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ODDS OF WINNING A SOCIAL SECURITY DISABILITY APPEAL

The chance of winning a Social Security Disability (SSD) appeal varies significantly by stage, with approval rates being very low at the reconsideration (around 15%) and Appeals Council (about 1% for direct approval) stages, but the odds improve at the Administrative Law Judge (ALJ) hearing level (around 45-50%). 

 Having legal representation can nearly triple your chances of winning at the ALJ level, and documenting functional limitations thoroughly is crucial for success at all stages.
 

Here are the 3 Levels of Appeal within the Social Security Administration

"Reconsideration" - the first level of appeal.  Your claim goes back to the state agency that denied it for review by a different evaluator.  The odds of approval here are no more than 10 percent, very poor.  This is a required appeal before other action may be taken.

Hearing by an Administrative Law Judge (ALJ).  Judges hold hearings on cases denied at the "reconsideration" level.  The national approval rate for hearings are between 45 and 50 percent--the best chance in the entire system.  Legal representation, while not required, is indispensable at the hearing stage because an experienced lawyer of disability advocate will understand the language, requirements and proceeding--and will know how to obtain and offer evidence at the hearing.

Appeals Council (AC) Review.  The AC may review cases denied by Administrative Law Judges (ALJs). Here again, you have very poor odds.  The AC does not hold hearings and neither the claimant or representative appears.  This is a paper review only.  The odds that the AC will directly overturn an ALJ's denial are less than 5 percent.  In about 15 percent of cases, the AC will remand (return) the case to the original Administrative Law Judge for further action, including perhaps a new hearing. In over 80 percent of cases, the AC will not take any action and the ALJ's decision becomes the final decision.

Note:  If denied at the AC level, a claimant may file a lawsuit against the Commissioner of Social Security in Federal District Court (FDC).  Here, too, the odds of reversal and approval are low (no more than 15 percent) and you must have a lawyer for FDC.  A case in FDC may involve significant expense.

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