Overview of Disability
Disability Back Pay
Requirements for Disability
Applications for disability
Tips and Advice for Disability Claims
How long does Disability take?
Winning Disability Benefits
Common Mistakes after a Denial
Mental Disability Benefits
Denials for Disability
Appeals for denied claims
Disability Benefits from SSA
Child Disability Benefits
Qualifications and How to Qualify
Working and Disability
Disability Awards and Notices
Disability Lawyers, Hiring Attorneys
Social Security List of Conditions
What Social Security considers disabling
Medical Evidence and Disability
Filing for Disability Benefits
Eligibility for Disability Benefits
SSD SSI Definitions
SSDRC authored by Tim Moore
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If You Get Denied For Disability Should You appeal Or file A New Claim?
I think most would agree that it is much more to a disability applicant’s advantage to file an appeal of their disability denial than it is to file another new initial disability claim. If you consider that about sixty to sixty-five percent of all initial disability claims are denied (depending on the state in which you live: despite the fact that social security disability and SSI are federal programs, approval and denial rates differ from state to state), that should tell you a lot about your chances if you continue to file new initial disability claims.
It would stand to reason, that your chances of being approved on a new initial disability claim are not any better than your first initial disability claim. Your new disability claim will go to the same state disability agency and it will most likely receive the same decision, the only difference being that the decision will be made by a different disability examiner.
Your chances of winning your disability benefits are not much better on your reconsideration appeal (the request for reconsideration is the first appeal in the SSA appeal system). About eighty-five percent of all reconsideration appeals are denied; basically for the same reason that new initial disability claims are denied.
The reason being: state disability examiners make the decisions on both initial disability claims and reconsideration appeals, and they are bound by very strict rules set forth in the blue book, officially titled “Disability Evaluation Under Social Security”. Disability examiners use this disability handbook, along with vocational guidelines to make all of their medical decisions, and they have very little leeway in making their medical determinations.
So now you may be thinking "Well why is the appeal process better than filing a new claim since only about fifteen percent of all disability applicants are approved at the reconsideration appeal level?". Well, reconsideration appeals are just the next step on the path to an administrative law judge hearing.
If your claim is denied at the disability application level, your goal should really be to get your case heard by a federal administrative law judge at a social security hearing. However, ALJ hearings can only be requested and scheduled after a claimant has gone through the first appeal step (the request for reconsideration).
Why are judges at hearings more likely to approve claims? Administrative law judges approve more than sixty percent of all cases that they adjudicate when the claimant is represented by either a disability attorney or a non-attorney disability representative (the ALJ approval rate falls to about forty percent for unrepresented claimants). Therefore, it stands on its face that the hearing level is the most favorable as compared to the initial claim and reconsideration levels.
As to why judges are more likely to approve claims, however, there are several explanations.
To begin with, administrative law judges have much more freedom than disability examiners when making their medical determinations. Although both administrative law judges and disability examiners use all the same disability tools to make their determinations, judges are able to use their own judgment when deciding cases without interference.
In stark contrast to this, disability examiners must not only confer with physicians and psychologists in their case processing units, but must often yield their judgement to their unit supervisors (who often try to hold down the number of approvals being issued because approved claims are more likely to be reviewed by an external quality control branch known as DQB, which stands for the disability quality branch).
In short, disability judges make decisions as they see fit, based on the medical evidence before them and the arguments presented by the claimant or the claimant's disability attorney; whereas disability examiners are influenced by the agency in which they work to hold down the number of disability claim approvals.
Return to: Social Security Disability Resource Center, or read answers to Questions
How to Appeal a disability claim denial from Social Security
Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits
What is a Social Security Disability Denial based on?
Are there ways to avoid being denied for SSI or social security disability?
What does a Disability Denial Letter from Social Security say?
Reconsideration of a Social Security Disability denial- what does it involve?
What to do if you receive notification of a Social Security Disability or SSI claim denial
If you receive a Social Security Disability Denial quickly does that mean the case is weak?
What happens if my SSI or Social Security Disability Application is denied?
Social Security Disability Denied — The Reasons Why (medical denials)
Information on the following topics can be found here: Social Security Disability Questions and in these subsections:
Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI
These pages answer some of the most basic questions for individuals who are considering filing a claim.
Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria