Denied claims do go to quality review, but not automatically

When Social Security denies your SSDI claim, the case does not automatically move into a quality review. Instead, a quality review happens only if you request it—and only within a specific window of time. The process is separate from the reconsideration appeal you may have already filed or are considering. Understanding the difference between these two paths matters because they have different timelines, different decision-makers, and different odds of success.

Quality review is a behind-the-scenes check that Social Security performs on some denied claims. A different examiner—not the one who made the original decision—looks at your file to see whether the first decision followed the rules correctly. It is not a new hearing where you present new evidence. It is a paper review only.

Key Takeaways

  • Quality review is a separate process from reconsideration and happens only if you request it in writing within 60 days of the denial letter.
  • A quality review examiner looks at whether the original decision followed Social Security's rules, not whether you have a stronger case now.
  • Quality review does not stop the clock on your other appeal rights—you can request it while also filing for reconsideration, though doing both is unusual.
  • Most quality reviews result in the original denial standing, but the process can catch errors in how your medical evidence was evaluated.
  • If quality review upholds the denial, you still have the right to file for reconsideration or request a hearing before an administrative law judge.

How quality review differs from reconsideration

Reconsideration is the standard first appeal after a denial. A new examiner looks at your entire file, considers any new evidence you submit, and makes a fresh decision on whether you meet the medical criteria for SSDI. Most people who appeal choose reconsideration because it gives you a chance to add documents, medical records, or statements that were not in the original process.

Quality review is narrower. The examiner is checking whether the original decision-maker followed the correct legal and medical standards—not whether you deserve benefits. They are looking for errors in how your case was handled: Did the examiner consider all your medical records? Did they explore the right definition of disability? Did they follow Social Security's own rules? If the original decision was made correctly according to the rules, quality review will uphold it, even if you think the decision is unfair.

You cannot have both a quality review and a reconsideration happening at the same time on the same claim. If you request quality review, you are choosing that path instead of reconsideration. This is why most people choose reconsideration: it gives you more control over what evidence gets considered.

When you can request a quality review

You have 60 days from the date on your denial letter to request quality review. This important date is firm. The 60 days starts the day Social Security mails the letter, not the day you receive it, so if mail is slow to reach you, the clock is still running.

To request quality review, you must write to Social Security and clearly state that you want a quality review of your denied claim. Include your name, Social Security number, and the date of the denial letter. Mail it to the Social Security office that handled your case—the address is on your denial letter. You can also deliver it in person to your local Social Security office, which gives you a receipt showing the date they received it.

If you miss the 60-day window, you cannot request quality review. Your only remaining appeal option is reconsideration, which has its own 60-day important date from the original denial letter. If you have missed both important date, you would need to file a new SSDI process.

What a quality review examiner actually looks at

The quality review examiner receives your entire file: the original process, all medical records Social Security obtained, the denial letter, and your request for quality review. They do not contact you, do not request new medical evidence, and do not hold a hearing. They read what is already there.

They check whether the original examiner correctly identified your medical conditions, whether they obtained records from all the doctors you listed, and whether they applied Social Security's medical rules properly. For example, if you have a condition that Social Security recognizes as automatically disabling under certain circumstances, the examiner checks whether the original decision-maker looked for those circumstances in your records.

The examiner also checks whether the original decision followed the legal process: Was the denial letter clear about why you were denied? Did the examiner consider your age, education, and work history? Did they explain their reasoning? If the original examiner skipped steps or did not follow procedure, quality review can send the case back for a new decision.

What happens after quality review makes a decision

Quality review results in one of three outcomes: the original denial is upheld, the case is sent back to the original examiner for reconsideration, or the case is approved.

If quality review upholds the denial, you receive a new letter explaining the decision. At that point, you can request reconsideration (if you have not already) or request a hearing before an administrative law judge. You have 60 days from the quality review decision letter to file either of these appeals.

If quality review finds that the original examiner made an error—such as failing to obtain records from a key doctor or misapplying a medical rule—the case goes back for reconsideration. The original examiner (or a different one) looks at the file again, this time with the error corrected. This is not a may provide of approval, but it means the case gets a fresh look with the mistake fixed.

If quality review finds that you meet the medical criteria for SSDI, your claim is approved. This is rare but does happen when the original decision contained a significant error.

Why most people choose reconsideration instead

Quality review is available, but most people who appeal a denial choose reconsideration instead. The reason is straightforward: reconsideration lets you add new evidence, while quality review does not. If you have gotten new medical records, a new diagnosis, or a statement from your doctor since you applied, reconsideration gives you a chance to submit those. Quality review only looks at what was already in the file when you were denied.

Reconsideration also feels more like a real appeal to most people. You can write a letter explaining why you think the denial was wrong, and a new examiner will consider your argument. Quality review is a compliance check—it is not designed to give you a second chance to make your case.

The approval rate for both processes is low. Most denials are upheld on reconsideration, and most are upheld on quality review as well. If your claim is denied twice, the next step is usually to request a hearing before an administrative law judge, which is where many SSDI cases are ultimately approved.

Frequently Asked Questions

Can I request quality review and reconsideration at the same time?

No. You must choose one or the other. If you request quality review, you are using your first appeal on that path. If quality review upholds the denial, you can then request reconsideration or a hearing. The two processes cannot run in parallel on the same claim.

What if quality review finds an error but still denies me?

If quality review finds that the original examiner made a procedural error—such as not obtaining records—the case goes back for reconsideration with that error corrected. You do not get a new decision from quality review itself; instead, the case is reworked. If you are still denied after that, you can request a hearing.

How long does quality review take?

Quality review typically takes 20 to 30 days, though it can take longer if your file is large or complex. You will receive a decision letter in the mail. There is no phone call or in-person meeting.

If quality review denies me, can I still request a hearing?

Yes. After quality review denies your claim, you have 60 days to request a hearing before an administrative law judge. This is often where cases are reconsidered with more thorough review of medical evidence and your testimony.

Should I request quality review or reconsideration?

If you have new medical evidence or records since your denial, choose reconsideration so you can submit them. If your file is complete and you believe the original examiner made a procedural error, quality review may catch it. Most people choose reconsideration because it gives them more control over what gets reviewed.