What the hell happened to all of my old (Prior) Social Security Applications and why can’t I go back to the old application date?
Oh, I know you know about this one. You get ready for a hearing and you are told that they are going to look at your case from a particular date of application but you KNOW that you have filed a few times before and YOU want to know WHY are they NOT considering those old applications. And why is this important? It’s because you KNOW that you’ve been disabled for a while and you think they need to understand so they don’t cut out your benefits. Will, let me get YOU right so get ready to read!!
Ok, ok, I’m sure quite a few of you have heard me give a break down of different things relating to Social Security but today, I have go over a topic that I get asked THOUSANDS of time. It’s really weird from a technical standpoint so I’m going to break it down into two parts. Part I is titled LEGAL talk and this is where I will discuss the various standards that Social Security relies on to make their determination. Part II is titled BEAT talk and this is the part where I will discuss how people tend to get into this situation and the little things that you do that may impact your ability to get your old application reopened.
PART I - LEGAL talk
If you get denied on your application and you refile, you may be able to request your prior file be re-opened. However, for purposes of my discussion, I’m going to give you a hypothetical scenario so you can see how this work. In the course of the discussion, I will rely on references 20 CFR 404.988, 20 CFR 404.989, 20 CFR 416.1488, and 20 CFR 416.1489.
HYPO: Let’s say that you filed an application on JANUARY 1, 2006 and you got your initial denial on MAY 1, 2006. Here’s what may happen if you re-file again on the below listed dates:
1) RE-FILE DATE DECEMBER 31, 2006 (It should be able to re-open automatically)
The regulations provide that if you re-file a new application, for any reason within 12 months from the date of the notice of the initial determination, it can be re-opened automatically (either by requesting it or SSA may do it by themselves). So under the example I just provided you, since you filed a new application within the 12 month window from MAY 1, 2006, you can re-open your JANUARY 1, 2006 application.
2) RE-FILE DATE JUNE 1, 2009 (Depends on your type of case and it depends on your reason for asking)
Here’s the point where you need to know what kind of case you have. If you have a case under Title II (which is Disability Insurance Benefits), you can request a re-opening because your reapplication occurred within 4 years of the May 1, 2006 determination (4 years from your initial determination in this hypothetical). However, under Title XVI (Supplemental Security Income), you only have 2 years from that date to ask. Since you were denied on May 1, 2006, you had up until May 1, 2008 to file a new application and ask for the old one to be re-opened. Since you re-filed on June 1, 2009, you are not within the window. Now, remember what I said in point #1. Within 12 months of the initial determination, you can ask for it to be re-opened for any reason. Beyond that 12 months (but within the window, DIB within 4 years and for SSI within 2 years), you gotta have a good reason. And here is what they consider:
(1) New and material evidence is furnished;
New meaning something that relates to the period of time to explain WHY you didn’t re-apply right away and it must be relevant (MATERIAL) to your case.
(2) A clerical error in the computation or recomputation of benefits was made; or
(3) The evidence that was considered in making the determination or decision clearly shows on its face that an error was made.
3) RE-FILED because you found out and realized that someone was using your information and SSA applied their information to you.
You can RE-FILE and ask for a Reopening, for any time if,
(1) It was obtained by fraud or similar fault ;
(2) Another person files a claim on the same earnings record and allowance of the claim adversely affects your claim;
(3) A person previously determined to be dead, and on whose earnings record your entitlement is based, is later found to be alive;
(4) Your claim was denied because you did not prove that a person died, and the death is later established—
(i) By a presumption of death; or
(ii) By location or identification of his or her body
PART II BEAT Talk
Alright, now that we got the legal MUMBO jumbo part out of the way, let me get down to the DIRTY and tell you why it is sometimes difficult to get your old applications re-opened:
1) Your last application is so long ago that there is NO way they are going to re-open it.
The one thing I wanted to make clear is that there are timelines for requesting your old applications to be re-opened. I’m sorry if you applied in 1994 and you have been out of work the entire time. However, if you can’t show that there was some fraud involved or someone used your information or something else as referred to above, SSA is NOT going to go ALL the way back to 1994 if you reapplied beyond the SSI (2 year) and DIB (4 year) window.
2) You were in prison during the time between your current applications and your new one.
Now, in theory, if you’re within the period of time, you could request a re-opening. Let’s say under the hypo I provided, you were denied on May 1, 2006, you went to prison on May 30, 2006 and you didn’t get out until November 1, 2007. So you reapplied that day and you want to go back to May 1, 2006. Of course, you got a good reason. You were in prison. You way have a good reason but (under the regulations), they can’t pay you for any time you were in prison. Now, if you have DIB claim where you are indicating that you were disabled up to a year before the application, you may want to request the re-opening. However, if you have an SSI claim, you can only get paid from the date of the application so why would they re-open that old application?
3) “I didn’t know I could appeal”.
I have heard this one a MILLION times. Now, let’s get real. Unless you have a cognitive problem or you have a low IQ or you were under some type of extreme emotional or physical situation, you are probably NOT going to get ANY sympathy from Social Security for the “I didn’t know I could appeal” reason. Those decisions that SSA generate are SO detailed that they explain two or three times about your RIGHT to appeal.
