In the event you miss the deadline to appeal denial of your Social Security disability claim, you may have recourse if you can demonstrate good cause. Your next step is to provide Social Security Administration, or SSA, a request to extend the deadline that includes a detailed explanation of your late appeal. You may also need to provide an affidavit. SSA will extend the deadline if they determine you have “good cause” for being untimely. 20 C.F.R. §§ 404.909(b), 404.933(c), 404.968(b). Consult with an Indiana Social Security disability law office for more information about this process.
Who Determines Good Cause
According to POMS GN 03101.020 A.1., “An individual from the component that has the authority to adjudicate the appeal being filed determines whether ‘good cause’ exists.” Two entities are empowered to make such a determination:
- If the Request for Hearing is late, an administrative law judge, or ALJ, will determine good cause; and
- If the Request for Review of Hearing Decision is late, the Appeals Council makes the determination. The Appeals Council also determines good cause for deadline extensions filed in federal court.
How Good Cause Is Determined
Regulation 20 C.F.R. § 404.911 defines “good cause” for late Social Security disability appeals. SSA will consider the three following situations [20 C.F.R. § 404.911(a)(1)-(3)]:
- Any circumstances that prevent timely appeal;
- Whether the claimant was misled by any SSA actions; and
- Whether the claimant did not understand the timely appeal requirement.
Failure to understand the requirement is further explained in 20 C.F.R. § 404.911(a)(4). It provides for limitations that are physical, mental, educational, or linguistic, including lack of ease with the English language, in nature.
Mental capacity limitations are expanded on in Social Security Ruling 91-5p. This ruling indicates that if no one was legally responsible for prosecuting on the claimant’s behalf, “e.g., a parent of a claimant who is a minor, legal guardian, attorney, or other legal representative,” and the claimant demonstrates that mental incapacity prevented him or her from a timely appeal, “regardless of how much time has passed since the prior administrative action, the claimant can establish good case for extending the deadline to request review of that action.” The evidence must, however, support the assertion that the claimant lacked the mental capacity to understand the review process. Any reasonable doubt should be resolved in the claimant’s favor.
To help clear up any confusion regarding your Social Security disability case, reach out to Indiana Social Security disability lawyer Martin Barnes. Schedule a consultation by calling 317-804-5058.