What Is Social Security Ruling (SSR) 91-5p?

In a nutshell, SSR 91-5p can be used to extend a claimant’s deadline to appeal an adverse decision based on what the Social Security Administration (SSA) considers “good cause.” According to the SSA, a tardy request for review will not automatically result in a dismissal of the appeal; if the claimant can present evidence that mental incapacity prevented him or her from understanding the review process, that claimant’s appeal will be given appropriate consideration.

Provided the claimant can satisfy the “good cause” requirement with sufficient evidence of mental incapacity at the time of the prior administrative action, his or her request for review will be granted, no matter how much time has passed since that action was taken.

Any evidence of mental incapacity that the claimant presents when requesting a review of a decision after the deadline to do so has passed must be what the SSA considers “good cause” in order for SSR 91-5p to take effect. The following factors will determine whether or not the claimant’s request will be considered; these factors must have existed at the time of the prior administrative action:

-Illiteracy

-Insufficient education

-Poor grasp of the English language

-Any physical or mental impairment that affects the claimant’s autonomy

Any reasonable doubt that arises surrounding these factors will be resolved in the claimant’s favor.  Note that SSR 91-5p only treats prior applications with unappealed denials as still pending if good cause exists, but does not reopen a prior application.