Every applicant has the right to appeal a denial of disability benefits by the Social Security Administration (SSA). However, you can also reapply for disability by filling out a new disability application instead of appealing the original decision, which would mean starting over at the initial determination stage. If you believe you are entitled to disability benefits, which road should you take?
In the vast majority of situations, you should appeal the decision rather than starting over by reapplying. The reason is simple: statistically, your chances of being granted disability are much better at certain levels of appeal than they are at the initial determination level. Only about one-third of disability applicants are approved for benefits in the SSA’s initial determination round. Because the rate of success after an ALJ hearing is so high, it makes sense to appeal to get a hearing.
If you appeal the SSA's initial determination, it is called a "reconsideration," because you are asking the SSA to reconsider their decision. Reconsideration is the first step in the appeals process. When you submit your request for reconsideration, you should also submit any new evidence you have that was not submitted with your original application. The SSA will look again at all of the evidence you submitted with your original application as well any new evidence you submitted with your request for reconsideration.
Even though the SSA claims examiner who reviews your request for reconsideration will not be the same examiner who was involved in your initial decision, most disability claims are again denied at the reconsideration level. Unless the original examiner who issued the initial determination did not follow the SSA’s regulations and rules, the chances are low that the initial determination will be overturned. Only about 10% of disability applicants who were denied disability in their initial determination are found eligible at the reconsideration level.
Even if your claim is denied at the first level of appeals, don’t give up! The next appeals level is where you have the greatest chance of being found eligible for disability benefits. This second level of appeal is a hearing in front of an administrative law judge (ALJ). If you have any new evidence, you should try to submit it with your request for a hearing. You may also present new evidence at the ALJ hearing. On average, ALJ hearings result in almost two-thirds of applicants being awarded benefits. (Approval rates for applicants who are represented by disability lawyers are even higher.)
It is very helpful to have a disability lawyer or nonlawyer representative who knows the ins and outs of the SSA appeals process. While you do not need to have a representative, it is a good idea to. Many communities have attorneys or other representatives you can work with through legal aid services who will help you to make sure you get the benefits you are eligible for.
Only if you have missed the deadline for appealing a decision and are not granted an extension would you want to reapply. But keep in mind that if nothing in your record has changed, your chances of being found eligible the second time around at the initial determination stage are small. The SSA will be looking at the same records, using the same guidelines, and it is unlikely you will be found eligible if you were not the first time. However, if your medical condition has worsened, you may be found eligible the second time around.