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I filed for Social Security Disability benefits last year, but did not appeal the decision. Social Security told me that I have to file a new case. Is there any way to reopen that previous case that I filed?

This is an excellent question. I frequently receive calls from individuals that filed for Social Security Benefits several times, but did not appeal the decision because they either did not know they were supposed to appeal, misunderstood how Social Security rules work or for other various reasons.

Social Security has rules in place that allow an individual to reopen a previously-filed case when the appeal period for that case has lapsed. Before we discuss those rules, we should review the basic rules that apply to perfecting an appeal on current Social Security Disability claims. Then we will discuss what you should do if your appeal period has lapsed, and finally how a claim can be reopened if necessary.

Once a claimant has filed his or her initial application for either Social Security Disability Insurance benefits (“SSD”) or Supplemental Security Income (“SSI”), Social Security will render a decision on that initial application within three (3) to six (6) months of the application date. After Social Security makes its decision, it will mail out a letter indicating whether the claim is fully-favorable (approved), partially favorable, or denied. If the application is fully-favorable (approved), then there is obviously no need to appeal, since the claimant will have been found “disabled” and entitled to benefits. However, if the claim is partially-favorable or denied, a claimant has sixty (60) days from the day he or she receives the letter within which to file a Request for Reconsideration. A decision is partially-favorable if it deviates from the claimed disability period to lessen the amount of time to which the claimant would be entitled to benefits.

Social Security rules add an additional five (5) days to the appeal period from the date the denial letter was issued to allow for any delay in mail delivery. Thus the appeal of the initial decision, known as the Request for Reconsideration, must be received by Social Security no later than sixty (60) days, plus five (5) days for mailing, from the date of the denial or partially favorable decision. If the appeal is received later than sixty-five (65) days, the claimant has the burden to show that he or she did not receive the letter within the five (5) days of the date of the denial letter. This same procedural process applies to a denial of a claimant’s Request for Reconsideration. This next appeal is called a Request for Hearing with an Administrative Law Judge (“ALJ”). The claimant has sixty (60) days, plus five (5) for mailing, to appeal a denial of his or her Request for Reconsideration, by filing a Request for Hearing.

The appeal timing rules are construed fairly strictly; however, Social Security provides for some considerations if the claimant fails to make the appeal with in the prescribed time frame. Social Security allows late appeals if the claimant can demonstrate “good cause.” A non-exclusive list of examples of “good cause” are serious illness preventing a claimant from appealing, not receiving notice of the determination or decision, and unusual or unavoidable circumstances demonstrating that the claimant could not have known the need to file timely. If you fail to demonstrate “good cause” to keep the case pending, and the decision becomes final, then you will need to file a new claim.

To reopen a case, a claimant will have to file a new application and then request that Social Security reopen the previous claim based under the following circumstances. A claimant has the right to reopen a claim within twelve (12) months of the decision or denial date for “any reason” under Social Security rules. Beyond the twelve month period, a claimant can reopen a case within four (4) years of the date of the notice of determination if the claimant can demonstrate “good cause.“ ”Good cause” to reopen a case includes (1) new and material evidence to submit to Social Security regarding the disability claim, (2) a clerical error in the computation of benefits made, and/or (3) the evidence considered in making the previous decision clearly shows on its face that an error was made. Beyond the four (4) year period, a claimant can reopen a case under only a few circumstances. The extent of these circumstances will not be addressed here.

In conclusion, to avoid the necessity of trying to reopen a previously-filed case, you should make certain to call a social security attorney as soon as you receive a denial so that they can assist in perfecting an appeal within the required time thereby keeping your disability claim open. You should pay close attention to appeal deadlines, and if you miss a deadline, you should act quickly to request that Social Security permit you to keep the case going, or file a new claim and request to reopen the previous case. If you have been denied, regardless of whether you have missed an appeal deadline, you should contact a social security attorney who can assist with your disability claim.

Should you have any questions regarding social security benefits, or if you would like to consult with an attorney, please contact our office.