
If the claim is once again denied, the person can ask for a review by the Appeals Council. If the appeal results in a denial, the final step is to file a lawsuit with the US District Court.
How to Reopen a Claim That Has Been Denied
Many people don’t realize they have the option of reopening a Social Security disability claim that has been denied, especially when they are filing a new disability claim. Once the timeline passes for reopening it, the decision becomes permanent. In some cases, a prior claim may be reopened.
These circumstances include the following:
- The original claim was denied incorrectly
- The prior claim relates to a current claim
- The date of onset for the current claim is within 17 months of the application for the first claim
It can be important to have the ability to reopen an SSDI review because it may directly impact the number of disability benefits a person can receive. Social Security usually goes back to the date on the first application to calculate benefits.
If the person meets the requirements, they can file a new application to reopen the original claim after the SSDI review was denied. The date of onset for the disability determines whether to open the claim.
Other factors to reopen a claim include the following:
- New evidence has been discovered that is relevant to the claim
- A clerical error was made on calculating benefits
- The written decision by the judge was in error on its face
It can be challenging to get an old claim reopened, which is why it’s important to have an attorney help you if you believe you should be able to reopen your denied claim.
Timeline for Getting an SSDI Review
It’s critical to know how long you have to reopen a claim. The following timeframes will help you understand your options.
Claims Under a Year
If the claim became final less than 12 months ago, you may be able to get it reopened for any reason. This is twelve months from the date of the decision rather than the date of filing or onset.
Claims Between Two and Four Years Old
There must be a good reason to open a claim that is more than two years old. “A good reason” is generally defined and new evidence about the claim or the discovery of an error. New material evidence may be anything that would have altered the decision, but it was not considered.
An error could be clerical, or it could be something more serious such as information included that belonged to someone other than the claimant. For example, a medical report used in the decision might have belonged to someone else or involved a different injury.
Claims More than Four Years Old
It’s rare for Social Security to reopen a claim after four years. If someone discovered fraud or if errors were made in the benefits computed or a few other unique situations, the claim may be reopened.
Who May Reopen the Claim?
Only a few people may reopen a claim that has been denied.
- An administrative law judge
- Claims examiner at DDS
- Disability Appeals Council
Who can reopen the claim depends on who denied it.
For example, if the Appeals Council denied the claim, they are the only ones who can reopen it. If the administrative law judge denied the claim, the council or another administrative law judge could reopen the claim.
If the request to reopen the claim is denied, it stands. You cannot appeal the denial of the request for reopening.
Get The Help You Need to Reopen a Claim
As you can see, it’s quite complicated to reopen an SSDI claim once it’s been denied.
You only get one chance, which is why you should hire a lawyer to help you with the process.
An experienced disability attorney can make the request and ensure the prior claim is relevant to a current claim. They can show why there was a mistake in the decision or what evidence is available to consider. We can also help with the workers’ compensation appeals process as well.
You want to work with an experienced team who understands disability and someone who cares about your rights.
Call Krasno, Krasno & Onwudinjo for a free consultation. We can help you determine if you can reopen your case and assist you with the process. Give us a call today.