Yes! In some situations, a prior claim that is closed can be reopened. When a new client comes into our office, we always discuss whether or not they have ever filed for disability or SSI benefits in the past. If they have, we look to see if the prior claim(s) can be reopened. This is important because the SSA pays back benefits either to the date of the application for benefits or earlier, depending upon what type of claim it is. Therefore, if we can reopen an older claim, it could mean a significantly greater amount of money could be due to our clients.
What is a Closed Claim? When a person files an application for disability or SSI benefits and that claim is denied, they have 60 days to appeal the decision. The same rule applies on a second denial. If that appeal is not filed, the claim is closed. In some situations, a knowledgeable representative can locate and reopen that old claim and argue to obtain benefits back to that original filing date while pursuing a new claim for a client.
With that said, there are several rules that apply in determining whether or not a closed claim can be reopened. For example, the closed claim must be for the same disability as the new claim. You cannot file a claim for one disability and then later file for a different disability and try to reopen the old claim. In addition, the onset of your current disability must be within the timeframe covered in the first application. There are also timeframe rules for reopening. If a closed claim is less than a year old, it can be reopened for any reason. Once those first twelve months have passed, reopening a closed claim becomes more difficult. The rules for reopening closed disability (SSD) claims and SSI claims differ after a year. A closed disability claim can be reopened within four years if the SSA finds that there is good cause to do so. An SSI claim can only be reopened within two years for good cause. To determine whether or not there is good cause to reopen either type of claim, the SSA will consider several things. They will take into consideration new and/or material evidence about the claim. This evidence could include anything pertinent to the claim that was not considered by the SSA when making their prior decision. The evidence needs to be substantial enough that it would change the outcome of the previous decision. Good cause could also be a clerical error in a decision or a calculation error. If the decision contains a piece of evidence or information that is clearly incorrect, grounds to reopen may be present.
With all of that said, there are always exceptions to these rules. For example, in very rare situations, the SSA will reopen a claim that is more than four years old if fraud was involved.
Who Decides What Claims Can Be Reopened? A claim that was denied by DDS (Disability Determination Services within the SSA), can be reopened by an examiner within this unit, an administrative law judge or by the Appeals Council. A claim that was denied by an administrative law judge can only be reopened by an administrivia law judge or by the Appeals Council. So, some cases must wait until they reach the hearing level before a decision can be made concerning reopening a prior claim. Finally, a claim denied at the Appeals Council can only be reopened by the Appeals Council.
It is important to understand that if a request to reopen a claim at any level is denied, that decision is final. Therefore, it is imperative that you either know how to properly execute these procedures on your own or you consult with an accredited disability expert in doing so. The SSA has strict protocols at every step of the application and claims process, therefore it is extremely important to take the proper steps within the required timeframes. Our firm is only paid if we win your case, therefore you have nothing to lose in hiring an expert to handle the process for you. Our office is open, and we continue to serve all of Solano County, including Vacaville, Fairfield, Vallejo, etc., as well as, the Sacramento Area and Northern Bay Area. Give us a call today at 707-580-9220.