Mental Incapacity and Extending the Deadline to Appeal

April 6, 2016

Many clients call me indicating they missed the date to file an appeal.  What they do not know is that there is a “good cause” exception which allows individuals to file an appeal late.  If a claimant satisfies the “good cause” standard due to a mental incapacity that prevented him or her from timely filing an appeal, it does not matter how much time has passed.  This would theoretically allow a client to request a review of an adverse decision from many years ago.

In determining whether a claimant lacks mental capacity, SSA will look at the following factors:

inability to read and write;

lack of facility with the English language;

limited education; and

any mental or physical condition that limits the claimant’s ability to do things for himself.

Note that reasonable doubt should be resolved in favor of the claimant.

Of course there are other good cause factors that could allow a person to file a request for review late, such as illness, extended hospitalizations, a death in family or a change of address, but these factors will likely be construed to allow a reasonable time frame in which to file an appeal.  The mental incapacity could allow appeals to be filed many months or years after the denial of benefits.

NOSSCR’s recent bulletin has an excellent and lengthy article on this issue.

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