Check your denial

The best tip I can offer if your case is denied is to check the paperwork. While there are several common deadlines, if you do not definitely know how long Social Security gives you to appeal, you may be using the wrong deadline.

The paperwork you are looking for is typically a denial. However, it may also be called a “decision,” “notice of disapproved claim,” “notice of proposed action,” or something else. The thing to keep in mind is that whenever Social Security decides something on your case, they will also tell you the following:

1. The appeal options. What you can do if you disagree with the action or decision.
2. The appeal process. What forms you need to fill out, where to get them, where to turn them in, or the website to go to appeal.
3. How long you have to file the appeal.

If you have lost your Social Security denial?

If you no longer have your Social Security paperwork, give your local Social Security office a call. You can also call the toll-free Social Security number at 1-800-772-1213.

Social Security should always be able to tell you the most recent decision (or action on your case) and any applicable deadlines.

Lets get down to brass tacks. Here are the most common Social Security deadlines:

65 days to appeal a Social Security denial

In most Social Security cases, you have 65 days to appeal a denial or decision. Again, there is no guarantee of 65 days; this is just the most common time limit.

Hold on, isn’t it 60 days?

Yes and no. Social Security typically gives you 60 days to file an appeal. However the 60 days normally do not start until 5 days after the date on the decision. Those 5 days are the mailing time Social Security assumes it will take to get the denial to you.

So, effectively, you have 65 days from the date on the decision to appeal.

In theory, if it took longer than 5 days to get the decision to you, you might have an extra couple of days beyond that. However, if you file the appeal more than 65 days after the date on the denial, Social Security will assume that it is a late appeal and you will have to explain the late filing. Can you prove it took longer than 5 days to get the denial?

Note: if the denial is sitting for several days in a mailbox or PO Box because you have not picked it up, this will not normally extend the deadline.

Deadline to what?

I mailed the appeal on the 65th day. I even got confirmation from the post office. I’m good, right?

Probably not. Appeals are not taxes. Getting a postmark by the last day does not stop the deadline clock.

You have to get the appeal into Social Security’s hands on or before the deadline. If you are close to the deadline, that may mean overnighting the appeal, or walking it in.

What if the deadline falls on a weekend or holiday?

If the deadline falls on a weekend or national holiday, then the deadline is moved to the next business day.

However, don’t bet your case on it! I have seen too many cases where the appeal was properly filed on the next business day after a weekend deadline and in every single instance, Social Security treated it as a late appeal. This was able to be resolved with a letter explaining the circumstances. However, it put an extra hurdle in the way of proving the disability case.

If at all possible, get the appeal in early!

Wrap-up

I want to remind you again, deadlines can change and the best source for finding the deadline in your case is to check your Social Security paperwork or contact Social Security directly.

Check out this article for more tips on dealing with Social Security deadlines.

If your Social Security case is denied after a hearing with an Administrative Law Judge (ALJ), you have a couple of options:

Appeal the ALJ’s decision to the Social Security Appeals Council

To do this, you need to file form HA-520-U5 “Request for Review of Hearing Decision/Order.”  

One benefit of appealing is that it preserves your entitlement to past benefits.  Whereas, if you start a new claim, you normally lose your entitlement to the back benefits from the just-denied claim.  

So, generally, if you can continue to appeal the current claim, you may get more back benefits that on a new claim.  

There are exceptions to this, including the possibility of reopening a prior claim during a new claim.  If the Judge decides to reopen the prior claim, you might not lose any back benefit.

However, there is no guarantee that you will be able to reopen a prior case.  You have to meet additional requirements to request a reopening, and, more importantly, the choice of whether to reopen a prior claim is discretionary.  If the Judge decides not to reopen the prior claim – that’s it!  In my experience in Colorado, judges generally do not like to disturb a prior judge’s decision.

So, you do not want to count too much on reopening a prior claim. I warn my clients not to expect that a prior claim will be reopened if they have to start a new application. 

Start a new claim from scratch by filing a new application  

You may be wondering:

Why would any one want to start a new claim when an appeal may get me more benefits?

The answer is that if you “win” at the Appeals Council, chances are that they will not approve your case outright. Instead, the Appeals Council typically will only vacate (throw out) the prior decision and send the case back for another hearing with specific instructions about what needs to be done differently at the second hearing. 

So, even if you win, you just get a “do-over.”

Here is the real kicker.  The hearing will most likely be with the same Judge.  I have seen quite a few cases where the Judge simply did not believe my claimant, or their doctors. Having another hearing with the same just is not much of a victory.

Sometimes, it is just better to start fresh with a new claim.  If the case has to go to hearing again, it will probably get a different Judge.  Of course, there is no guarantee you wont get the same judge, but, by filing a new claim, you have a significantly better chance of getting a new judge.

Which is faster?  A new claim or an Appeals Council appeal?

