Skip to main content

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.

Comments

Post a Comment

Popular posts from this blog

WHAT YOU WILL BE ASKED AT A DISABILITY HEARING

Most Social Security disability claims will be denied twice:  First at the end of the Application process, and again after the "Reconsideration" process.  The third stop will be a hearing before a federal Administrative Law Judge (ALJ). It is here at the hearing level that most SSDI claims are paid.  So, what do you need to know about your Social Security disability hearing?     First, the judge will follow the rules established by the Social Security Administration.  His or her job is to determine whether you meet the particular laws and rules to receive disability payments.  So, it is a legal proceeding where you must prove certain things in order to get paid. Among the things you must prove:  Your insured status with Social Security:  You have worked recently enough and paid into the Social Security trust fund to gain the required "work credits" to support your claim.  You have a severe medical or mental impairment supported by adequa...
Post a Comment
Read more

CAN YOU WIN YOUR DISABILITY APPEAL WITHOUT A LAWYER?

The Social Security Administration does not require you to have a lawyer to file an appeal or to appear at a hearing.  However, most people heading for a disability hearing will hire a lawyer or advocate to help them.   Studies have shown that you are about twice as likely to win with a lawyer.  A recent study found that claimants with no lawyer win about 30 percent of the time while claimants with a lawyer or advocate win 60 percent of the time.   " He just cooked his own goose." These statistics cover only one aspect of a disability appear--your odds of winning. The other important aspects are time and convenience. If you prepare and adjudicate your own disability appeal, expect to spend 12 to 24 months working on the case.  You will be collecting, reading and submitting hundreds or thousands of pages of medical records.  These records are complex and often difficult to understand.  And you must know how each medical record helps (or hurts) your dis...
Post a Comment
Read more

RED FLAGS IN SOCIAL SECURITY DISABILITY CASES

  RED FLAGS IN A SOCIAL SECURITY DISABILITY CASE A red flag is something that causes concern or raises a problem in a Social Security disability case.   In short, it’s something that may get the claim denied or cause a big problem. Here are some of the red flags that we see crop up: ·          Work after the alleged onset date (AOD).   Since the process takes so long, many claimants feel that they are forced to return to work for income.   Social Security often sees this as a sign that the claimant is not disabled. ·          Severe substance abuse.   Chronic and frequent abuse of drugs or alcohol can pose problems. ·           A skimpy work record.   A claimant who has worked very little or has jumped from job to job frequently may not have good credibility. ·          Quitting wo...
Post a Comment
Read more