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).
If you have previously filed a claim for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), and you now find yourself in need of those benefits again, it is important to know that your prior claim may be reopened. This can be done if a request is made within twelve months of the date of the notice of initial determination.
The Social Security Administration ( SSA) may also reopen a prior claim if it is proven that a mistake was made in the determination of your previous claim.
Although reopening a prior claim can be beneficial, it is important to understand that not every old claim can be reopened. Understanding the process and seeking professional assistance from an experienced disability attorney can help you determine whether or not you are eligible for reopening your earlier claim.
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.
- a disability or illness that prevents the person from working, being at least 65 years old, or having a terminal condition.
In order for a prior application to be reopened, it is necessary to show proof of good cause, as outlined in 20 CFR 404.989 and 416.1989.
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.
Why Would You Reopen an SSD Case?
Reopening an SSD case can be beneficial for a number of reasons. Firstly, if there is new and material evidence that has been found since the initial denial of your claim, it may be possible to reopen the prior application in order to receive retroactive benefits. Secondly, reopening an SSD case may allow you to receive additional medical treatment or services that were not available when the initial claim was denied. Lastly, it may be possible to reopen a prior claim in order to receive an increase in benefits.
It is important to note that the decision to reopen or deny a prior application is at the discretion of the Social Security Administration and will depend on individual circumstances. Therefore, it is important to consult with an experienced disability attorney before requesting that your prior case be reopened.
Appealing a Denial
If your request to reopen is denied, there are still options available to you. You may be able to file an appeal if you believe the denial was based on a mistake of law or facts, or if new and material evidence has been located since the denial of your prior claim.
An appeal must be filed within sixty (60) days from the date of the notice of denial. A hearing before an administrative law judge (ALJ) will be held if your appeal is granted. During this hearing, you can present new evidence and make arguments as to why your prior claim should be reopened.
If you are successful in appealing a denial, it may be possible to receive retroactive benefits beginning from the date of your initial application or the date of your hearing.
Don’t miss your chance to reopen your case.
If you’ve come to us for help in reopening your case, we understand that you may have been through this process before and are looking for a different outcome this time. We want to assure you that we are prepared to provide the best legal representation so that your case is heard with fresh eyes and a new perspective.
We will use our experience and knowledge of the law to make sure that your case is presented in the best possible light, and that all relevant evidence is taken into account. Our ultimate goal is to secure the outcome you deserve. Contact us now to learn more about how we can help you.
References:
Code of Federal Regulations § 404.988. (n.d.). Code of Federal Regulations &Sect; 404.988. https://www.ssa.gov/OP_Home/cfr20/404/404-0988.htm
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