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You’ve Missed the Deadline for Appealing a Denial of Benefits – Now What?

If you’ve been denied benefits and missed the deadline for filing an appeal, you must demonstrate to the Social Security Administration (SSA) that you had “good cause” for missing the deadline. In determining whether you had “good cause” for missing the deadline the SSA will examine the underlying facts. That’s why it’s critical for you to write a factually accurate letter explaining why you missed the deadline and include that letter with your request for an appeal. You may or may not have to execute an affidavit attesting to the underlying facts.

If you prevail and the SSA determines that there was, in fact, good cause for missing the deadline, you will receive an extension of time.

What Is “Good Cause?”

In considering whether you had good cause for missing the deadline for filing an appeal, the SSA will take into account whether any mental, physical, educational, and linguistic limitations impacted your ability to understand the importance of the deadline for filing an appeal or prevented you from filing an appeal in a timely manner.

If you missed the deadline due to mental incapacity and the fact that there was no one else legally responsible for filing the claim on your behalf, good cause exists for extending the deadline no matter how much time has elapsed since the unfavorable decision. To the extent there is any reasonable doubt, such doubt must be resolved in your favor under such circumstances.

In addition to the circumstances described above, “good cause” may exist if you can demonstrate that you were misled by the SSA in regard to the deadline or that you failed to comprehend the importance of filing by the deadline.

Who Will Determine Whether You Had “Good Cause”?

That depends on what stage in the process you appeal. 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.”

This means that if your Request for Hearing is filed late, the good cause determination for missing the deadline will be decided by an administrative law judge (ALJ). On the other hand, if you missed the deadline for filing a Request for Review of Hearing Decision, the Appeals Council will make the good cause determination. The Appeals Council also decides if good cause exists for extending the deadline to file an appeal in federal court.

Because the deadlines for filing appeals from an adverse determination are so critical, you should consult with an experienced New York disability lawyer. For a free consultation, contact Herbert Forsmith or fill out the Claim Evaluation form on the right side of this page.