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

A DISABILITY DENIAL IS NOT THE END OF YOUR CASE

By Charles W. Forsythe The Forsythe Firm Social Security denies a lot of applications.  It's expected.  But it's not the end. The good news is:  You can probably win your case on appeal and get paid benefits.  It just takes a bit longer. About 8 out of 10 new disability claims will be routinely denied.  So, it's rather unusual to be approved just by filing an application. An appeal sounds like a last resort or tricky legal maneuver.  It's really quite common--almost  normal--in a Social Security disability case. 8 out 10 claims will be appealed at least once, often twice, before they are paid. The process that pays Social Security disability is not the application, it's the appeal process. Many claimants who don't understand the importance of appeals give up after the first denial.  A serious mistake.  You odds get better in appeals. TIME LIMIT ON APPEALS .  All unfavorable Social Security decisions must be appealed within 60 days ....
Post a Comment
Read more

HOW TO PASS A SOCIAL SECURITY DISABILITY EXAM

  So, Social Security is sending you to one of their doctors for an exam.  The first thing you may ask is, How do I pass this exam?   First, I should say that Social Security exams are not "pass or fail."  The doctor or examiner cannot tell Social Security whether or not you are disabled or whether you should get a benefit.  The doctor is going to check certain facts. For example, the doctor may check the range of motion in your joints and list the measurements. They may check your grip strength. (S)he may determine if you have difficulty walking, squatting, kneeling standing from a seated position.  The examiner may answer specific questions asked by Social Security: Is the use of a cane or assistive device medically necessary? Why is it necessary? Can the claimant use his/her hands to grasp and hold objects? Is the claimant able to understand and follow simple directions?  Here is advice I give my clients for a Social Security examination:  ...
Post a Comment
Read more

IF I CHANGE ATTORNEYS WILL IT DELAY MY DISABILITY CASE?

No.  Getting a new attorney will NOT delay your pending Social Security disability claim or appeal .  Your new attorney "inherits" the case and picks up where the other attorney left off.  There is no re-filing or starting over, so your case is not set back or delayed at all.  Social Security maintains an electronic folder stored in its system.  This folder contains every document ever submitted concerning your claim or appeal.  Your new lawyer may log into your electronic files and see, in real time, all the evidence and other documents in your file. While we do not recommend changing attorneys while your case is pending a decision, it is sometimes necessary.  You may need a new lawyer if your attorney dies, retires or  becomes disabled before your case is settled.  You may choose a new attorney without delaying or causing any set back to your case. If you are considering obtaining a lawyer to handle your Social Security disability case in...
Post a Comment
Read more