Step 4 is when the Social Security Administration sends your case to a disability examiner and medical consultant who have not seen your file before

At reconsideration, Social Security assigns your case to a new examiner and doctor — different people from those who made the original denial. This is the second level of review, and it is your first real chance to add new medical evidence. Step 4 is when that review actually happens: the examiner reads everything you submitted, the medical consultant evaluates your condition against the listing of impairments, and they make a new decision.

The process is not automatic. You must have filed a reconsideration request within 60 days of your denial notice (or within the extended period if you had good cause for the delay). Once Social Security receives your request, they send your entire file — your original process, medical records, work history, and anything you added — to the reconsideration unit in your state. That unit assigns it to an examiner, who works with a medical or psychological consultant depending on your condition.

Step 4 typically takes 2 to 4 months, though it varies by state and how much new evidence you submitted. During this time, you will not hear from Social Security unless they need more information. You can check the status of your case by calling 1-800-772-1213 or logging into your my Social Security account online.

Key Takeaways

  • A new examiner and medical consultant review your case at reconsideration, not the same people who denied you initially.
  • You can submit new medical records, test results, or statements from your doctors before or during the reconsideration review.
  • The examiner must explain in writing why they approved or denied your case, and they must address any new evidence you provided.
  • If reconsideration is denied, you have 60 days to request a hearing before an administrative law judge, which is Step 5.
  • Submitting strong medical evidence at Step 4 significantly increases your chances of approval without waiting for a hearing.

What the examiner and medical consultant actually review

The examiner reads your entire case file: your process, your work history, your medical records from your doctors, hospital visits, and any statements you or your doctors wrote. The medical consultant — usually a doctor or psychologist employed by Social Security — reviews the medical evidence to see whether your condition meets or equals one of the impairments listed in the Blue Book (Social Security's official list of disabling conditions). They also assess your residual functional capacity, or RFC — what you can still do physically and mentally despite your condition.

The examiner and consultant work together. The consultant writes a medical opinion, and the examiner uses that opinion along with the rest of your file to make the final decision. They are looking for the same thing the original examiner was: objective medical evidence that your condition prevents you from working. But because they are new to your case, they may weigh the evidence differently or notice something the first examiner missed.

This is why submitting new evidence matters. If your first denial was based on incomplete medical records — for example, your doctor had not yet done imaging or testing — new records can change the outcome. If your condition worsened between your initial process and reconsideration, medical evidence of that worsening strengthens your case.

How to submit evidence before or during Step 4

You can submit evidence in two ways: before reconsideration officially starts, or after Social Security has assigned your case to an examiner. If you file your reconsideration request and include new medical records with it, those go into your file when ready. If you think of new evidence after you have filed, you can send it to the reconsideration unit in your state — your denial notice lists the address, or you can call 1-800-772-1213 to confirm where to send it.

Write a cover letter with any evidence you submit. List what you are sending, explain why it is relevant (for example, "This MRI from Dr. Chen shows the herniated disc that limits my ability to sit"), and include your Social Security number. Keep a copy for your records and consider sending it by certified mail so you have proof of delivery.

The strongest evidence is recent, objective, and specific to your condition. Recent means within the last few months. Objective means test results, imaging, lab work, or a doctor's clinical notes — not just your own description of your symptoms. Specific means it addresses the work you cannot do: "Patient cannot sit for more than 30 minutes due to back pain" is more useful than "Patient has chronic pain."

What happens if the examiner needs more information

If the examiner or medical consultant needs clarification, Social Security may contact your doctors directly to request records or ask you to attend a consultative examination — a brief medical exam paid for by Social Security. You will receive a notice in the mail telling you where and when to go. These exams are usually straightforward: the doctor checks your range of motion, strength, and basic neurological function, then writes a report for your file.

If you receive a notice for a consultative exam, attend it. Missing it can result in a denial. If you cannot make the appointment, call the number on the notice when ready and ask to reschedule. Bring any medical records or test results you have, and be honest about what you can and cannot do — do not exaggerate or minimize your symptoms.

The reconsideration decision and what it means

When the examiner makes a decision, Social Security mails you a notice. If you are approved, the notice explains your benefit amount and when payments begin. If you are denied, the notice must explain the reason in writing and must address any new evidence you submitted. This is important: if the notice does not explain why your new evidence did not change the outcome, that is a potential error you can raise at the next level.

Roughly 10 to 15 percent of cases are approved at reconsideration. That is a low rate, but it reflects the fact that most people who reach this stage have already submitted their strongest evidence. If you are denied again, you have not failed — you have straightforward moved to the next step, where a judge reviews your case instead of an examiner.

When to consider hiring a representative before Step 5

If you are denied at reconsideration, you can represent yourself at a hearing before an administrative law judge, or you can hire a lawyer or non-lawyer representative. Many people wait until after reconsideration to hire help, which is fine — representatives can take your case at any point. However, if you think your case is weak and you want information on whether to continue, or if you have a complex medical history, talking to a representative before the hearing can help you prepare.

Representatives work on contingency, meaning they take a fee only if you win. The fee is capped at 25 percent of your back pay (the money owed from when you became disabled until your approval), up to a maximum of $7,200. You can find representatives through the Social Security Administration's website or through disability advocacy organizations in your state.

Frequently Asked Questions

Can I call Social Security to ask how my reconsideration is going?

Yes. Call 1-800-772-1213 and have your Social Security number ready. They can tell you whether your case has been assigned to an examiner and sometimes how far along the review is. If you submitted new evidence, ask them to confirm it is in your file.

What if the reconsideration examiner makes the same decision as the first examiner?

You can request a hearing before an administrative law judge within 60 days of the reconsideration denial notice. This is Step 5. Judges approve cases at a higher rate than examiners, especially if you have strong medical evidence and can explain your limitations clearly.

Do I have to wait for reconsideration to finish before I can work?

No. You can work while your case is pending. If you are approved, your benefits will be back-dated to your process date, and any work you did will not affect that. If you earn over the substantial gainful activity limit (roughly $1,550 per month in 2024, but this changes yearly), Social Security may consider you able to work and deny your case, so check the current limit before taking a job.

What if I disagree with the medical consultant's opinion?

You can submit a statement from your own doctor disagreeing with the consultant's findings. This goes in your file and the examiner must consider it. At a hearing, you can also have your doctor testify or submit a detailed written statement about your condition and why you cannot work.

How long do I have to request a hearing if reconsideration is denied?

You have 60 days from the date on the reconsideration denial notice. If you miss this important date, you can ask for an extension if you have good cause — for example, you did not receive the notice, or you were seriously ill. After 60 days, you would have to start the process process over.