4) “I was going through some things” (You better be specific, dammit, and it better be good and you better have proof).
Now, let’s be honest here. You are going to have some situations where you are in a devastating circumstance. Your loved one died. You went through traumatic divorce. Something of that nature. In some instances, SSA may be sympathetic. However, SSA is not dumb. They are going to want SOMETHING to demonstrate that you did go through what you went through to support your assertion.
5) You were working.
And this is another one I’ve seen. people, the FIRST step of the SSA process is “Are you performing a Substantial Gainful activity?”. In other words, are you working? Say (like under the HYPO), you applied on Jan. 1, 2006. You were denied on May 1, 2006. You went back to work. Now, it’s not that simple. If you only worked a few weeks or you tried a month here and a month there with no success, you might get some sympathy (depending on your reason for not working). However, if you went back to work on May 2, 2006 and worked until June 2008 and you earned $14000 a year but now you’re saying that you were struggling and so you can’t do it, you might get the hoochie lips from SSA. Why? Did i mention that you earned $14000 a year? and OH, SSA knows that you earned $14,000 so if you can’t explain how you worked under some special set of circumstances, you are probably not going to get that old application re-opened.
I I know that so many people find themselves reapplying for disability benefits so I wanted to make sure that I took the opportunity give some insight into how this situation works so you can understand why your old applications may or may not be affected.
Why does it take so long to get Disability benefits when I start over?
WOW! This question comes up a few times. Here’s how it usually plays out:
1) You have applied and you got denied. So you decided to reapply, OR
2) You went all the way to a Judge and got denied. So you decided to reapply, OR
3) You went all the way to an Appeals Council Decision and you got denied. So you decided to reapply, OR
4) You were receiving disability benefits and you were cut off. So you decided to reapply, OR
5) You got a closed period of disability benefits. So you decided to reapply!
In any event, most people ask the same question “Why does it take so DAMN long to get Disability when you reapply??” And trust me, DAMN, is usually thrown in there somewhere.
Unfortunately, the short answer is “Just because you went through the process once, doesn’t mean you get preferential treatment when you go through the system again.” In other words, every time you go through the system, a new set of hands and eyes will be evaluating your case. As such, your case is treated as if you are filing for the very first time.
Now, I know what you’re thinking. You’re thinking “What about those earlier applications?”, “Do they check those records?”, or “What about the fact that I was disabled before?”. All of those are good questions so let’s go through the scenarios I provided:
1) You have applied and you got denied. So you decided to reapply, OR
OOOOOO, please don’t do this. SO many times, people think that if they just keep reapplying, they will ‘hit it’. Ladies and Gentlemen, this is NOT LOTTO!!! You have to go through the system to get the best results. Now, I’m not saying that you shouldn’t reapply. I’m saying that you should be mindful of the fact that you are starting over every time you reapply. They will go and get the info from your previous application (depending on how soon you reapply) but you are still starting over.
2) You went all the way to a Judge and got denied. So you decided to reapply, OR
I’ve said it to people a million times that you don’t usually get your best opportunity unless you actually go through the process. The process usually means from initial application to a Judge. Now, for Social Security’s purposes, your disability period is the day after the judge’s decision. Why? In their eyes, the Judge has already determined that you are NOT disabled up to the date of his or her decision so even if you were found disabled, SSA is probably not going to back beyond that date (Sometimes they do but most times they don’t).
3) You went all the way to an Appeals Council Decision and you got denied. So you decided to reapply, OR
Sometimes, people want to wait until they go all the way through the administrative process. Most representatives will probably tell you that while your case is pending before the Appeals Council, you should start a new application. In any event, if you reapply, the earliest date of benefits would be the day after the judges decision.
4) You were receiving disability benefits and you were cut off. So you decided to reapply, OR
This situation comes up a lot. You’ve been receiving benefits for an extended period of time. Then, for whatever reason, SSA determines that you are no longer disabled or no longer entitled to benefits. So you decide to reapply. Now, in your mind, you’re thinking that since you were receiving benefits before, you should have a leg up. NOT SO FAST, my good friend (in the words of ESPN’s LEE CORSO). You don’t get preferential treatment just because you were receiving benefits before. Remember, a determination was made that you no longer need the benefits so you have to prove the you do.
5) You got a closed period of disability benefits. So you decided to reapply!
This one is tricky. A closed period is a clearly defined start and stop. You were determined to have been disabled from one point to another. Let’s say from Jan. 1, 2008 through Jan. 1, 2009. Now, you decide to reapply. The same rules apply. You’re treated as if you have started from scratch.
Please remember that you are not entitled to any special privileges or opportunities just because you started over. You still must go through the process as if you are starting from scratch.
No one is saying you’re crazy but it may help your Social Security case
Now, before you lose your mind and think that I am implying that you need to put that you’re CRAZY on your application for disability benefits, I AM NOT!!!!! LOL
When you apply for Disability benefits, it is important that you be honest and truthful about all of your medical conditions that affect that your ability to work.
