A “Request for Reconsideration” may be filed at an SSA office after 60 days from the date of the initial determination, but the applicant must provide a written statement explaining “good cause” for missing the 60 day deadline. A statement of “good cause” must contain one or more good reasons why the claimant did not request reconsideration within 60 days of the date on which he or she received the notice of the initial determination. Federal regulations state that SSA must consider the following in making their determination as to whether “good cause” exists: 1) all the circumstances which prevented a claimant from making the request on time; and 2) whether a claimant had any physical, mental, educational, or linguistic limitations (including problems speaking or reading in English) which prevented the claimant from filing the “Request for Reconsideration” within the 60 day period described above. If SSA finds that “good cause” exists for failure to file a timely request for reconsideration, the appeal will be accepted and forwarded to the DDS for a second medical determination. See Sections 2015.5 and 2015.6 for information on “good cause.”
An example for possibly granting “good cause” for late filing is a severe disability, particularly mental illness, which prevented the claimant from contacting SSA. Other examples are the loss of important records due to fire or theft, incarceration, illiteracy, and the inability to understand or read English.
The most common reason for requesting good cause is non-receipt of a decision due to homelessness. If a claimant was unaware that a determination had been made in their case, then there is a solid argument to be made that they were unaware of when an appeal needed to be filed. If homeless people are hospitalized, they usually do not have any family that can communicate with SSA on their behalf. In addition, determinations or other important documents are sometimes lost or misplaced.
Many homeless persons may not see a case manager or representative right after receiving a notice saying that they were found “not disabled.” Or, in the event that the homeless person loses the denial notice, a case manager might not find out about the determination or the ability to appeal until after the 60 days have passed. In these situations, the case manager must contact the SSA toll free number or the local field office number on behalf of the claimant to explain the situation and request appeal. Preferably, it would be advisable for the case manager keep the phone number of the SSA field office employee on file.
A case manager should work with a claimant to submit a written statement of “good cause” for missing the 60 day deadline.
Last Revised: Apr. 19, 2010