The Request for Reconsideration

Welcome to Season 1, Episode 11 of Winning Isn't Easy: Navigating Your Social Security Disability Claim. In this episode, we'll dive into the complicated topic of "The Request for Reconsideration."

Join host Nancy L. Cavey, an experienced disability attorney, and associate attorney Krysti Monaco, as they explore the process of filing a request for reconsideration. Unfortunately, the majority of disability applications are denied after the initial application. If you've received this disappointing news, you may be wondering if it's the end of your claim. The good news is that it’s not, and the next step is filing a request for reconsideration. Today, Nancy and Krysti will walk you through the form and share essential tips to make your request as impactful as possible. 

In this episode, we'll cover the following topics:

1 -  What Does the Social Security Administration Do with My Request for Reconsideration of My Social Security Disability Claim?

2 - What You Need to Know About Appealing the Denial of Your Initial Social Security Disability Application and Filing a Request for Reconsideration

3 - How to Prepare for the Next Steps After Filing a Request for Reconsideration

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Listen to Our Sister Podcast:

We have a sister podcast - Winning Isn't Easy: Long-Term Disability ERISA Claims. Give it a listen: https://wiedisabilitypodcast.buzzsprout.com


Resources Mentioned In This Episode:

LINK TO YOUR RIGHTS TO SOCIAL SECURITY DISABILITY: https://mailchi.mp/caveylaw/your-rights-to-social-security-disability-benefits

FREE CONSULT LINK: https://caveylaw.com/contact-us/


Need Help Today?:

Need help with your Social Security Disability claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.

Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.

Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

Transcript

Nancy Cavey [00:00:00]:
 Foreign welcome back to Winning Isn't Easy. Social Security Disability Benefits. This is a podcast where we break down everything you need to know about navigating the Social Security system. I'm your host, attorney Nancy Cavey, and today I'm joined with my associate Christine Monaco. Before we get started, I've got to give you a legal disclaimer. This podcast is not legal advice. The Florida Bar association says I have to tell you that. So now that I've said that, nothing will ever prevent us from giving you an easy to understand overview of the Social Security disability claims process, the games that are played during this process, and what you need to know to get the disability benefits you deserve.
 
 Nancy Cavey [00:00:56]:
 So off we go. Now, in our last episode, we talked about the work history report and how it plays a crucial role in your Social Security disability claim. Today we're going to dive into a new topic, the request for reconsideration. Now, if your application, initial application was denied, don't panic. This is your chance to appeal. And we're going to walk you through what happens after you submit that request, how the Social Security Administration reviews your claim, and what you can do to strengthen your case. So stick around and learn how to navigate this process effectively and improve your chances of approval. We will specifically be talking about, number one, what does the Social Security Administration do with your request for reconsideration of your Social Security disability claim? Number two, what you need to know about appealing to denial of your initial Social Security disability application and and filing that request for reconsideration.
 
 Nancy Cavey [00:01:55]:
 And three, how to prepare for the next steps after you file the request for reconsideration. So before we dive in, let's take a break for a moment and then we're going to dive into these topics. Come back with a pad and a pencil so you can take notes. Got it. We'll see you in a minute.
 
 Speaker B [00:02:15]:
 Are you considering filing for Social Security disability or has your claim been denied already? Either way, you require a copy of your rights to Social Security disability benefits, which will cover everything you need to know about the Social Security disability claims process. Request your free copy of the book@kvlaw.com today.
 
 Nancy Cavey [00:02:39]:
 Welcome back to Winning Isn't Easy. You ready to get started? So the first thing we're going to talk about is what does the Social Security Administration do with that request for reconsideration of your Social Security Security disability claim? Now, if your initial application is denied or you disagree with the start date of your benefits, you have just two choices. You can accept the denial and walk away from your Social Security disability claim. But if you disagree with the start date that Social Security has said your benefits should start or your claim has been denied, then you need to file what's called a request for reconsideration. And that's really crucial because this appeal has to be received by Social Security within 60 days of the date you receive notice of the disapproved claim. So, Christy, let's talk about what is a request for reconsideration.
 
 Christy Monaco [00:03:36]:
 Absolutely. So Request for reconsideration asks Social Security to do a complete review of your disability claim. The Social Security administration will reevaluate your entire claim, including material that was in your file at the time of the denial. This is your opportunity to provide updated medical records, any updated residual functional capacity forms completed by your medical providers. Let them know of any new diagnosis or any new treating physicians you may have had since your denial.
 
