My claim for Social Security disability benefits was previously denied but my situation has changed – can I file a new claim?
Author: Attorney Lonnie Roach
If your claim for Social Security Disability benefits was previously denied but your medical condition has worsened or your financial status has changed, you may now be eligible for disability benefits even though you were previously denied.
Financial circumstances fluctuate and illnesses may progress.
Whether to appeal a decision or refile (or “reopen”) a claim depends on why the claim was denied, the stage in the application process when the claim was denied, and if there have been any significant changes in the applicant’s case and condition since the original application was submitted. Some applicants have disabilities which do not last at least 12 months or they do not meet the medical criteria of a disability as listed in Social Security’s Blue Book. Other applicants are denied because they don’t meet Social Security’s income requirements or they don’t have enough work credits. If you still do not meet these eligibility requirements, you will not be approved the second time around either.
Knowing if and when to refile can be confusing, but even if you were originally denied for medical reasons, you may qualify for Social Security Disability benefits in the future.
If your condition has worsened, and you have been unable to return to your job for at least one year or more, you can refile at any time. Or, you may get approved through an RFC (Residual Functioning Capacity) analysis.
If you have been denied disability don’t give up! Contact a Disability lawyer at 512-454-4000 for a free consultation and get the benefits you deserve.
There are good reasons to appeal a decision instead of filing a new claim.
An applicant’s protected filing date is based on the date the applicant first informed Social Security that they intended to file for Social Security Disability Income. This date is used to determine when a person can begin receiving disability benefits and to calculate the amount of back pay that is due to the claimant. When a claim is eventually approved, the applicant is paid all the money they would have received if benefits began on the protected filing date. If a new claim is filed, the process starts all over, changing the protected filing date and moving it forward. The new date would be used to determine the amount of back pay a claimant is due and an applicant could lose thousands of dollars.
If you have new medical information to support your case, it is not necessary to start a new claim.
The appeals process allows an applicant to gather additional evidence to present to Social Security. When an applicant receives a notice of denial, the letter will state a deadline for filing an appeal, usually 60 days from the date the notice of denial is received. If an applicant misses that deadline, they will be unable to appeal the case.
If you met the medical requirements when you initially applied for SSDI, but not the non-medical requirements, for example, your income was too high or you didn’t have enough work credits, you may consider refiling your claim if your financial situation has changed.
However, if your application was denied for lack of work credits, even if you have accumulated more work credits in the interim, approval will depend on the length of time since your initial application was filed.
A claim can be refiled or reopened if an appeal deadline has been missed, the applicant didn’t request reconsideration or request a hearing, or a final determination denying the claim was reached by an administrative law judge or Disability Determination Services (DDS).
Under these circumstances, it is in an applicant’s best interest to reopen their disability claim since the protected date of onset will remain unchanged and, if approved, their back pay will be greater. The second application must be related to the initial claim; for example, a claim for a herniated disk must be related to a previous claim for back problems. Social Security will not reopen a claim that is not related to the current claim. Also, the onset date of disability in the second claim must be within 17 months of the initial application.
A claim for SSDI where a final determination was reached by DDS or an administrative law judge can be reopened within 12 months of the decision for any reason; after one year, it is more difficult to reopen a claim.
Opening a claim that is two to four years old is difficult, but Social Security may reopen a claim that is up to four years old if there is good cause.
Good cause may be explained as:
- Having new and material evidence regarding the claim; i.e. information the prior decision maker did not consider that would have changed the decision.
- A clerical error in the manner benefits were calculated.
- The decision showed an “error on its face;” for example, a medical report was cited in the decision that did not belong to the claimant.
If a claim is more than four years old, Social Security will only reopen the case for unusual reasons, such as someone knowingly made false statements or withheld important information.
A claim can be reopened by Disability Determination Services, an administrative law judge, or the Disability Appeals Council.
A claim that was denied by an administrative law judge can only be reopened by an administrative law judge or the Appeals Council. Denial of a request to reopen a claim cannot be appealed.
If your claim for disability benefits has been denied, you should consult a qualified disability attorney.
An experienced lawyer can review your options and counsel you on options for appealing or reopening your case. If you decide to reopen your claim, an attorney can make sure your application is relevant to your initial claim and can submit a request for reopening the claim for you. An attorney can also argue why new evidence should be considered and point out mistakes in the initial determination. The attorneys at Bemis, Roach & Reed are ready to assist you in submitting your claims for Social Security Disability benefits.
Disability benefits are an important source of income for those who are unable to work. If you are not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.
Author: Attorney Lonnie Roach has been practicing law for over 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion rated by Martindale Hubbell. Through his extensive litigation Mr. Roach obtained board certifications from the Texas Board of Legal Specialization. Lonnie is admitted to practice in the United States District Court - all Texas Districts and the U.S. Court of Appeals, Fifth Circuit. Highly experienced in Long Term Disability denials and appeals governed by the “ERISA” Mr. Roach is a member of the Texas Trial Lawyers Association, Austin Bar Association, and is a past the director of the Capital Area Trial Lawyers Association (Director 1999-2005) Mr. Roach and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.
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