In the last two posts, we covered the key dates at the beginning of a disability claim: the onset date (AOD), the date last insured (DLI), the filing date, and the entitlement date. It’s important to keep these dates in mind at the beginning of the claim and at various other times in the claim. When I review a file, these dates and the date of birth are the first things I write down.
Now let’s get into the deadlines along the way. For the most part, these are going to be the same whether the claim is Title II/SSD or Title XVI/SSI.
The first deadline is to complete the application. You have 8 months from the date of initial contact to complete your application and still have the initial contact date count as the filing date. If you take longer than that to complete the application, the date resets and you may lose retroactive benefits.
Next we come to a series or relatively minor deadlines on paperwork. SSA will send you several questionnaires and each will say it must be returned within 10 days. This is really 14 days, because it’s business days, and it’s actually 19 days from the date of the letter since they allow a five day margin for “mailing.” If you don’t complete these questionnaires, they can deny your claim for failure to cooperate, but that denial is appealable, and the next level up will simply start over and give you a second chance to provide the information.
Next in the batch of “deadlines” will be an appointment date for a consultative examination. This is an appointment with a government-contracted doctor that you must attend to be evaluated for benefits. If you don’t attend this appointment, they can deny the claim for failure to cooperate, but again, you can appeal.
Once all your paperwork is in, you will eventually get a decision. This will be a short letter, just a few pages, that either says your claim is granted or denied. If you get a letter that says Notice of Disapproved Claim, you now have a deadline for filing your appeal. That deadline is 65 days (60 days plus a five day mailing margin) from the date on the letter. By that time, you have to submit your appeal online or on paper, or you will have to start over and file a new application.
The appeal of an initial determination is a Request for Reconsideration. More paperwork may be sent by the agency again, and again you will need to comply with those short deadlines on each batch of paper. Time is of the essence here, so don’t ignore the letters. If this appeal is denied, you will receive a denial labeled as “Notice of Reconsideration.” You again have 65 days to appeal this.
The appeal of a reconsideration denial is a Request for Hearing. This is also easily done online, but still has to be within 65 days of the date on the denial letter.
Once you’ve filed a hearing request, hang tight. Wait times vary, but the shortest I’ve seen is around six months, and it’s often been several years, varying by location. More deadlines are coming!
Eventually you will get a Hearing Notice, which the government is obligated to send by 75 days before the scheduled hearing. You now have a new deadline to gather and submit your evidence. That deadline is 5 business days (usually a calendar week, but sometimes more with holidays) before the hearing date. By that date, you are required to either submit or at least inform the government of the existence of all the evidence you have to present in your case. This one is kind of a big deal and missing it can be very detrimental to a case. Fortunately the rule is “submit or inform” so as long as you know what’s missing, you’ll be fine as long as your attorney prepares the letter on time.
So you have your hearing, and you wait for your Decision to come in the mail. If this is denied, you have guess how long to appeal it? 60 days again, yes! 65 counting the mailing buffer. So within 65 days of the date of the denial, you need to submit your Request for Review by the Appeals Council.
Most Appeals Council (“AC”) appeals are denied, unfortunately, so we’ve got one more deadline to consider: the deadline to file a lawsuit in Federal District Court. This is, believe it or not, also 60 days.
Once you’re in a Federal Court claim, a new series of deadlines will be announced as both sides get their turns to submit motions and answers and replies. This is fairly variable and determined by the court, so I’ll leave those details off from here.
If you’re denied again by Federal Court, we once again have 60 days to appeal from District Court to Court of Appeals. But if we’re denied there, and have to go to the Supreme Court? That’s a whole different world which I will for the moment stay silent on. It is a bridge seldom crossed.
For the most part, all of these deadlines are actually a bit flexible. Late appeals can still be accepted, but at the discretion of the agency being appealed to. You will usually be asked to provide “good cause” for the late filing. There are a number of potential situations that can constitute good cause, but it’s not really hard and fast. Some reasons worth citing would be if you didn’t receive the notice on time, if you were in the hospital or otherwise unable to respond at the time, if it was mailed to the wrong address, or if some kind of family emergency got in the way. Sometimes it’s even enough to have not understood until talking to a lawyer, but I wouldn’t count on that one.
If you are approaching any of these deadlines, give us a call and we can help make sure all your deadlines are met to get your claim approved.