 Nancy Cavey [00:04:03]:
 So, Christy, you used the term residual functional capacity form. Can you explain to our audience what that is and why it's so important in a Social Security claim?
 
 Christy Monaco [00:04:14]:
 Absolutely. So a residual functional capacity form are forms that were created by lawyers for the Social Security disability process. A lot of times when you send a form to your physician or Social Security sends forms to your physicians, they're blanket forms that are being sent to physicians for every single medical condition. And they're the same. Residual functional capacity forms are tailored to your specific conditions so that the doctors can talk about what symptoms you have as a result of your specific conditions and how those conditions conditions impact your ability to do your work or any other work. So it's really tailored to exact specific symptoms of specific conditions.
 
 Nancy Cavey [00:04:52]:
 Right. So there are probably, I think, about 70 different RFC forms from arthritis to, you know, tarsal tunnel syndrome. And we think that it's really crucial that you have your doctor complete the applicable RFC form because medical records rarely speak to the question of your physical, cognitive, or psychiatric restrictions and limitations. So, Christy, let's talk about the local Social Security field office and your request for reconsideration. And I think this is important in view of what's going on. We are filming this podcast in late March of 2025 and things are changing practically daily. So Christy, give us the current update on the local field office in filing the request for reconsideration.
 
 Christy Monaco [00:05:45]:
 So a review for your request for reconsideration starts at your local Social Security field office for what's called a non medical determination. This local representative is responsible for verifying every non medical eligibility requirement, which could include determining your age as that impacts how many quarters of coverage. You must have to be insured for disability purposes Reviewing your employment status and wage records. As you know we've spoken before, you cannot Earn as of 2025, $1,620 per month in gross wages and still be eligible for disability benefits. They're going to be checking your marital status since if you are insured for Social Security disability purposes, you may be insured for Supplemental Security income, and that's going to depend on your asset limit and your spouse's income. Reviewing receipt of unemployment benefits which may make you ineligible for disability benefits, workers compensation benefits which are an offset if you meet the non medical requirements, then Social Security Field Office will send your request for reconsideration to Disability Determination Services for evaluation of your medical conditions.
 
 Nancy Cavey [00:06:54]:
 So let's talk about DDS and the request for reconsideration. The Social Security Administration has a nationwide contract rather with state agencies known as Disability Determinations Services. DDS and these agencies are charged with reviewing not only the initial application but the request for reconsideration using the five step sequential evaluation process that we have discussed. DDS is responsible for making the initial medical determination of whether you're blind or disabled using the five step sequential evaluation. Now, when you file a request for reconsideration, a different DDS claims examiner is assigned. So you're not going to have your claim reviewed by the same one who denied your initial application. So Christy, what does DDS do with that application?
 
 Christy Monaco [00:07:45]:
 So they take all the forms you filled out with all the answers to the many questions about the medical reasons for your disability claim, the names and contacts of your medical providers, and they reach out to your medical providers to gather your medical records, including test results laboratory work. However, some medical providers may not supply the records or the records may not be sufficient, and both of those situations can be problematic. If there are no medical records or if DDS determines the medical records are insufficient, they may schedule what's called a consultative medical examination. Unfortunately, consultative medical examinations are not always helpful because the physician may not be an expert in your medical condition, may not be provided accurate records, may not thoroughly review the records they're provided, and often performs only a brief examination. It is noted that Social Security does pay for the consultative examination. After completing its review, DDS will make a disability determination to either approve or deny your application, and in fact, over 90% of initial claims and requests for reconsideration claims are denied at DDS nationwide. If DDS finds you are entitled to benefits, then it goes back to the field office for further non Medical disability development. And if you're approved, in the end, you will receive a notice of award in the mail.
 
 Nancy Cavey [00:09:05]:
 So you made several important points that I want to expand on. In our practice, we do submit medical records that we get to dds, asking that they review them because we know that the records that they get are not necessarily complete. We also want to submit those residual functional capacity forms that we're getting to DDS so that they can understand why our clients meet the five step sequential evaluation. And I think we have a better track record in getting benefits awarded at the initial application stage and the request for reconsideration because of our strategy. So, Christy, what happens if DDS denies the claim? What's the next step?
 
 Christy Monaco [00:09:52]:
 Well, if the claim is denied, you're going to receive a notice of disapproved claims, same as you did when your initial application was denied. When you get this notice, you want to read it very closely, paying particular attention to the last page that's going to outline particularly what Social Security used to make their decision, what they relied upon, and also the date, because remember, you only have 60 days to file an appeal.
 
