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YOUR CHANCES OF WINNING A SOCIAL SECURITY DISABILITY CASE (AT VARIOUS LEVELS)

 

Chances of Social Security Disability Approval at the “Initial Application” Level.  At the first (called “Initial Application”) level, only about 30 percent of all claims are approved.

Those that are approved are usually for claimants who meet a “Listing” (check out the SSA’s “Listing of Impairments”) or who are so clearly and obviously disabled (for instance, those in a coma or rendered quadriplegics from accidents) that there is no question they cannot work.

This leaves roughly 70 percent of the original 2 million (or about 1.4 million) claims rejected at the Initial Application level.

Chances of Social Security Disability Approval at the “Reconsideration” Level

The second step in the SSA’s process is called “Reconsideration.”

At this step, a different Claim Examiner at the state’s Disability Determination Services (“DDS”) office reviews the work of the Examiner who reviewed the case at the Initial Application stage to see if anything was missed or of if the decision should be changed for other reasons.

On average, the chance of approval at the Reconsideration level is only 13 percent.

This means that only in 13 percent of the cases that are originally denied, DDS reverses the denial into an approval. The rest are denied a second time.

It is very frustrating for claimants at the Reconsideration stage because they have very little control over the time it takes to get through this stage (generally several months) or the result.  Other than attending any doctor examinations or other appointments the SSA asks you to attend and making sure DDS has all your medical records, the Reconsideration stage simply involves waiting.

Chances of Social Security Disability Approval at the “Hearing” Level

If your case is denied at the Reconsideration level, the next (third) step is to request a hearing before an Administrative Law Judge (“ALJ”). At this level (known as the “Hearing Level”), the odds of success go up significantly.

Nationally, about 47 percent of all cases at the Hearing Level are won by claimants.

Bear in mind, this percentage is for ALL claimants whether or not they were represented by a lawyer at the Hearing Level. Studies have shown that claimants who are represented by a lawyer at this level have a better statistical chance of receiving benefits.

>>DID YOU KNOW? In fact, research shows that only 34 percent of those who do not hire an attorney are ultimately approved for disability benefits, but 60 percent of those who do hire an attorney are ultimately approved.

This leaves over half of the claimants who asked for a hearing before an ALJ without benefits. However, you have a better chance of being approved at the Hearing than at any other stage in the entire process.

Chances of Social Security Disability Approval at the “Appeals Council” Level

Some of these claimants believe the ALJ did not decide their case properly or fairly. Many of them appeal their ALJ denial up to the next level – the Appeals Council.

This Council is comprised of a number of Administrative Appeals Judges (“AAJ”) and staff whose job it is to review decisions of the ALJ’s to see if any mistakes were made. However, the odds that they will do that are low. Even though the Appeals Council has the power to reverse a denial by an ALJ, they rarely do this (statistically, only about 1 percent of the time).

However, the Appeals Council also has the power to send a case back to the ALJ who decided it to correct any errors they might believe were made. The Appeals Council does this about 9 percent of the time.  Sending a denied case back to the ALJ for further review is called a "remand."

So, essentially 90 percent of the time, the Appeals Council approves the ALJ’s denial of benefits.

It's important to know that your absolute BEST chance of being approved, statistically, is with a hearing before an Administrative Law Judge.   Compared to all other phases in the entire process, your odds are better at a hearing.  Take your case to a judge and give yourself the best chance of being approved.  The process to get before a judge is intentionally long and tedious.  Get an experienced advocate/lawyer to help you and get before a judge.

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