SSDRC authored by Tim Moore
Social Security Disability and SSI Questions and Answers
What is the Application Process for Social Security Disability and SSI?
How do you Win Benefits under Social Security Disability or SSI?
If I am determined disabled, how far back will Social Security pay benefits?
How do you prove your disability case if you have a mental condition?
What Can I Do to Improve My Chances of Winning Disability Benefits
Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits
How to File for Disability - Tips for Filing
If You Get Approved For SSDI Will You Also Get Medicare?
How much does a Social Security disability attorney get paid?
Social Security Disability SSI Criteria and the Evaluation Process
How long does it take to be approved for SSI or Social Security disability?
What do you Need to Prove to Qualify for Disability Benefits?
Social Security Disability SSI and Fibromyalgia
Social Security Disability SSI and Degenerative Disc Disease
Can I Qualify For Disability and Receive Benefits based on Depression?
More questions about SSD and SSI
What Disabilities Qualify for SSI and Social Security Disability Benefits?
Social Security Disability Status
Social Security Disability Tips — how a claim gets worked on
Social Security Disability, SSI Disability - Terms, Definitions, Concepts
If You Get Denied For Disability Should You appeal Or file A New Claim?
How to prove you are disabled
and win disability benefits
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: SSDRC, or the Social Security Disability Questions page