Thursday, July 28, 2011

Social Security forces claimants to chose between Appealling or Re-applying

In the event that a claimant receives an unfavorable decision at a hearing with an administrative law judge, the question becomes what does the claimant do next.  Typically, an appeal is filed with the Appeals Council which is the branch of the Social Security Administration that reviews the judges' decisions.  In addition to filing an Appeal, the claimant had been able to file a new application for disability benefits with the SSA.  The Social Security Administration has today revised their policy for filing subsequent applications where a prior application is pending at the Appeals Council.  The SSA "will no longer process a subsequent disability claim if you already have a claim under the same title and of the same type pending in our administrative review process".  The revision in policy does not apply to cases where an appeal is pending in Federal District Court.  Nor does it apply to subsequent applications that were filed prior to today. 

Key Provisions:

1.  A claimant who wants to file a new disability claim under the same title and of the same benefit type will have to choose between continuing with the administrative appeal or declining to pursue administrative rev iew and filing a new application.
2.  If the choice is to pursue the administrative appeal, SSA will not accept the subsequent application.
3.  Additional evidence reporting a new medical condition or a worsening of existing medical conditions can still be submitted.
4.  If the claimant decides to pursue the first claim and it is pending at the Appeals Council and additional evidence is submitted, the Appeals Council will first determine if the evidence relates to the period on or before the date of the ALJ hearing decision.  If it does, the Appeals Council will consider this new evidence with the rest of the record.
5.  If the new and material evidence relates to the period on or before the date of the hearing decision and "shows a critical or disabling condition, the Appeals Council will expedite its review of the pending claim".
6.  If the evidence relates to the period after the date of the ALJ decision, the Appeals Council will return the evidence to the claimant.
7.  If the claimant decides not to pursue further review of the pending claim, a new application can be filed.  However, the claimant will need to withdraw the request for review.

Obviously this change in policy is terrible for unsuccessful claimants who have legitimate issues to raise on Appeal and who wish to file a new claim that may be approved due to a worsening of their condition.  They are now forced to chose between reapply and giving up their claim for their retroactive benefits from their prior case or waiting 6 to 9 months for the Appeals Council to act on their appeal.  If the Appeal is unsuccessful, the new application will revert back to the same date that the Appeal was filed.  A link to the ruling is at:
http://www.gpo.gov/fdsys/pkg/FR-2011-07-28/pdf/2011-19103.pdf .  For more information contact us at http://www.delellis.com/

5 comments:

  1. I think it is important to also find out through your lawyer what types of documents he will need to carry on the claim. I wonder how long something like this can take for an individual. It would be tough if you were forced to reapply or do something.

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  2. It can definitely be difficult to have to make a call on something like this. I know that it can be difficult sometimes to think about keeping some people from trying to get benefits, and that's what this does. But you need to find a way to stop the fraudulent claims, and this works towards that goal. I think it would definitely be in the best interest of people going through this to seek professional help to ensure that they make the best move to help themselves.
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