 Nancy Cavey [00:10:16]:
 Yeah. So what's important is you can see on that last page several important things. One is, as Christy said, the medical records that they have used to review and deny your claim. And many times our clients are obviously upset that Social Security doesn't have the complete record record or ignored what was in the record. And then additionally, as Christy has pointed out, what's really important is the date of the denial because you've got 60 days in which to file that request for reconsideration or a request for hearing. And if you don't timely file, you get to start all over again and get back in that long line. And here in Florida, it's taking over a year from the time we file the initial application to get a claims examiner assigned assigned to look at the claim. So we want to, if your claim is denied timely, file that request, that appeal, request for reconsideration or request for a hearing as appropriate so that we don't have to get back in line.
 
 Nancy Cavey [00:11:20]:
 Got it. So let's take a quick break, and then we're going to be coming back and talking about what you need to know about appealing that denial of the initial Social Security application and how to file that request for reconsideration. Got it. We'll see you in a minute. Welcome back to Winning Isn't Easy. Now we're going to be talking about what you need to know about filing the appeal of the denial of your initial Social Security application and filing a request for reconsideration. So, Christy, tell everybody what it is they need to know.
 
 Christy Monaco [00:12:05]:
 Absolutely. So making the decision to stop working and applying for Social Security disability benefits is difficult one. And you did not make that decision lightly. Well, receiving that denial letter from Social Security can be just as difficult. However, it is important not to give up, because like I said earlier, over two thirds of initial applications are denied. Like we also said in the beginning of this podcast episode, you have two choices. You can give up or you can file an appeal by submitting a request for hearing within 60 days of receiving that denial letter.
 
 Nancy Cavey [00:12:36]:
 So if your initial application has been denied, you're going to be filing a request for reconsideration. And if the request for reconsideration is denied, you'll be filing a request for hearing. And in both situations, you've got 60 days to file the appropriate appeal, and that's 60 days from the date you receive the denial letter. So don't fool around, Christy. Let's talk more about requests for reconsideration and explain to our audience what it is.
 
 Christy Monaco [00:13:06]:
 So this is your opportunity to tell Social Security in detail what has changed since the initial application. As Nancy said earlier, these claims are taking a year to have somebody be assigned to them. That means sitting on someone's desk for a year before they even review it. A lot can change in a year. So you want to make sure before you submit any new documentation, you read your denial letter, you pay particular attention to the last page so that you can figure out what stage you were denied at. If you have a representative, we can help you figure that out. You want to make sure that you gather all of your documents, your new physicians, their contact information, any new diagnoses, any new medical records or medication that you're taking that may cause side effects contributing to your inability to work. This is your opportunity to submit all of that new updated information to try to change the mind of this new examiner who is going to be reviewing your claim.
 
 Nancy Cavey [00:14:02]:
 Now, obviously, the test is going to be whether you generally at step three, meet a listing and most people don't, and at step four, whether you can go back to the lightest job you held in the five years before this claim was adjudicated, and at step five, whether you can do other work in the mythical, hypothetical, not real world national economy. In view of your age, education, skills, and whatever those restrictions and limitations are, it's really important over time that you are giving a really good interval history to your doctor about Your symptoms and your functionality. Because at least in the course of our practice, we're asking doctors to do updated residual functional capacity forms, and we're submitting, getting that as the appeal process progresses. So it's really important that you are doing a really good medical history to your doctor. But, Christy, there's other supplemental information that may have to be submitted to Social Security, so can you talk about that, please?
 
 Christy Monaco [00:15:03]:
 Absolutely. So this is really important. Social Security is going to be sending you forms to fill out once your request for reconsideration is filed. Forms like the function report, the work history report, potentially a pain questionnaire, a headache questionnaire, and these may be forms that you filled out during your initial application process. Please fill them out again. I know it's redundant. I know it takes time, but it's important. If you don't fill it out, they could just deny the claim for a lack of information, and that's not something you want.
 
 Christy Monaco [00:15:33]:
 After waiting in line for all of these months, completing the work history form, the function report completely and accurately can be a big game changer in your claim, as those forms are actually used when their claim is being adjudicated.
 
 Nancy Cavey [00:15:47]:
 Now, I think that it's also important to understand that Social Security is looking also for consistency. A lot of our clients are tempted to rush through these forms that Christy just talked about because it's like, I want to get my homework done before the dog eats it. Okay? That's not the way to go about this. We need to be very precise and accurate about the information that we're giving Social Security. Why? Because consistency is key. Social Security and ultimately, if we are in front of a judge, is going to be looking at several things, one of which is going to be that medical history. They're going to be looking for consistency in the nature of your symptoms and your functionality. Then they're going to compare that against what you put on these forms or other people put on forms.
 
