Can You Reopen a Disability Claim in California?

At Kenton Koszdin Law Office, we understand the challenges you may face regarding the complex and often consuming rules and regulations set by the Social Security Administration (SSA).

In this post, our experienced Social Security disability attorneys will explain the process of reopening disability claims, the circumstances under which a claim can be reopened, and the difference between appealing and reopening a denied SSDI claim.

Why You Might Consider Reopening a Prior Claim

Reopening a disability claim you made at an earlier time can be beneficial for several reasons.

For instance, if your initial claim was denied due to a lack of medical evidence or a clerical error, reopening it allows you to present new evidence that could potentially overturn the former denial.

Additionally, if your disability fell within the timeframe covered by your prior application, reopening the claim could lead to your receiving retroactive benefits.

How to Reopen a Disability Claim

Reopening SSDI claims involves submitting a request to the Social Security Administration or the Disability Determination Services (DDS).

This request should include any new material evidence that supports your claim — it could be a new medical report, a statement from a medical expert, or any other evidence that wasn’t included in your initial application.

When a Previous Social Security Disability Claim Can Be Reopened

Per federal regulation 20 CFR §404.988, the SSA stipulates that for someone to reopen a claim for SSDI benefits, the circumstances surrounding the older claim must have a direct connection to the new and current claim.

If the two disabilities are deemed unrelated or dissimilar, the SSA is bound by law and won’t entertain the prospect of revisiting a prior denied claim.

Furthermore, the onset date of the claimant’s disability in the second claim must fall within the timeframe originally covered by the first application for Social Security disability benefits. The possibility of reopening a claim hinges on how long it’s been since the initial claim was submitted.

Reopening a Claim Within 12 Months

Following an initial determination by either a claims examiner or administrative law judge, a prior SSDI or SSI claim can be reopened within 12 months of the date of that decision for any reason. However, once this 12-month period has passed, reopening a claim becomes more complex.

Reopening a Claim Between 12 Months and Four Years Later

You might have the opportunity to reopen an SSDI claim within four years, or an SSI claim within two years if the SSA determines that there’s “good cause” to revisit the old claim.

“Good cause” can be defined as having new evidence related to the claim, uncovering a clerical error in the calculation of benefits, or identifying an error in the written DDS decision that’s evident “on its face.”

Evidence is considered new and material if it was available at the time of the previous decision and would have altered the decision’s outcome but wasn’t taken into account.

For instance, if you were denied disability benefits because the agency believed your back pain wasn’t severe enough, but you can provide an MRI dated before the denial revealing extensive disc degeneration, the SSA will likely reconsider the previously denied claim.

Clerical errors are minor yet significant mistakes that can greatly impact your entitlement to disability benefits. For example, an erroneous application date or the accidental swapping of numbers in your established onset date can lead to a miscalculation of your retroactive benefits.

A decision is deemed to contain an error on its face when the error is glaringly obvious and unquestionably contributed to an incorrect decision. An example would be an unfavorable decision that references a medical report intended for a different claimant.

Reopening a Claim over Four Years Old

If you have a claim that’s more than four years old, getting it reopened can be challenging. Doing so will require new and compelling evidence that the initial denial was incorrect due to a clerical error or false statements.

Eligibility to Reopen a Claim

Reopening a disability claim denied by Disability Determination Services can only be done by a select group with the proper authority, including:

• An administrative law judge
• A DDS claims examiner
• The Disability Appeals Council

The decision depends solely on the evidence presented and who issued the prior denial. Reopening can occur through explicit requests (“express reopening“) during a disability hearing or implicitly (“implied reopening”) based on submitted evidence.

Appealing an SSDI Claim Denial and Reopening a Denied SSDI Claim: What’s the Difference?

Appealing a denied SSDI claim involves challenging the SSA’s decision in a disability hearing or federal court. By contrast, reopening a denied claim involves presenting new and material evidence to the SSA or DDS that prompts them to reconsider their initial decision.

Get Legal Assistance to Reopen a Claim

Reopening a disability claim in California is a viable possibility, especially if your first claim faced rejection. That said, attempting to go through the process, which is full of intricate rules and regulations, can be difficult without reliable legal advocacy.

This is where a skilled disability lawyer like those at Kenton Koszdin Law Office can be an indispensable ally.

Our attorneys can help you navigate the appeals process, collect vital new and material evidence, and effectively represent you in a disability hearing. Contact us to arrange a no-obligation consultation today and take the first step toward securing the disability benefits you rightfully deserve.