If your initial application for Social Security Disability benefits is denied, the Social Security Administration (SSA) provides a claimant sixty days to file an appeal. In filing the appeal, a claimant can either request a reconsideration of their claim or to request a hearing before an Administrative Law Judge (ALJ). If a claimant misses the sixty day deadline, they may have their claim dismissed and be forced to file another application for benefits and restart the entire process. Fortunately for some, the SSA has issued a policy ruling setting out certain exceptions to the sixty day deadline rule.
Social Security Ruling 91-5P
According to Social Security Ruling 91-5P, the deadline to appeal can be extended if “good cause” exists. The SSA has stated the purpose of the ruling is to clarify their policy on establishing the “good cause” requirement for missing the deadline to request review, and specifically to avoid improper administrative finality when the claimant is able to prove that they missed the deadline because they lacked the mental capacity to understand the procedures for requesting review. This exception enables claimants to avoid automatic dismissal of their appeal if they miss the deadline. It is also meant to ensure that the court will recognize and give proper attention to a claimant who presents evidence that because of a mental disability, they were unable to appreciate the implications of the sixty day deadline to file their appeal. The SSA requires that a claimant’s request for an extension of time must be in writing and must give the reasons why the request for review was not filed timely.
Factors to Consider
Under normal circumstances, the following factors are considered in determining whether the claimant has shown good cause for missing the deadline
- What circumstances prevented the claimant from making the request on time
- Whether any action on part of the SSA misled the claimant
- Whether the claimant did not understand the requirements as a result of amendments, other legislation, or court decisions.
However, when a claimant presents evidence that missing the deadline was due to mental incapacity, and that the claimant did not have a third party legally responsible for prosecuting the claim, the claimant establishes “good cause” when the evidence shows that he or she lacked the mental capacity to understand the procedures for requesting review. The following factors are used to determine whether a claimant lacked the mental capacity to understand the procedures for requesting review:
- The claimant’s inability to read or write
- Lack of facility with the English language
- Limited education
- Any mental or physical condition which limits the claimant’s ability to do things for him/herself.
The final decision as to whether mental incapacity is established must be based on all of the relevant facts in each case. Any reasonable doubt is decided in favor of the claimant. If the adjudicator finds good cause exists, the time for requesting review is extended and the claimant is allowed to take the action which would have been appropriate had they filed a timely request for review. If the adjudicator does not find that good cause exists, the claimant’s request for review is considered untimely, their request for extension is denied, and their request ultimately dismissed.
An experienced attorney at Hoffman, Larin & Agnetti, PA. is invaluable in applying for and securing social security benefits. Our team of social security lawyers is experienced in these matters, and can discuss your case with you to provide guidance and advice in the process. If you are looking for a social security lawyer in Florida, contact us today for a consultation.