A claimant who is dissatisfied with the initial determination on his or her claim
may call, write, or visit an FO for an explanation of the determination. When a claimant
requests an explanation, describe, to the claimant, as objectively as possible, how
the Social Security Administration (SSA) handled the claimant's case, the basis for
the determination, and his or her appeal rights. Explain that if he or she appeals,
SSA can review all issues, including those decided favorably. This means that the
claimant’s disability status may change from “disabled” to “not disabled”, or that
the established onset date (EOD) may be the same, earlier, or later than the EOD established
in the initial determination. See DI 25501.260 Establishing the Established Onset Date (EOD) in Reconsideration and Appeal Claims.
If the claimant decides to request reconsideration after receiving the explanation,
follow the instructions in this subchapter to develop and process the request.
EXCEPTION: Reconsideration is not the first level of appeal for a medical determination on
an initial claim in Prototype states, unless expedited reinstatement is involved.
For additional information, see DI 13050.085 Appeals Process Under Expedited Reinstatement and DI 12015.100 Disability Redesign Prototype Model
When a claimant requests reconsideration of an initial disability determination, the
FO explains the reconsideration process and obtains the appropriate appeal forms (the
SSA-561 Request for Reconsideration, or the SSA-3441-BK Disability Report-Appeal).
The claimant’s case then receives an independent and thorough reexamination of all
evidence on record including any new evidence received after the initial determination.
NOTE: To process a request for reconsideration of a medical cessation or an adverse reopening
of a favorable initial determination due to medical/vocational reasons, follow the
instructions in DI 12026.001 Reconsideration of a Continuing Disability Review (CDR) Based on Medical Cessation
or Adverse Medical Reopening.