In this situation, I’m talking to those people who are too proud to admit that they have other issues going on in their medical life that keep them from being able to work. In some instances, when people are applying for Social Security Disability benefits, they are applying based on one condition that they CLEARLY feel is the sole reason that is keeping them from working.
However, most people don’t realize that when Social Security Administration is evaluating whether you are disabled or not, they are looking at the combination of all of the person’s impairments and not just one. However, you have to be careful about a few things:
1) Mention impairments that impact your ability to work
Listen, when you apply for Social Security, don’t take the ‘kitchen sink’ approach. Don’t use this as the opportunity to talk about everything that bother you. The important thing is to focus on those conditions that effect your ability to work.
2) If you are depressed, don’t be ashamed to tell them
For some odd reason, people get embarrassed to admit that they have talked to a doctor about being depressed or that they are being treated for depression. More importantly, people have this fear that they may be viewed differently if people were to find out. Remember, if your depression or anxiety or other mental health problems affect your ability to work, Social Security needs to know about it. These things can actually help your case.
3) If you’ve gotten treatment, let them know
If you went to a therapist or a counselor or a psychiatrist, let Social Security know about it. If you are having additional problems that require you to get treatment, don’t be SHY. Let SSA know so they can determine if it impacts your case.
4) No one will know the reason you get disability except YOU!!
Your disability determination is NOT public record. Your family and friends can’t call the Social Security Administration and find why you’re on disability. That information is private to you and your case. Don’t let it frustrate you. It is private for a reason.
5) They will consider it if you say it.
Remember, SSA is going to investigate information that is provided to them about your case. Don’t HIDE information that may be helpful. Take a hard look at your conditions because it’s better to be upfront now than to make them try and figure out what’s wrong with you.
The important thing to remember is that Social Security has a big responsibility in evaluating all of your conditions as it relates to your ability to work. Don’t be shy about sharing the information because it can go along way to help your case.
Anthony Reeves
http://www.reevesfirm.com
Dedicated to representing the Disabled and the Discriminated
What happens after you file a claim for Social Security benefits and beyond!
Alright, so you get the word. You have an appointment with Social Security coming up. You got your papers. You got everything you need. You go to your appointment. Now what?:
1) Make sure you complete what they give you and send it back.
In some situations, Social Security is going to probably give some forms to sign. These forms are designed to assist Social Security in obtaining the records and information that they need for you. If you DON’T complete this information, Social Security can’t develop your case. If that happens, your case could be closed for lack of evidence or failure to comply.
2) Your case may be LEAVING SSA to DDS.
Depending on your state, once Social Security has your forms, your case may be referred to a state agency responsible for developing your case. This agency is called the Disability Determination Services.
3) What does it mean “DEVELOP my case”??
When you apply for Social Security Disability, you are indicating that you are DISABLED. In order to determine if you ARE disabled, they need to get your medical records. In essence, they have to develop your file to determine if you have medical records to support your disability.
4) There is no time line so stop being a pest.
Social Security recognizes that they have a lot of cases so they take every effort to aggressively push their cases forward. However, they don’t drag their feet because they are trying to keep you back. In most cases, Social Security and DDS are awaiting the evidence they need to make a determination. So the WAIT is what they are doing as well.
5) Get your point of contacts right (i.e. 3d parties)
Most people don’t realize that part of the delay in your case is due to lack of response from your 3d parties (you know, the people you listed that Social Security could talk to about your case). Make sure you inform your third parties that they may be getting a call from Social Security about YOU!
6) Get your doctors right (i.e. medical records)
Docs get request for records ALLLLLLL the time so please take the time to make sure you inform them that these request are on the way so they can make the effort to ensure the records are available. Here’s a little tip for you. Social Security works on a budget just like any other organization so they are not going to pay $200 to $400 and above for a huge file on you.
7) They have to consider everything so if you SAY it, they will consider it.
You have to think about what it is that keeps you from being able to work. The law regards the Social Security Administration to consider your combination of impairments. With that being said, be careful. If you mention something new every time they talk to you, Social Security is going to investigate it and THAT may take time.
YOU don’t run the show. THEY do!
Alot of times, CLAIMANTs will want to TELL SSA or DDS exactly what it is that is keeping them from working and what specifically they need to look at in terms of medical records. In other words, if you’ve been to 4 doctors but one of them says you’re disabled, you may tell SSA or DDS to ignore those other 3 because the one that says you’re disabled is the one they should focus. NOT! Social Security has to consider everything.
9) I got a DENIAL! Now what?
APPEAL! APPEAL! APPEAL! Most people don’t realize that you don’t get your best opportunity for results unless you appeal your case. Take it to the next step.
10) If I appeal, what happens?
Depending on the state, you either case will be re-reviewed (Reconsideration) or go before a Judge (Hearing). If it’s reconsidered, you will go through the whole process again so they can determine if they got it wrong. If it’s a hearing, it goes from the Local Office to the Hearing office for a hearing date.
The biggest thing that you need to know is that you need to be patient. The process is not short but be mindful that YOU may do things that may cause the process to go on longer.
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