It is too close to call.  Both can take more than two years to get back in front of a judge.  The main exception is if there has been a significant change in the case which might cause Social Security to approve a new claim at the initial review level.  Since the initial review takes only 4-6 months, under these circumstances, a new claim might be faster.  

In some case, you cannot reapply

There are several situations where you cannot reapply for Social Security:

1. You are beyond your “Date Last Insured (DLI).” See my article about this here. DLI only applies in Disability Insurance cases, so if you are applying for SSI, this will not prevent you from applying.  
2. If you are applying for SSI, your spouse’s income or other household income may make financially ineligible for SSI.  Strictly speaking this does not keep you from applying, but you may quickly get a denial for financial ineligibility.

Deadlines for Appealing a Hearing Denial

Normally, you have 5 days to receive the denial and 60 days to submit the appeal. Check your paperwork for the specific dates.  Also, keep in mind that it is not 60 days to mail the appeal.  The appeal has to be received at the Appeal’s Council (the address is in the denial) by the 60th day.

I hear this one with some frequency. I am meeting with a client and they tell me that someone at Social Security told them that if they want to appeal, they have to wait sixty days before starting a new claim / filing a new application.

That’s just not true.

You do not have to wait any length of time after a denial before starting a new claim. You can start a new application the same day as you receive the denial.

I think the confusion comes from the 60 day (actually 60 + 5 day) time period you have typically have to file an appeal. That is the deadline by which you have to get your appeal submitted to Social Security. But the appeal deadline does not have to expire before you can start a new claim.

You, or your child, are on Social Security, when out of the blue, you get a letter:

Your benefits will cease as of …

or

An overpayment was detected due to your failure to notify Social Security of your spouse’s income …

or

Since turning 18 years of age, we have determined that you are no longer disabled under our rules …

You may be thinking, “this is clearly a mistake;” “I go in every year with my spouse’s paystubs;” or “nothing has changed in my condition.”

So, you call Social Security to clear this up. Maybe you make an appointment to go in. Maybe you speak to an understanding soul who says it is all a mistake. You think to yourself:

The letter said I could appeal, but I don’t need to do that, I will just get it cleared up.

Watch out!

There is almost certainly a clock running.

In many circumstances, Social Security gives you 60 days to file your appeal after your receive a notice from them (Social Security assumes you recieve the notice 5 days after the notice’s date).

In some circumstances, you only have 30 days to appeal; and you only have 10 days to request the benefits continue during an you appeal if Social Security plans on stopping your benefits.

Ok, so there is a deadline. Who cares? I am just going to get this taken care of.

There is nothing wrong with trying to resolve a problem with Social Security informally. In fact, it is almost certain that if you are able to resolve the issue informally, this will be a lot faster that getting pursuing an appeal.

Here is the catch, if you do not resolve the problem before the appeal deadline, unless you qualify for an exception, you lose the right to challenge Social Security’s action through an appeal.

Sixty days may seem like a lot of time to get your problem solved, but it can quickly slip away:

• You schedule an appointment, but when you arrive at Social Security, they do not have you down for the appointment, or the person is running behind and cannot see you, or has left for the day, or is on vacation. You schedule another appointment, but there is another reason why you cannot be seen.
• You speak with Person A at Social Security who is very understanding and genuinely wants to help you. However, weeks pass and you hear nothing from Social Security. You call, but you cannot reach Person A. You leave messages, but you never get called back. You call again and speak to Person B. Person B cannot find any record of your conversation with Person A and is unwilling to do what Person A promised.

I have seen too many cases where an individual was “strung along” by Social Security until the deadline passed and the appeal window closed.

I do not think Social Security is intentionally trying to string you along, mislead you, or take away your appeal rights. The vast majority of people working at Social Security are honestly trying their best. But, Social Security is greatly over-worked, under-staffed, and under-funded.

Delays happen, misunderstandings occur, instructions can be miscommunicated, misdirected, or simply buried under a pile of other tasks. All the while, tick-tock, the appeal deadline rapidly approaches.

So, here is what it all boils down to:

1. You can try to resolve your problem with Social Security informally, but always remember the deadline to file a formal appeal. If it turns out that you do have to file a formal appeal, make sure you get a receipt!
2. No matter what anyone at Social Security tells you or promises you, it is not a done deal until you have it in writing. If you are told that the problem will be fixed and you will receive a letter “shortly.” Ask for a date that you should receive it by, and the direct extension number to the person you are working with. Make sure the date is before the deadline. If you do not receive the letter by the time promised, contact the Social Security worker immediately.
3. If you cannot get written confirmation that the problem will be resolved, file the appeal.

Pursue every avenue you can to resolve a problem, but keep the appeal deadline in mind. The appeal is the only way to preserve your rights if you cannot resolve the problem informally with Social Security.