If you have been denied at hearing before an Administrative Law Judge (ALJ) and you either failed to appeal your case within 60 days (with an additional 5 days provided for receipt of the mailed decision), or you did appeal unsuccessfully, all may not be lost. As a Maine Social Security lawyer, having handled these matters throughout Maine, Massachusetts and New Hampshire for the past 35 years (and with offices in all 3 states), we have routinely assisted individuals in this very circumstance obtain the Social Security disability benefits they need and deserve. Much will depend on your individual circumstances in terms of whether 1) we’ll be able to get you Social Security disability insurance and/or Supplemental Security Income (SSI) benefits and 2) whether such receipt of benefits will include retroactive benefits (and to what extent: that is, whether it might go back to a period of time already decided by an ALJ or, perhaps, would involve benefits after that point in time of the ALJ decision).
First, it’s important to understand that if you are denied by an ALJ this decision becomes final unless you continue to appeal the decision timely and have the decision in some manner overturned. This might be at the Appeals Council or Federal District Court, or in the very rare case, at the Circuit Court of Appeals or United States Supreme Court. An appeal of the ALJ can result in a remand (or sending back) of the case to an ALJ for additional proceedings in accordance with instructions from the Appeals Council in Virginia or from one of the courts mentioned above. However, if the decision is allowed to become final (that is, all appeal deadlines are over and all appeals right have been exhausted), it then becomes necessary that you think about filing a new claim.
A final decision, wherein an ALJ determines you are not “disabled” under Social Security’s rules, will cause the Social Security Administration (SSA) to understand that there is a limit as to what they can provide on a new application or on reconsideration. The earliest date that SSA could find one disabled in such a circumstance would be the day after the ALJ determination (as all past periods of time have been determined finally) based on the doctrine of Res Judicata (which means the matter having been decided). Options do remain available at the hearing level, however, for one to argue that there are reasons why the judge decision should not be deemed binding for the earlier period of time: see below.
In the meantime, if in fact an ALJ has determined at the initial or reconsiderations levels that one is not disabled through the date one was last insured for benefits (that is, through their DLI) under the SSDI program, there still remains the possibility of collecting Social Security benefits under the SSI program assuming one remains otherwise in poverty circumstances. Turning to the hearing level, options do remain available at the hearing level to argue that the prior decision should not be deemed binding. The Social Security regulations provide that Res Judicata only applies to the same facts and issues that were decided at the time of the prior hearing. Thus, if there is new evidence that relates to the prior period of time that would suggest one was in fact disabled, or if there were issues that were not raised during the prior claim (for example, certain condition(s) was (were) not previously raised and determined at the time of the prior decision), this can form the basis for a reopening of the past claim as part of what is now a favorable determination for the prior period of time. Likewise, if there has been a change in the law since the time of the prior ALJ denial, this can likewise form the basis for allowing a new ALJ to award benefits, going backwards in time prior to the date of the prior ALJ decision.
Assuming one is able to reopen a past ALJ decision, retroactive benefits can then be awarded as far back as 1 year prior to the filing date of the initial application (assuming a 5 full month waiting period has been met).
If you have been previously denied by a judge at hearing and you’re wondering what benefits you may still be entitled to collect, contact the Law Offices of Russell J. Goldsmith so we can evaluate your individual circumstances as part of a no-cost, no obligation assessment.