If you’ve applied for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits in Pennsylvania and received a denial, you’re not alone — and you’re not without options. The first step in appealing a denial is called disability reconsideration. This guide will walk you through everything you need to know about the reconsideration process in Pennsylvania, from timelines to local statistics, and what you can do to improve your chances of success.
Key Takeaways
- Disability reconsideration is the first level of appeal after an initial denial of SSDI or SSI benefits.
- In Pennsylvania, the reconsideration approval rate is generally low (around 10-15%), so strong evidence and careful preparation are crucial.
- The reconsideration decision is made by a different Disability Determination Services (DDS) office than the one that handled your initial claim.
- You have 60 days from the date of your denial letter to request reconsideration.
- If reconsideration is denied, the next step is a hearing before an Administrative Law Judge (ALJ), which has a much higher approval rate.
What is Disability Reconsideration?
Disability reconsideration is the first formal appeal you file if your initial application for SSDI or SSI benefits is denied by the Social Security Administration (SSA). During reconsideration, a team of new federal employees at the Disability Determination Services (DDS) office will review your case from scratch. This includes:
- A new review of your medical records and evidence
- Possibly contacting your doctors for updated or additional information
- Reassessing your residual functional capacity (RFC) to determine what work you can still perform
- Looking at your age, education, and work history to see if you qualify under SSA rules
In Pennsylvania, the DDS offices responsible for reconsideration claims include those in Harrisburg and Philadelphia, depending on your location.
How Does Reconsideration Work in Pennsylvania?
Step 1: Requesting Reconsideration
Once you receive a denial letter for your initial claim, you have 60 days from the date on that letter to file your request for reconsideration. You can do this by:
- Calling the SSA at 1-800-772-1213
- Visiting your local Social Security office (Philadelphia, Pittsburgh, Allentown, etc.)
- Filing online through the SSA website (though reconsideration requests are often best handled by phone or in person)
Make sure to keep a copy of your request and proof of submission.
Step 2: Case Review by Pennsylvania DDS
Your case will be assigned to a different team of disability examiners and medical consultants at the Pennsylvania DDS office. They will:
- Review all medical evidence, including recent doctor’s notes, test results, and hospital reports
- Possibly request new evidence or additional exams if your file is incomplete
- Evaluate your work history and ability to perform past work or other jobs in the national economy
- Use the SSA Blue Book criteria to determine if your condition meets or equals a listed impairment in Section 1.00 (Musculoskeletal), 3.00 (Respiratory), 12.00 (Mental Disorders), etc.
Step 3: Decision Notification
Once the DDS completes its review, you will receive an official reconsideration determination letter. This letter will either:
- Approve your claim, meaning you qualify for benefits retroactive to your date of disability
- Deny your claim, meaning you can proceed to the next appeal level — a hearing before an Administrative Law Judge (ALJ)
Pennsylvania Reconsideration Statistics
Understanding your chances at reconsideration helps you prepare realistically. Here are some key statistics for Pennsylvania compared to national averages:
| Measure | Pennsylvania Average | National Average |
|———————————|———————|——————|
| Initial Application Approval Rate | ~35% | ~34% |
| Reconsideration Approval Rate | ~12-15% | ~13% |
| Average Processing Time (Initial) | 3-5 months | 3-5 months |
| Average Processing Time (Reconsideration) | 3-4 months | 3-4 months |
| Percentage of Requests Moving to ALJ Hearing | ~60% | ~60% |
Source: SSA.gov, Pennsylvania DDS reports (2023)
Common Reasons for Reconsideration Denial in Pennsylvania
Many claims are denied at reconsideration for the following reasons:
- Incomplete or outdated medical evidence: Pennsylvania DDS examiners need recent, detailed medical records that document your disabling condition.
- Failure to meet or equal a Blue Book Listing: Your impairments must meet SSA’s medical criteria exactly or be medically equivalent.
- Residual Functional Capacity (RFC) underestimated: Sometimes the DDS concludes you can still do some work, even if limited.