 Nancy Cavey [00:16:38]:
 Now, we don't want to exaggerate. We want to be truthful. Because at some point, the judge may scratch their head and say, well, you know, what they're saying they can't do is not consistent with what's being reported in the medical history. So what other suggestions do you have, Kristi?
 
 Christy Monaco [00:16:55]:
 Sure. Another key to winning your case is obtaining completed residual functional capacity forms or updated residual functional capacity forms. One of the best things that we can have in a case is a doctor who fills out a residual functional capacity form at the initial application stage, and then that same doctor being willing to fill out Another one a year later, two years later, at the request for hearing or the request for reconsideration stage. That is fantastic. That residual functional capacity form compared to the old one is going to be able to show progression, worsening new symptoms, different symptoms, worsening symptoms. And that is going to hopefully correlate with the medical records, which is going to give the judge a better picture of the longevity of the symptoms that you're experiencing.
 
 Nancy Cavey [00:17:39]:
 Now, we use multiple residual functional capacity forms. So if the doctor is willing to fill one out, that's great. But if you got multiple medical conditions, we want doctors who are specializing in each one of those medical problems to complete residual functional capacity forms. Now, Social Security isn't going to tell you or your doctor about these RFC forms, and that's one of the reasons why you do want to be represented. So your lawyer or representative can take a look at your medical records, talk to you about your medical conditions, and pick the right residual functional capacity forms that should be completed and submitted to Social Security. Christy, let's talk about delay, which is inevitable, but is getting worse in the current situation.
 
 Christy Monaco [00:18:25]:
 Yes, delay is no stranger in the Social Security disability world. So they are experiencing delays and reviews for requests for reconsideration, lack of staff, lack of funding, and it may take as long as 9 months to 12 months to get an analyst assigned to your claim. Which means that's the point in time where they're at least starting to request medical records. That's why at our office we request them right away. We file the request for hearing or the appeal, and we request records right away so we can get them to dds so that in a year when it's assigned to somebody, they have everything handed to them on a silver platter. During that time, you need to be updating either Social Security or your attorney on any new physicians. You know, we're not mind readers, so if you get a referral to a neurologist, we need to know about it. Physical therapy, any, any new type of physician or medication or diagnosis that you receive, we need to know about it.
 
 Christy Monaco [00:19:17]:
 Social Security needs to know about it so that that can be properly analyzed.
 
 Nancy Cavey [00:19:21]:
 And you need to understand that once we find out that information from you and we request that, sometimes it takes weeks and months with lots of follow up phone calls, for example, from our office to try to get those records. So we're only as good as you are. So you need to keep us or your representative advised as to what's going on medically. And certainly if you're not represented, let Social Security know and cross your fingers and hope they get the records. All right. Anything else to add before we take a break, Christy?
 
 Christy Monaco [00:19:52]:
 Nope, I think just making sure that you document your symptoms with your physician, get some RFC forms and make sure Social Security is updated. I think they're great.
 
 Nancy Cavey [00:20:00]:
 Great. So before we take a break, I want to let you know that what we're going to be talking about next is how to be preparing for the next step after filing the request. Reconsideration and how being proactive is really key. Got it. Let's take a break.
 
 Speaker B [00:20:17]:
 Struggling with your Social Security disability case. The right attorney can make all the difference. Get our booklet the key to hiring a great attorney for your Social Security disability case. Discover how to find an experienced attorney who will fight for your rights and navigate the process with ease. Don't leave your future to chance. Request your free copy@kvlaw.com today and ensure you have the expert support you deserve.
 
 Nancy Cavey [00:20:56]:
 Welcome back to Winning isn't easy. Let's talk about how to prepare for the next steps after filing a request for reconsideration. Now, just because you've submitted a request for reconsideration doesn't mean that everything's going to have a happy ending. You really have to stay proactive in your case and we're going to give you some keys that we think can make a difference in getting your benefits. Number one is monitoring your mail. So you need to be on the lookout for correspondence from SSA or DDS regarding additional requests for information or them scheduling you for a medical examination. Number two, continued medical treatment. You can just destroy your claim by stopping getting medical treatment.
 
 Nancy Cavey [00:21:42]:
 Now, I know you may have difficulty affording treatment, but that is not always an acceptable excuse for Social Security. There are lots of free or low cost medical providers that are in the area and judges and Social Security know about them. So they are going to expect that you are attempting to get medical treatment and that you're following prescribed treatment and that you're documenting the progression of your problems with any worsening conditions. So, Christy, talk about new information that Social Security wants to know about.
 
