After receiving a denial of your Social Security disability claim, reconsideration represents your first opportunity to appeal the decision. While reconsideration approval rates are relatively low, this stage remains important for building your case and preserving your appeal rights. Understanding how to strengthen your application during reconsideration can improve your chances of success or at least position you well for the more favorable hearing stage that follows.
What Happens at Reconsideration
Reconsideration involves a complete review of your claim by someone who was not involved in the initial decision. A disability examiner at a state agency, typically called Disability Determination Services, will look at all the evidence from your original application plus any new evidence you submit. The reviewer examines your claim fresh, though they apply the same medical and vocational standards that led to your initial denial.
In most states, reconsideration is a paper review without any face-to-face meeting. However, ten states have eliminated the reconsideration step for most claimants, allowing them to proceed directly to a hearing before an Administrative Law Judge. If you live in one of these prototype states, your initial denial letter will explain your specific appeal options.
Filing Your Reconsideration Request
You have 60 days from the date you receive your denial notice to file a request for reconsideration. Social Security assumes you received the notice five days after the date printed on it, so your effective deadline is 65 days from that date. Filing online through your my Social Security account is often the fastest method, though you can also file by phone, mail, or in person at a Social Security office.
When you request reconsideration, you have the option to submit additional evidence and provide an explanation of why you disagree with the denial. Taking advantage of this opportunity is crucial. Simply checking a box requesting reconsideration without providing new information rarely changes the outcome. The more you can do to address the specific reasons for your denial, the better your chances.
Understanding Why You Were Denied
Your denial letter contains important information about why Social Security determined you do not qualify for benefits. Reading this letter carefully reveals what aspects of your claim were considered insufficient. Common denial reasons include findings that your medical conditions are not severe enough, that you can still perform your past work, or that you can adjust to other types of work despite your limitations.
Requesting your complete claims file from Social Security provides even more insight. This file contains the medical records that were reviewed, consultative examination reports, the disability examiner's notes, and the medical consultant's opinions. Reviewing these documents helps you understand exactly what evidence was considered and identify gaps or misunderstandings that you can address with new evidence.
Gathering Additional Medical Evidence
The most effective way to strengthen your reconsideration request is by submitting additional medical evidence. Updated medical records documenting your ongoing treatment since your initial application show that your conditions persist and may have worsened. If you have started seeing new specialists or received new diagnoses, these records should be submitted.
Medical opinions from your treating physicians carry significant weight when they specifically address your functional limitations. Ask your doctors to complete detailed statements explaining how your conditions affect your ability to work. These opinions should address specific physical or mental limitations such as how long you can stand, how much you can lift, your ability to concentrate, or your limitations with handling stress and interacting with others.
If your initial denial cited insufficient medical evidence, consider what examinations or tests might document your conditions more thoroughly. Medical imaging, psychological evaluations, functional capacity assessments, and other diagnostic testing can provide objective evidence supporting your claimed limitations. Discuss with your healthcare providers what additional documentation might help establish the severity of your conditions.
Improving Your Function Report
Your function report describing daily activities and limitations plays an important role in disability determinations. If you feel your original report did not adequately convey your limitations, reconsideration allows you to submit updated information. Be specific and detailed about how your conditions affect routine activities like dressing, bathing, preparing meals, managing finances, and maintaining your living space.
Avoid the temptation to exaggerate or understate your abilities. Inconsistencies between your function report and medical records raise credibility concerns. Instead, focus on accurately describing your worst days along with your better days, explaining how symptoms fluctuate and how you manage activities despite your limitations. Include information about any help you receive from family members or friends.
Third-Party Statements
Statements from people who observe you regularly can corroborate your own descriptions of your limitations. Family members, former coworkers, or friends can provide valuable perspectives on how your conditions affect your daily functioning and ability to work. These statements should focus on specific observations rather than medical opinions, describing what they have witnessed regarding your symptoms, limitations, and capabilities.
Former employers might also provide useful information, particularly if your conditions caused problems at your last job before you stopped working. Evidence of accommodations you required, performance issues related to your health, or the reasons you ultimately left employment can support your claim that you cannot maintain competitive employment.
Realistic Expectations
Reconsideration approval rates are relatively low, with most statistics suggesting only about 10 to 15 percent of claims are approved at this stage. This does not mean reconsideration is a waste of time. Filing reconsideration preserves your appeal rights and allows you to proceed to the hearing stage, where approval rates are significantly higher. The evidence you develop and submit at reconsideration also becomes part of your record for the hearing.
If your reconsideration is denied, you will have 60 days to request a hearing before an Administrative Law Judge. Many disability attorneys consider the ALJ hearing the most critical stage of the appeals process, where claimants have the opportunity to testify in person and respond to questions about their conditions. The work you do strengthening your case during reconsideration positions you well for this important next step.