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Managing a claim for Social Security Disability Insurance (SSDI) can be complicated and time-consuming. If the Social Security Administration doesn’t approve your request, it can be disheartening and feel like the end of the world. However, If your disability claim was denied, you may be eligible for an SSDI review. 

Pennsylvania allows people with a disabling condition to receive benefits from SSDI, but many of these claims are denied. A number of these claims may qualify for reopening so the claimants can request an appeal on their decision. However, you need to know what to do if you want to have your case reopened. 

Your best course of action is to contact an experienced disability appeals attorney who can help you with the process.

Who is Eligible for SSDI?

SSDI is meant for individuals who are injured or become ill and cannot work for an extended period of time. A person may qualify for SSDI benefits if they meet specific requirements:

• They must be able to prove their injury is disabling.
• They must prove they cannot fulfill their job duties as before the injury.
• They must satisfy two earnings requirements tests.

Once these requirements have been met, the disability benefits should receive approval. However, many claims receive a denial even if they meet requirements. Once someone is denied, they can request an appeal hearing before an Administrative Law Judge. 

It takes about an average of one year from the time of the request to the time of the hearing.

If the claim is once again denied, the person can ask for a review by the Appeals Council. If the appeal results in a denial, the final step is to file a lawsuit with the US District Court.

How to Reopen a Claim That Has Been Denied

Many people don’t realize they have the option of reopening a Social Security disability claim that has been denied, especially when they are filing a new disability claim. Once the timeline passes for reopening it, the decision becomes permanent. In some cases, a prior claim may be reopened. 

These circumstances include the following:

• The original claim was denied incorrectly.
• The prior claim relates to a current claim.
• The date of onset for the current claim is within 17 months of the application for the first claim.

The ability to reopen an SSDI review can be important because it may directly impact the number of disability benefits a person can receive. Social Security usually goes back to the date on the first application to calculate benefits.

If the person meets the requirements, they can file a new application to reopen the original claim after the SSDI review was denied. The date of onset for the disability determines whether to open the claim.

Other factors to reopen a claim include the following:

• New evidence has been discovered that is relevant to the claim.
• A clerical error was made in calculating benefits.
• The written decision by the judge was in error on its face.

It can be challenging to get an old claim reopened, which is why it’s important to have an attorney help you if you believe you should be able to reopen your denied claim. Your lawyer can put their team to work gathering and preparing new materials such as medical reports, scans, and test results to demonstrate your need for benefits.

Timeline for Getting an SSDI Review

Because so many people are applying for SSDI benefits, the system can be overloaded and slow. Working with a skilled SSDI claim attorney can definitely make things easier, but It’s critical to have a reasonable expectation of how long you have to reopen a claim. 

Reopening a claim is allowed under the Federal Code of Regulation (20 CFR §404.988). The following timeframes will help you understand your options.

Claims Under a Year

If the claim became final less than 12 months ago, you may be able to get it reopened for any reason. This is twelve months from the date of the decision rather than the date of filing or onset.

Claims Between Two and Four Years Old

There must be a good reason to open a claim that is more than two years old. “A good reason” is generally defined as having new material evidence about the claim. It may also qualify when you discover an error was made in your original claim. 

New material evidence may be anything that would have altered the decision, but it was not considered. For example, suppose you suffered a back injury and were treated for damaged muscles. If you later discover that you actually had a spine injury, that is a more severe injury and requires additional treatment. Your new evidence could allow you to reopen your claim.

An error could be clerical, or it could be something more serious, such as information included that belonged to someone other than the claimant. For example, a medical report used in the decision might have belonged to someone else or involved a different injury.

Claims More than Four Years Old

It’s rare for Social Security to reopen a claim after four years. If someone discovered fraud or if errors were made in the benefits computed or a few other unique situations, the claim may be reopened.

Who May Reopen the Claim?

Only a few people may reopen a claim that has been denied by Disability Determination Services (DDS). These include:

• An administrative law judge
• Claims examiner at DDS
• Disability Appeals Council

The ability to reopen a claim depends on who issued the denial. For example, if the Appeals Council denied the claim, they are the only ones who can reopen it. If the administrative law judge denied the claim, only the Appeals Council or another administrative law judge could reopen the claim.

You should also be aware of implied and express reopenings. If you explicitly ask the administrative law judge to reopen your claim at a disability hearing, that is an express opening (you’ve expressed your wishes that it be reopened). If you do not ask the judge directly, they will assume you want to have the claim revisited, making it an implied reopening. Submitting new evidence is generally enough to trigger an implied reopening.

If the request to reopen the claim is denied, it stands. You cannot appeal the denial of the request for reopening.

What Is the Difference Between Appealing an SSDI Claim Denial and Reopening a Denied SSDI Claim?

On the surface, it may seem like appealing a denied claim is the same thing as reopening a denied claim. However, the key difference is the timing. When you first submit your SSDI request for benefits, you may receive a denial. You will have 60 days to request an appeal, and you have as many as four opportunities to get the claim approved. 

The appeals process has four escalating levels, and all but the last one can be completed on your own. For the final level, a lawyer is required, although professional legal guidance will certainly benefit you for every step of the process. The levels are:

1. Requesting a reconsideration of your claim
2. Requesting a hearing before an administrative law judge
3. Requesting a review by the Appeals Council
4. Filing a legal action for review in Federal court

As mentioned before, when you are reopening a denied claim, it is typically done a minimum of one year after the claim was denied. Again, you only have one opportunity to request a reopening, and if it is denied, your claim is completed. 

Why Choose Krasno, Krasno & Onwudinjo as Your Social Security Disability Lawyers to Reopen Your Claim

As you can see, it’s quite complicated to reopen an SSDI claim once it’s been denied. 

You only get one chance, which is why you should hire a skilled, knowledgeable, and compassionate Social Security Disability Insurance lawyer to help you with the process. An experienced disability attorney can educate you on the process and make the request on your behalf. 

They will ensure the prior claim is relevant to a current claim. They can show why there was a mistake in the decision or what evidence is available to consider. At Krasno, Krasno & Onwudinjo, we can also help with the workers’ compensation appeals process as well.

Our firm has worked with those in need of worker’s comp and SSDI benefits for over 80 years. We have a proven track record of success and are proud of our client testimonials regarding our services. Our top-notch attorneys are recognized as some of the best in Pennsylvania.

Get The Help You Need  to Reopen a Claim

When you are facing issues or concerns about your Social Security Disability Insurance claim, you want to work with an experienced team that understands the needs of those with disabilities. You need a powerful legal advocate who can explain the process and someone who cares about your rights. 

Contact the legal professionals at Krasno, Krasno & Onwudinjo for a free consultation. We can help you determine if you can reopen your case and assist you with the process. Schedule your meeting to learn more using our online form today.