Being denied for Disability Insurance Benefits or Supplemental Security Income is not an unusual experience, as this blog has discussed before. As mentioned in the earlier post, you can appeal the denial and it is something we do here at Greeman Toomey on a daily basis. The Social Security Administration’s rules give you sixty (60) days to appeal a denial and meeting that deadline can mean the difference between eventually receiving benefits and being denied benefits for a very long time.
Appealing the SSA’s denial not only keeps your claim for benefits moving forward, it is an official way for you to state that you disagree with the SSA’s determination. If you do not appeal the denial within 60 days then you are not challenging the SSA’s determination, implicitly stating that you agree with it – even if you actually don’t! You do have the option of re-filing for benefits if you do not appeal in time, but there are consequences for not challenging the prior denial.
Determinations made by the SSA have a doctrine called “administrative res judicata” applied to them. This doctrine means that the SSA and its Administrative Law Judges will not usually reopen something that was already decided in the past and was not challenged within 60 days. For example, if the SSA determines that John Doe’s back injury does not prevent him from working as of June 1, 2010 and Mr. Doe never appeals, then Mr. Doe cannot claim that he was unable to work as of January 1, 2009 on a new claim – he can only claim that he was unable to work on June 2, 2010 or later because the SSA has not made a determination about his condition after June 1, 2010.
This limit in how far back in time you can allege a disability can reduce the amount of back pay available to you when re-filing a claim, but it can have a more significant affect on your ability to file for benefits. Claims for DIB require you to show that your conditions prevented you from working on or before your Date Last Insured. Using the same example, Mr. Doe would generally ineligible to re-file for DIB if his DLI was on March 31, 2010 because the June 1, 2010 determination was not appealed and now cannot be challenged because of the administrative res judicata doctrine, leaving Mr. Doe limited to only an SSI claim when re-filing.
Tracking and meeting these deadlines are part of the service firms like Greeman Toomey provide to clients. It is our job to explain how missing these deadlines can affect our client’s claims, to prevent our clients from missing the deadlines, and to help our new clients mitigate any problems created by determinations that weren’t appealed in the past.
