The Appeals Process - Reconsideration

When the Social Security Administration makes a determination on your claim, they will send you a letter explaining why they made their decision. Should you disagree with their decision, based on medical or non-medical reasons, you should appeal. You will need to explain the reasoning behind your appeal.

Reconsideration is step one in the appeals process for a client who disagrees with the outcome of their case. In this first stage of the appeal process, your entire file is thoroughly and independently reviewed. If there is new evidence that is reviewed as well. An altogether different review team from the initial review, which consists of a Disability Examiner, a Disability Officer and either a psychological or medical consultant has the task of reconsidering your claim.

You must file, and include your additional evidence, within 60 days after receiving your letter of the Agency's initial determination of your claim. We are happy to assist you in filing the necessary forms to accompany your appeal.

The Reconsideration process affords a client the right to present additional evidence regarding their claim. Once a Field Officer receives your claim it is sent to a Disability Examiner. The examiner evaluates on the entire record and the new evidence as well. If the review is warranted, then a client will receive a re-hearing at the Medical Continuing Disability Review Reconsideration level. A client's medical sources of treatment will be contacted as well for the existence of new medical evidence.

Accordingly once the treatment record is received, a new medical or psychological examiner, who was not involved a client's initial decision, will review the record. Once the medical evidence is assessed and reviewed, the new examiner then makes a determination on your medical record.

There are several outcomes with the Reconsideration process. The team may decide to affirm or “rubber stamp” the initial determination. They may even state that a client's condition is no worse, and there are not any new impairments presented. Importantly too, that there has been no new treatment received since the initial determination. Finally, that there aren't any changes functionally in limitations and everything is otherwise the same as the initial decision. These are several outcomes that will warrant another appeal if the client so chooses.

This blog is intended for information purposes only and does not establish legal representation or financial guidance.