- Non-medical factors: Age, education, and work experience can affect your ability to find other work.
Tips to Strengthen Your Reconsideration Claim in Pennsylvania
1. Gather Comprehensive Medical Evidence
Make sure your doctors provide detailed reports that explain how your condition limits your daily activities and work abilities. In Pennsylvania, providers may be more familiar with state-specific DDS expectations—ask them to include:
- Specific functional limitations (e.g., cannot lift more than 10 pounds, cannot stand for more than 1 hour)
- Test results and imaging studies
- Treatment history and prognosis
2. Submit a Function Report
Use SSA Form SSA-3373-BK (Function Report – Adult) to describe your symptoms, daily activities, and limitations in your own words. This helps the DDS understand the real impact of your condition.
3. Follow Up on Outstanding Evidence
If the DDS requests additional records or exams, respond as quickly as possible. Delays can prolong your case and reduce chances of approval.
4. Consider Representation
While not required, hiring a Pennsylvania-based disability attorney or benefits counselor can greatly improve your chances of success. They can:
- Ensure your evidence is complete and well-organized
- Communicate effectively with DDS examiners
- Prepare you for next steps if reconsideration is denied
What Happens If Reconsideration Is Denied?
If your reconsideration claim is denied, your next option is to request a hearing before an Administrative Law Judge (ALJ). This is the third step in the disability appeals process and has significantly higher approval rates — nationally around 45-55%. ALJ hearings in Pennsylvania are conducted at hearing offices in Philadelphia, Pittsburgh, and Harrisburg.
You have 60 days from your reconsideration denial letter to request a hearing. This is often the best opportunity to present your case in person, submit new evidence, and have an attorney or advocate represent you.
Pennsylvania-Specific Resources
- Pennsylvania Disability Determination Services (DDS) Offices
– Harrisburg DDS Office
– Philadelphia DDS Office
- Pennsylvania Social Security Field Offices
– Philadelphia SSA Office
– Pittsburgh SSA Office
– Allentown SSA Office
- Pennsylvania Protection and Advocacy, Inc. (PPA) — Provides free legal assistance for disabled Pennsylvanians
- SSA Blue Book Online — Lists all impairments and medical criteria used to evaluate disability claims: ssa.gov/disability/professionals/bluebook
Frequently Asked Questions
How long does reconsideration take in Pennsylvania?
Reconsideration decisions typically take 3 to 4 months after your request is filed. Processing times can vary depending on local workload and the completeness of your file.
Can I submit new evidence during reconsideration?
Yes. You can and should submit any new medical records or documentation that support your disability during reconsideration. This can include new doctor’s reports, test results, or statements from family and friends.
What if my condition worsens after reconsideration?
If your condition worsens, you can file a new application or update your existing claim with new evidence. You can also mention worsening during the appeals process to strengthen your case.
Do I need a lawyer for reconsideration?
You do not need a lawyer at the reconsideration stage, but representation can help. Many claimants choose to get a lawyer or a Certified Benefits Counselor to improve their chances.
What if I miss the 60-day deadline to request reconsideration?
Missing the 60-day deadline can result in your appeal being dismissed. In some cases, late filing can be excused due to “good cause,” but this is rare and must be well-documented.
Final Thoughts and Next Steps
Disability reconsideration in Pennsylvania is a critical step in the appeals process, but it is also challenging given the low approval rates. If you are denied reconsideration, don’t lose hope — the hearing level offers a much better chance for approval.
If you feel overwhelmed or uncertain, I strongly recommend consulting a Pennsylvania disability attorney or a Certified Benefits Counselor who understands the local DDS offices and SSA processes. They can guide you through the complex paperwork, gather necessary evidence, and advocate for you effectively.
Remember, you don’t have to navigate this process alone. Reach out for professional help to protect your rights and secure the benefits you deserve.
Written by Michael T. Hargrove, former SSA Claims Examiner and Disability Benefits Consultant.