SSA reinstating the reconsideration step to Alabama’s disability appeals process

September 5, 2019 – by Patrick D. Potter

Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) applicants will soon have to navigate an additional step before requesting a hearing with an Administrative Law Judge. SSA’s mandatory reconsideration step is coming back to Alabama.

Since 1959, the reconsideration step has been the first level of SSA’s disability appeal process. However, during the mid-1990’s, in an attempt to research ways to improve the appeals process, SSA cut out the reconsideration step in Alabama and nine other states. The nine other states include Alaska, California (only certain areas), Colorado, Louisiana, Michigan, Missouri, New Hampshire, New York, and Pennsylvania. Since that time if someone disagrees with a denial, or any detail of a decision for that matter, at the initial level, they can then request a hearing with a Social Security Administrative Law Judge (ALJ).

On October 1st of this year, the mandatory reconsideration step will be reinstated back into the appeals process for residents of Alabama and the other nine states who are pursuing benefits from SSA due to a disability.

This will apply to SSDI and/or SSI applicants who receive an initial determination on or after October 1, 2019. Those individuals will then have to request a reconsideration if they want to appeal their initial determination, instead of going directly to a hearing with an ALJ. If they are again denied or otherwise disagree with the decision at the reconsideration step, only then may they advance to the hearing level.

Why?

According to SSA Regional Commissioner, Rose Mary Buehler, this reinstatement will provide the following positive benefits:

• SSA will have a national, unified disability process that affords all claimants the same due process rights no matter where they live;
• Some disability claimants will receive a favorable determination more quickly; and
• SSA will be able to reduce the average wait times for a hearing, thereby achieving greater balance to the overall disability appeals process.

Will it work?

These are great reasons for reinstating the reconsideration step! The same disability process being in place across the nation is most definitely a fairer process. But personally, I am skeptical that THIS change will reduce the backlog of cases in Alabama at the hearing level. If it does at all the effect will barely be noticeable and come at a large cost to the majority of those applying for benefits.

According to SSA’s latest Annual Statistical Reports, the approval rate for SSDI and SSI applicants at the reconsideration level is 9.2% and 9.9% respectively. These extremely low percentages show that those who are denied at the initial stage are VERY unlikely to receive a different result at the reconsideration level. In my opinion, which believe it or not they didn’t ask for, the way claims are decided at the reconsideration step needs some major improvements. If there is only a 9 point something percent rate of approval there and yet a much higher percent rate at the hearing level, obviously the decision makers and/or process at the reconsideration level are a major obstruction to the program’s efficiency.

Now to the select few whose claims are approved at the reconsideration level, this will be a God sent. But for the rest of those with claims pending it will be just another obstacle they have to face before getting a hearing with a judge.

In the ten years I have been representing applicants before the Social Security Administration, I’ve seen first hand the hardships people pursuing benefits have to endure. The process is already a slow and lengthy one, during which a large number of applicants are unable to work even part-time. As a result, applicants face a period of time that they are bringing in very little to no income, which quickly deals a blow to their financial situation. The lack of consistent income results in diminished savings, cashed out personal retirement plans, and often times home forclosures. It’s a challenge for many just to keep the lights on. And a lot of people eventually end up relying on family and friends to make monthly payments, cover medical expenses, and provide groceries and other necessities for their household.

This financial burden only adds to the emotional and physical stress they are already experiencing due to their medical problems. I believe that this will cause some to abandon their claim for benefits. While some of those who give up on their claim may be able to find a job that they can perform, the question is: for how long? If they cannot endure the physical and/or mental demands and attendance requirements of the job, they will be right back where they were before. And legit applicants only file a disability application in the first place because they are no longer able to perform the full-time job they had in the past.

For the majority of those who apply and follow through with their claim to the hearing level, the likely result of this mandatory reconsideration step will be an additional 100 days of waiting. That’s the national average processing time of a claim at the reconsideration step according to SSA’s latest data. For most, that means another 100 days with no income and no medical insurance coverage. Another 100 days of worrying about the next utility payment, the next car payment, the next house payment, or next month’s rent. Another 100 days of stress, and another 100 days before they have any chance of the weight of their world being lifted off their shoulders.

So how long of a wait can you expect as a claimant?

That’s the million dollar question! But here are some averages. It will be approximately 3-5 months after you file your application before you receive an initial decision. If it’s a denial you can expect another 18-22 months from then before you are scheduled a court date (unless you’re among the lucky 9% at the reconsideration step). These averages are based on the current processing times I’m seeing at the local hearing offices. If SSA stays on track to meet their backlog reduction goals, the wait time for a hearing will be reduced.

SSA is currently taking other steps that are rapidly reducing its backlog at the hearing level. The hearing offices that have less backlog and shorter processing times are assisting other offices around the country by taking over cases and adjudicating claims by means of video hearings. But the economy and agency policies and procedures are constantly changing so only time will tell how long they can maintain any progress they make.

What can claimant’s do?

What advice do I have for those applying? DON’T GIVE UP! Find a representative who seems to care and doesn’t see you as just a number. After enduring such a long wait and the hardships that accompany it, the last thing you want is to end up siting in front of a judge with an attorney or other representative who doesn’t know YOU.