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
What kind of Final Decision can I receive on my Disability Application?
How to prove you are disabled
and win disability benefits
Disability Decisions at the Initial Claim and First Appeal Levels
If you have a pending application for disability, or you are waiting on a decision for a request for reconsideration appeal, the decision you receive can only be a disability approval or a disability denial.
In either case, after your medical records and "other evidence" is reviewed (for an adult, this would be information regarding one's work history and normal daily activities, and for a child this would constitute information that substantiates the child's ability or in ability to engage in age-appropriate activities, typically meaning academic, IQ, and achievement records), you will receive written notification of the decision.
If an approval occurs, you will be informed of the amount of your ongoing monthly benefit payments, how much you may receive in back pay, and when your benefits may commence. If a denial of benefits occurs, you will receive some explanation (generally brief) as to why the claim was denied, as well as an explanation of your appeal rights.
How often do approvals and denials occur on disability claims? National statistics have been fairly consistent with regard to approval and denial rates over the past decade. On average, about 30 percent of all disability claims are approved at the disability application level. At the reconsideration level (the first appeal that can be filed, which is also decided by a disability examiner at DDS, or disability determination services), only about 13-15 percent of claims receive an approval.
It goes without saying, of course, that a person who has been denied should immediately file their next available appeal. The social security administration will allow 60 days for the filing of a disability appeal (plus an additional five days added to this for mailing the appeal paperwork); however, it is always best to get an appeal submitted as quickly as possible to eliminate processing time and also to allow a "cushion" in case it is later learned that the appeal paperwork that was submitted was not received by SSA.
Disability Decisions at the Social Security Hearing Level
Decisions on cases that occur at the disability hearing level allow for more variation. If a claimant has had a hearing and the administrative law judge has decided to deny the claim, the claimant will receive an Unfavorable Notice of Decision. This decision will synopsize the evidence that was presented at the hearing and explain the basis for the decision of the judge. If the claim is approved, it may come in the form of a Partially Favorable Decision or a Fully Favorable Decision.
If the disability decision made by a judge is "fully favorable", this will mean that A) the judge has determined that the claimant, via their medical and vocational evidence, has satisfied the social security administration definition of disability (meaning that their condition is severe enough to prevent substantial, gainful work activity for 12 months or longer, or may even result in death) and B) the available medical evidence supports the onset date that has been alleged by the claimant.
The alleged onset date, or AOD, of course, is the date stated by the claimant as to when their condition became severe enough to be disabling. A fully favorable decision by a judge simply means that the judge has concluded that the claimant is, in fact, disabled, and is disabled as of when they claimed on their application for disability (meaning the AOD).
If the decision that is delivered by the judge is "partially favorable", this will mean that the judge has found the claimant to be fully disabled, but that the claimant's condition did not become disabling at the time the claimant has alleged or contended. In such cases, the judge will determine that the claimant's EOD, or established onset date, is later than was claimed.
This will usually make no difference as to when monthly disability benefits will be received; however, a less than fully favorable (i.e. partially favorable) onset date can make a difference in the amount of back pay received. It can also make a difference as to when medicare coverage begins. And this is exactly why, in some cases, a disability attorney may decide to appeal the judge's decision if it has been partially favorable (though, in most cases, it will usually be safer for the claimant to accept the decision as it has been rendered by the judge).
Return to: Social Security Disability Resource Center, or read answers to Questions