 Christy Monaco [00:22:18]:
 So before I move on to that, I just want to expound a little bit about what you just said about continuing medical treatment. One of the things that I hear almost every day is there's nothing that these doctors can do for me. They tell me, you know, there's nothing they can do. My disease is not curable and they don't want to see me anymore. I explained to our clients that is a problem in the Eyes of Social Security. So what I explained to them is when you go to a physician, you're talking to them about your symptoms, right? You're talking to them about the impact your symptoms are having on your functionality. And that is how Social Security is going to determine whether or not you can do past relevant work or any other work that exists in the national economy. So if your doctor says there's nothing more I can do for you, you need to explain to your doctor that you would like to continue treatment so that you can continue to go to tell your doctor about the symptoms that you're continuing to experience.
 
 Christy Monaco [00:23:12]:
 Because without medical records, the judge is going to be looking at Nancy. And I like, what am I supposed to look at? And so it's important that you explain that to your physician that you're still having the ongoing symptoms and that you want to make sure that you're explaining it to them, that it's being documented so that you have that consistent medical treatment for when and if this makes it to a hearing. So new information with Social Security, like I said, they're not mind readers, and neither are we. So if your medical condition changes, if you get new referrals for new physicians, you need to make sure that you're providing that information to both Social Security and your representative. You may want to consider legal representation. Another one of the questions I get every day is, does having an attorney speed my claim up? Well, I'm going to tell you right now it does not. Having a disability attorney represent you in this process does not make it go faster. However, what it does is it allows that year that your claim is sitting on someone's desk at Social Security.
 
 Christy Monaco [00:24:12]:
 It allows us time to prepare your case. We're gathering medical records. We're getting residual functional capacity forms. We're reviewing the forms and answering any questions you have about the forms that you fill out so that by the time that Betty at DDS picks up your file, Betty has a complete file. She has all of your medical records. She has all of your forms completed. And we know that they don't need anything on your file. And the individuals who don't have representation, well, when Betty gets their file, she's just now requesting records.
 
 Christy Monaco [00:24:42]:
 So, no, it doesn't speed it up, but it does make sure that Social Security has a full and accurate history of what's going on.
 
 Nancy Cavey [00:24:49]:
 So I would differ a little bit with that comment in that certainly it's not going to speed up the wait for the claims examiner to be assigned, but when the claims examiner is assigned it speeds things up because as Christy has pointed out, we've already supplied the medical records and the RFC forms, so they're now not now going out to try to get those records and maybe, you know, do a ce. So you need to understand that preparation is key because when that claims examiner picks up the claim, we want everything there and we want to give it to them on a silver platter and make it very, very easy for them to say, oh yes, they meet the five step sequential evaluation and we're going to pay those benefits. So we think having an experienced Social Security disability attorney who can help navigate the reconsideration process will really improve your chances of approval. Being prepared can make a significant difference in the outcome of your appeal. So stay informed, follow up diligently, and don't hesitate to seek professional guidance. Many times we're asked, well, how do we get paid? We don't get paid unless we win the case. That's called a contingency fee. And under the Social Security rules and regulations, there's a statutory fee.
 
 Nancy Cavey [00:26:11]:
 It's 25% of the back pay benefits that may be due, capped at $9,200 plus a cola. And that cola will increase every year. So it comes out of the back benefits and it's a one time fee. With a capped arrangement, it's less than a contingency fee in a workers comp case or a personal injury case. So you need to understand that the value we provide is significant in terms of helping you get the disability benefits you deserve and at a fraction of a cost if you were in a personal injury law claim. Got it. Okay. So you can see that filing a request reconsideration can be overwhelming.
 
 Nancy Cavey [00:26:55]:
 Understanding the process and submitting strong supporting documentation really will improve your chances of success. Persistence is the key. One of my heroes is Churchill who said, you know, we're never going to give up. We're never going to give up. We're never going to give up. And we'll fight at the. At the shores, if you will, and we'll fight in the fields, we'll fight in the cities. That's not a very good summary of the quote, but you get the point that giving up really is not an option if you want to get those benefits.
 
 Nancy Cavey [00:27:29]:
 So if you have any questions or want some personalized guidance, reach out to our office. If you found this episode helpful, please share it and subscribe to this podcast for more expert tips on navigating the Social Security disability claims process. Thanks for listening and we'll see you next time. Where we're going to discuss more forms. The disability adult report, appeals. Got it.
 
 Christy Monaco [00:27:51]:
 Thanks.