Personal Injury Blog

Not Your First Time?

Posted By Shook & Stone || 1-Mar-2013

Many claimants file multiple applications for disability benefits when they are no longer able to work. However, for whatever reason, they do not follow up on the first application, or maybe even the second application. It is not until they fully understand the process that they realize that they can appeal the initial and reconsideration determinations and request a hearing with an administrative law judge. At that point, they may be on their third or fourth application, some with little to no time in between filing dates. Claimants are often wondering when, if ever, can those older claims be reopened.

This is an important question because the amount of retroactive benefits is determined based, not on the alleged onset date, but the filing date of the application. For instance, Social Security Disability Insurance (SSDI) payments will only be paid up to one (1) year prior to the date that the application was filed, while Supplemental Security Income ("SSI") is only payable as of the month that the application is filed. Therefore, whether or not a prior application can be reopened could mean that a claimant is entitled to a significant amount of retroactive payments that otherwise could not be paid on the current claim. However, not every old claim can be reopened.

Reopened for Any Reason

Prior claims for both SSDI and SSI claims can be reopened for any reason if a request is made to reopen the claim within twelve (12) months of the date of the notice of initial determination. 20 CFR §404.988(a) and §416.1488(a).

Reopened with Good Cause

If your request to reopen is not within the above time limit, then you must show good cause to reopen the prior application. With regard to SSDI, prior applications are permitted to be reopened with good cause if within four (4) years of the notice of initial determination. 20 CFR §404.988(b). For an SSI application to be reopened for good cause, the request to reopen must be filed within two (2) years of the date of the notice of initial determination. 20 CFR §416.1488(b).

Good cause for both SSDI and SSI cases includes any one of the following:

  • New and material evidence is furnished;
  • A clerical error in the computation or recomputation of benefits was made; or
  • The evidence that was considered in making the determination or decision clearly shows on its face that an error was made.

20 CFR §404.989 and §416.1989. Without showing one of the above, no finding of good cause will be found and the prior application will not be reopened.

Request to Reopen

There are several ways to request to reopen your prior claim. The easiest is by filing a new claim within the time period wherein it can be reopened for any reason (12 months). An SSDI claim alleging an onset date prior to the date of the initial denial on the prior claim is generally treated as an implicit request to reopen. If you are represented by counsel, the request should be made at the hearing or in any pre-hearing briefs submitted. If you believe that your case is ripe for reopening, you should contact your representative to alert them of this matter so that they can adequately prepare to argue this point at your hearing.

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