Appeal Under Review/Reconsideration
 

I'm at reconsideration and this is the message that is on my SSD webpage as of yesterday :

Appeal Under Review

A medical decision has been made and we are working to process your decision. A Social Security Representative may contact you directly if we need any additional documents or information.

After I saw this message I called the 800 # and was told that a decision was made, I would be getting a letter soon and that my case was sent back to the local office.

I called the local office and asked to talk to my case worker, the woman who answered the phone told me that my case isn't assigned to anyone and that I don't have a case worker ??? She then told me that my case was denied .

I would like to know if anyone knows what Appeal Under Review means, is it common to not have a case worker and can a case be under review and denied at the same time .

Hi Alice,

Did your appeal go to a hearing to be presented in front of a judge? I would recommend taking your case to an attorney.

Appeal under Review means just that, your appeal is being reviewed. Hope this helps.

~Amy~

Hello Amy,

There was no hearing because my case is at the reconsideration stage. I do have an attorney (I hired her after the initial denial) and as soon as we get the denial letter she will file a request for a hearing with an administrative law judge (ALJ).

My attorney said that the wait for the hearing is 17 mouths, so I figure between waiting for the denial letter, waiting for the hearing and waiting for the decision from the judge I'm looking at 20+ months.

My attorney said we would request an On the Record (OTR) as well.

So its all just wait and see right now.....


The Appeal Under Review is confusing because I was told that it was denied, so if its denied why would it need to be reviewed ?

Thank you for responding

Apparently the "Appeal Under Review" notation is shown after a decision has been made, but doesn't mean anything else. There is a different message shown when a decision goes to QR.

Why not ask your attorney? :confused:

:hug:

I will be talking to her tomorrow. When I called her on Friday, she gave me a lot of information and I didn't think to ask her what it means.

it sounds to me like they just didnt update your page yet....it was under review is now denied and the page hasnt been updated to reflect that.

This is a copy of the update :

Current Status
Step 2 of 3

Processing
01/12/2018
Appeal Under Review

A medical decision has been made and we are working to process your decision. A Social Security Representative may contact you directly if we need any additional documents or information.

07/24/2017
The Disability Determination Service for your state started processing the medical portion of your appeal.

07/21/2017
We started reviewing your request for an appeal.

07/21/2017
Your request for an appeal was submitted.

07/21/2017
Your online appeal was started.

As I said in my OP I called the 800 # and was told that a decision was made, I would be getting a letter soon and that my case was sent back to the local office.

I called the local office and asked to talk to my case worker, the woman who answered the phone told me that my case isn't assigned to anyone and that I don't have a case worker ??? She then told me that my case was denied .

So, the update happened on the 12th and I was told that I was denied on the 12th.

The language online is standard, if confusing. The denial letter will be mailed and posted online as well.

It is correct that you are not assigned a case worker at the local office. You will submit your appeal and essentially be in limbo waiting for an ALJ to be assigned. SS was having Senior Attorneys review files for OTR decisions a few years back, but I'm unsure if that's continuing. You should ask your attorney when she will file an OTR request, because most seem to wait until right before a hearing will be scheduled.

Thank you for clearing that up for me. I was quite shocked when I was told that I did't have a case worker at the FO. lol

Do you know if a person has to have new medical evidence to go OTR ? And if so does it have to pertain to the original claim ? I was just DX with degenerative disc disease so I wonder if I could use that to go OTR .

New evidence is fine but if there was no mention of the impairment previously, then would you be amending your Alleged Onset Date? With an OTR it must be a Fully Favorable Decision, so they can't set a different Established Onset Date.

Similarly for the hearing you can add a new impairment but if there is no medical evidence previously, it might effect the EOD. The ALJ will first determine if the original impairments will allow an approval or not.

DDD would be unlikely to meet a Listing prior to a hearing, but there is a chance you could be approved via the Grid. Or, it could be determined both impairments equal a Listing.

Even approaching advanced age, education and skills are still a factor. Registered nurses or many with sedentary desk jobs, for example, struggle to be approved via the GRID even after age 55. Link: Sedentary Work Grid Rules | Maximum Capacity Sit Down Work

I know you thought early on the Grid was a factor on your first denial, but you were denied because they claimed you could still perform the same type of work, which means they didn't proceed to factor the Grid. You may have understood this later, but I just wanted to clarify.

There are fine points to each strategy for approval, which there is plenty of time for you to learn, but I would not give up on trying to prove you meet the COPD listing which should maximize your benefits.

“New evidence is fine but if there was no mention of the impairment previously, then would you be amending your Alleged Onset Date? With an OTR it must be a Fully Favorable Decision, so they can't set a different Established Onset Date.

Similarly for the hearing you can add a new impairment but if there is no medical evidence previously, it might effect the EOD. The ALJ will first determine if the original impairments will allow an approval or not.”

Interesting….definitely something I should discuss with my lawyer before moving forward.

“Even approaching advanced age, education and skills are still a factor. Registered nurses or many with sedentary desk jobs, for example, struggle to be approved via the GRID even after age 55. Link: Sedentary Work Grid Rules | Maximum Capacity Sit Down Work “

All of my jobs have been in food and beverage. Cocktail server, bartender, cook, waitress and eventually restaurant management. All of these jobs you hit the ground running and don’t stop until your shift is over lol. So I’m not sure where that puts me on the Grid Rules. I’ve never had a sedentary job and its my understanding that SSD is more lenient, as far as retraining goes, with people of “advanced age.” I think what disqualifies me on the Grid is that I have transferable skills from being a restaurant manager, but I’m not sure.

“ I know you thought early on the Grid was a factor on your first denial, but you were denied because they claimed you could still perform the same type of work, which means they didn't proceed to factor the Grid. You may have understood this later, but I just wanted to clarify. “

Yes, you are right about the first denial. Do you think they used the Grid for reconsideration ? I really want to see the letter so I can know why I was denied.

“There are fine points to each strategy for approval, which there is plenty of time for you to learn, but I would not give up on trying to prove you meet the COPD listing which should maximize your benefits.”

A few weeks ago I had a PFT test done and submitted the results to DDS. My pulmonologist has scheduled more tests for me in the coming months so maybe that will help with my case with COPD .

Thanks for the info !

If you had management experience they will likely consider those as transferable skills if you held the job within 15 years from your AOD. The Vocational Expert rules are exceptionally complex IMO.

If at Recon they denied you based upon your ability to do prior work, then no the Grid was not considered. If they decided you can no longer do prior work, then they would have evaluated the Grid before moving on to Step 5.

I would recommend reading/rereading 3.00 E. It covers all SS requirements for
valid spirometry testing including your height without shoes, legible tracings, etc. One technicality on the way it was reported and you would have been denied.
https://www.ssa.gov/disability/profe...tory-Adult.htm

Lit Love

Yes, the Grid is complex and confusing. Two of the jobs that I had over the last fifteen years were managerial. So, I don’t know yet if that comes into play …

I still haven’t received the denial letter, nor has my lawyer so we don’t know what the reason was.

Thanks for the link. Wow that’s A LOT of info !! lol Its going to take me awhile to dissect it all !

Thank you so much for taking the time to respond to my posts .