Applying for SSI – Part 4: Request for Reconsideration

It’s been months since I last blogged about applying for SSI. Not the most gripping subject matter, but if the young person is unlikely to be able to support himself or herself due to mental health challenges, it is really, really important subject matter. So from here on I’ll try not to drag this topic out quite so much, especially because there are other financial topics to address once we’ve gotten through this.

Request for reconsideration is what you do if your initial SSI application is denied. You may recall from previous posts that people who are young are more likely to be denied benefits, as are people with mental (as opposed to physical) challenges. Since we are talking about young people with mental health challenges, being denied is a very good possibility.

You have 60 days after receiving word of the application’s denial to file for reconsideration. During reconsideration, a different claims examiner reviews your initial application, plus any new supporting evidence you or other people can provide.

I like how the following link explains the realities of this phase of the application process: appealing an SSI benefits denial.

You’ll need to know what the Social Security Administration wants you to do to request reconsideration, so here’s the link for that: http://www.ssa.gov/online/ssa-561.html. This information will also be in the letter you receive from SSA.

As you can see, there are a few more lovely forms to fill out. Mainly, the forms ask you to state why you disagree with the decision, and they want updates to the claimant’s condition since the initial application: doctor’s visits, hospitalizations, new medications, etc. You of course would want to document things that indicate the claimant has gotten worse or at least has not improved.

In Nathan’s case, I was tweaked because the initial application was denied before SSA had heard from his current psychiatrist (whom we’ll call “Dr. W”). Before submitting the request for reconsideration forms, I called SSA and pointed this out. The person I spoke to said I could state on the reconsideration forms that I didn’t want a decision to be made without the input of Dr. W. All right, so this time we’d have a better shot at being approved, right?

I’ll bet you saw this coming: a little over two months after filing the reconsideration paperwork, we received a letter from SSA saying that the first decision was correct, and Nathan still was not eligible for SSI. The letter listed supporting evidence they had received in the interim. Was Dr. W on that list? No he was not. My statement about needing Dr. W’s input had been ignored, or it was trumped by SSA’s determination to move things along. I hadn’t been informed of the timeline for making the reconsideration decision, nor was I informed that Dr. W still hadn’t supplied any input. I probably should have called SSA to find out after about a month had passed.

But it didn’t really matter too much, since very few requests for reconsideration end up with a reversal of the initial decision. It was time to advance to the next step: I had 60 days to request a hearing before an Administrative Law Judge. What happened with that hearing will be the subject for one or more future blog posts.

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About janet565

I've lived in the Inland Empire of Southern California since 1982. Born and raised in New Jersey, I've also lived in upstate New York and in Oregon. My profession involves maps and geography, which is usually very interesting. My hobbies are pretty boring - none of them involve tigers (or ligers) or jumping out of aircraft - so they do not bear mention here. I hope you find the blog useful, and wish you well....

4 responses to “Applying for SSI – Part 4: Request for Reconsideration”

  1. Anahi Ortiz M.D. says :

    Hi Janet,
    I actually work for SSA now and can give you some further insight and advice. Claims for ADHD, autism, any mood disorders, etc are solely the purview of the psychologist reviewer to look at. If your child or family member has any medical problem add it in e.g. asthma, orthopedic problems, sensory issues requiring OT or PT. This way you also have a physician look over the claim.
    Read over the criteria for the impairment you are claiming for and you can get an idea if you will be granted or not. Many of the psych claims as we call them are extremely difficult to get granted on. If you are denied due to missing records or as we call it insufficient evidence, file for reconsideration and find out what records were not received. I can tell you that the people at SSA really do try to get records. They send out faxed requests, mailed requests, phone the sources. I would advise a phone call by you in two to three weeks asking for an update. If they say certain records are missing, I would advise that you call the physician with the records and firmly request they are sent. You have no idea how many times physicians or clinics just do not send in necessary records!
    Many times if we can’t get the records, the claimant or parent can with enough pushing.
    Good luck and I hope this time around you are successful!

    Like

    • janet565 says :

      Thanks for your comment. This is great insider info! The key I think is knowing to make a follow-up phone call 2 to 3 weeks after filing, and not to hold back on bugging the health professional(s) who haven’t responded.
      In earlier SSI-related posts I discussed the criteria the SSA use in making decisions on psych claims. That is also REALLY important info for anyone applying for benefits due to mental health challenges.

      Like

  2. rr407r says :

    Great article. Thanks for the info, you made it easy to understand. BTW, if anyone needs to fill out a request for reconsideration, I found a blank form here http://goo.gl/qeA7OH.

    Like

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