Why is it So Hard to Get Awarded at the Reconsideration Level?

By: Disability Group

If you’ve already been denied at the initial application level most states require your case to pass through an appeal level, called reconsideration, before moving onto a hearing. The reconsideration is often a frustrating and disheartening process. Only 15% of cases are awarded at this level, and it usually takes 3-5 months to hear a decision. This method leaves many people wondering why this level is required, and why is it so hard to get awarded?

Reconsideration is literally what the name implies. Once the reconsideration appeal is filed, it is sent to Disability Determination Services and assigned to a different adjudicator than was used at the initial application level. This new adjudicator “reconsiders” the first decision to make sure it was correct. The process is generally similar to the initial application.

  • They send out requests for updated medical records to all the doctors and clinics provided on the appeal.
  • New ADL’s, or Activities of Daily Living, are completed which outline how the disability affects the individual.  
  • If the adjudicator believes there is insufficient evidence they will schedule another consultative exam.
  • Then all the collected evidence is reviewed, which includes medical records from the initial application level and the updated records.

You may be thinking, why is it harder to get awarded when there are more records provided at this level to prove my disability?

Many claimants do not have major medical changes within a period of a few months. There may be some changes in medication and a new doctor or two, but not enough new evidence to change the previous decision. The adjudicator is making sure the first decision was the correct one and that no mistakes were made. So if there are no major changes in a claimant’s condition, the case will usually be denied.

The reconsideration level is necessary because Social Security wants to catch any mistakes that may have been made before the case moves on to a hearing. To be awarded disability benefits, your conditions must last continually for at least 12 months. Some claimants who apply at the initial application phase have not been disabled for long and are unsure how long their conditions will last. Continuing to seek medical attention throughout the entire process is critical. By receiving treatment through this process, which last roughly 12 months, you will be able to prove your disabilities have been consistent by the time you reach the hearing phase. Although this process is lengthy and frustrating, it is important to not be discouraged. Most cases are awarded at the hearing and the only way to get there is to be patient throughout the appeal process.