SSDI Reconsideration in Virginia: What You Need to Know

When the Social Security Administration (SSA) denies your initial application for Social Security Disability Insurance (SSDI) benefits in Virginia, you have the right to challenge that decision through a process called reconsideration. This critical step in the appeals process gives you a second chance to have your case reviewed before proceeding to a hearing before an administrative law judge.

Understanding the reconsideration process and how it works in Virginia can significantly impact your chances of ultimately obtaining the disability benefits you deserve. The reconsideration stage represents your first opportunity to correct deficiencies in your initial application and present additional evidence supporting your claim.

Understanding the SSDI Reconsideration Process

Reconsideration involves a complete review of your disability claim by someone at the SSA who did not participate in the initial determination. This reviewer examines all evidence submitted with your original application, plus any new evidence you provide. The reconsideration process takes place at the Disability Determination Services (DDS) office, the same agency that handled your initial claim, but with different personnel reviewing your case.

In Virginia, the DDS operates under contract with the federal SSA to make disability determinations for residents of the Commonwealth. The Virginia DDS maintains offices that serve different regions of the state, though most communication occurs through mail and electronic systems rather than in-person visits.

The reconsideration review is considered a "de novo" review, meaning the new examiner looks at your case with fresh eyes. However, the approval rate at reconsideration is historically low, typically ranging from 10-15% nationally. Despite these discouraging statistics, filing for reconsideration remains an essential step because you must exhaust this administrative remedy before proceeding to a hearing, where approval rates are substantially higher.

Time Limits and Filing Requirements in Virginia

You have exactly 60 days from the date you receive your denial notice to file a request for reconsideration. The SSA assumes you received the notice five days after the date printed on the letter, unless you can prove otherwise. Missing this deadline can have serious consequences, potentially requiring you to start the entire application process over from the beginning.

To request reconsideration in Virginia, you must complete and submit Form SSA-561, "Request for Reconsideration." You can file this form through several methods:

• Online through your personal my Social Security account
• By visiting your local Social Security office in person
• By mailing or faxing the completed form to your local office
• By calling the SSA at 1-800-772-1213 to request assistance

When filing for reconsideration, you should also complete Form SSA-3441, "Disability Report - Appeal," which allows you to explain any changes in your condition since your initial application and identify new medical evidence or treatment providers.

Strengthening Your Case During Reconsideration

The reconsideration stage provides a valuable opportunity to address the weaknesses that led to your initial denial. Simply resubmitting the same information rarely produces a different result. Instead, you must take proactive steps to strengthen your claim.

Obtain new medical evidence: If significant time has passed since your initial application, you likely have additional medical records, test results, or treatment notes. These updated records can demonstrate the ongoing nature and severity of your condition. Contact all healthcare providers you've seen since applying and request that updated records be sent to the DDS.

Address specific reasons for denial: Your denial letter should explain why the SSA determined you were not disabled. Common reasons include insufficient medical evidence, non-severe impairments, or a determination that you can perform past work or other jobs. Your reconsideration submission should directly address these stated reasons with specific evidence and arguments.

Provide detailed functional limitations: Medical diagnoses alone do not establish disability. You must demonstrate how your conditions limit your ability to perform work-related activities. Written statements from you, your doctors, family members, or former employers describing your limitations can be powerful evidence.

Include consultative examination results: If the DDS scheduled you for a consultative examination during your initial application, those results are part of your file. If the examination was cursory or failed to capture the severity of your limitations, statements from your treating physicians can provide important context or contrary opinions.

What Happens After You File for Reconsideration

Once you submit your request for reconsideration, the Virginia DDS will retrieve your file and assign it to a new disability examiner and medical consultant. The processing time for reconsideration claims in Virginia typically ranges from three to five months, though this can vary based on the complexity of your case and the current workload at DDS.

During the reconsideration process, the examiner may:

• Contact your medical providers to request additional records
• Schedule you for another consultative examination if gaps in evidence exist
• Request clarification or additional information from you
• Review any new evidence you have submitted

You will eventually receive a written decision by mail. If your reconsideration is approved, you will begin receiving SSDI benefits, with back pay dating to your established disability onset date. If denied, the letter will explain the reasons and inform you of your right to request a hearing before an administrative law judge.

Preparing for the Next Steps

Given the low approval rates at reconsideration, you should prepare for the possibility of denial and the need to request a hearing. Many disability attorneys recommend beginning preparation for the hearing stage even while your reconsideration is pending.

If your reconsideration is denied, you again have 60 days to file a request for a hearing. The hearing stage, conducted by an administrative law judge at the Office of Disability Adjudication and Review (ODAR), has significantly higher approval rates than reconsideration—often exceeding 50%. Virginia has ODAR hearing offices in multiple locations, including Richmond, Norfolk, Roanoke, and other cities.

Many claimants find that legal representation becomes especially valuable at the hearing stage. Disability attorneys work on contingency, meaning they only receive payment if you win your case, with fees capped by federal law at 25% of past-due benefits or $7,200, whichever is less.

Documentation is key throughout the reconsideration and appeals process. Keep copies of everything you submit, maintain a log of all communications with the SSA and DDS, and continue treating with your doctors regularly. Gaps in treatment can be interpreted as evidence that your condition is not as severe as claimed.

Need Help? If you have questions about your case, call or text 833-657-4812 for a free consultation with an experienced attorney.

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