The Lee Steinberg Law Firm helps individuals applying for Social Security Disability throughout Michigan. Our team of Social Security Disability lawyers can walk you through the process from beginning to end. We take on all kinds of cases, even the tough ones.
Lee Steinberg Law Firm Case Review: Individual Was Denied Benefits Multiple Times Before Seeking Help
Here is a recent example where we were successful in getting benefits for a person who had been denied multiple times by the Social Security office.
A claimant contacted our firm seeking representation for his upcoming Social Security disability hearing. This claimant was a 43-year-old man suffering from significant coronary artery disease. His past medical history consisted of multiple cardiac arrests and numerous hospital admissions secondary to his ischemic heart disease and psychiatric impairments.
In 2016, the claimant filed an application for title II Disability Insurance Benefits (SSDI) and title XVI Supplemental Security Income (SSI) alleging he became disabled on October 9, 2006. His claim for SSI benefits was approved from the initial filing date but his claim for SSDI was disapproved because the reviewing State Agency (Disability Determination Services), concluded that the record lacked medical evidence to establish a disability prior to the date last insured (DLI) of December 31, 2010.
Why Representation for the Appeals Process is Important
Procedurally, the claimant had filed many initial applications for benefits in the past, all of which resulted in denial of benefits. The claimant failed to pursue those applications further because he lacked representation and navigating the appeals process on his own was challenging due to a multitude of medical issues.
Following a review of the file, it was evident that the record was devoid of pertinent medical evidence relating to the claimant’s severe coronary artery disease from his alleged onset date of disability through his date last insured. Due to dates of service from various medical providers, there was a great chance that those medical records were no longer available.
However, with due diligence, medical records from various facilities were secured and submitted to his record by our law office. A thorough review of the new evidence revealed that the claimant met a listing relating to his ischemic heart disease prior to his date last insured. Since the claimant had previously filed applications for disability benefits in the past relating to his heart condition, a request for reopening of the prior determinations was raised in a prehearing brief.
How We Can Help You Reopen a Denied SSI Claim
Reopening of a prior determination may be granted under a specific set of circumstances under the law. Furthermore, requesting a reopening of a prior initial determination is not an automatic process and the specific request for reopening must be raised at the initial application or at the administrative law hearing.
Pursuant to the regulations, an administrative law judge (ALJ), “has the authority to reopen an initial, revised or reconsidered determination, or a hearing decision under title II or title XVI of the Social Security Act for any reason within 12 months from the date of the notice of the initial determination. (See 20 CFR 404.988(a) and 416.1488(a))” (HALLEX 1-2-9-30.) Aside from the 12- month period of reopening a claim for any reason, an ALJ may reopen a prior final determination for good cause within four years from the date of the notice of the initial determination in a claim under title II (SSDI) and within two years from the date of the notice of the initial determination in a claim for title XVI (SSI). Good cause exists when (1) new and material evidence has been discovered and relates to the prior claim; (2) finding a clerical error in the way benefits were calculated; or (3) when the evidence considered in making the determination clearly shows on its’ face that an error was made.
Successful Appeal Verdict
In this case, pursuant to the “new and material” evidence clause, reopening of the prior determination was certainly warranted and granted at the hearing.
Accordingly, the ALJ determined that the prior determination clearly showed on its face that an error was made and that the new and material evidence presented was substantial and established a disability finding relating to the claimant’s ischemic heart disease.
Consequently, a fully favorable decision was issued, and the claimant obtained benefits dating back to his original onset date of the disability. In sum, the claimant received a total of $170,000 in retroactive back pay.
To Receive Disability Benefits, Contact a Michigan Social Security Disability Attorney Today
The Lee Steinberg Law Firm has proudly represented individuals denied social security benefits for over 40 years. We only represent people, never corporations. Our team of tested Michigan social security disability attorneys will assist you every step of the way.
Call our office today at 1-800-LEE-FREE (1-800-533-3733) for a free consultation. We never charge a penny until we win your case and we are standing by, ready to answer your questions.
