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Overview of Disability

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Common Mistakes after a Denial

Mental Disability Benefits

Denials for Disability

Appeals for denied claims

Disability Benefits from SSA

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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

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Can you be approved for disability without having to go to a hearing?

You can be approved for disability without having to go to a hearing. The disability hearing is the third level of the Social Security disability process, and while a fairly large percentage of disability applicants must go to a hearing to be approved for disability, it is certainly not the rule. In fact, approximately thirty percent of claimants who file for disability will be approved on their initial claim and will never see a hearing office or an administrative law judge.

The odds of being approved for disability without a hearing

Prior to a disability hearing, a disabled individual may be approved for disability at their initial disability claim or during their reconsideration appeal (the reconsideration is the first appeal). In fact, you have a fairly good chance of being approved for disability benefits prior to a disability hearing.

Though the statistics vary considerably by state, national Social Security approval rates show that approximately that about a third of all disability applicants are approved for disability benefits at their initial disability claim, while another ten to fifteen percent are approved at their reconsideration appeal. Bear in mind, however, that this still means that seventy of claims will be denied at the disability application level and that the odds of being approved at the first appeal level—the request for reconsideration—are fairly low.

Improving the odds of approval when appealing

If you want your disability claim to have a better chance of being approved at your initial disability claim or at your request for reconsideration appeal there are a few things you can do. To improve your chances of approval, you should, if at all possible, have your own medical treatment sources rather than rely on the social security administration to send you to a medical exam (referred to as a consultative exam).

Note: Consultative exams are generally scheduled by a disability examiner when a claimant has not been seen by a doctor for more than three months. The exams are scheduled because SSA actually requires that recent, or current, medical evidence be available in the claimant’s file before they can be determined medically disabled and awarded disability benefits.

Social Security prefers to have a twelve month medical history that contains both past and current (treatment within the past ninety days) medical treatment records to make their medical determinations.

If you can get your treating doctor to complete a statement that includes your diagnosis, prognosis, response to treatment, a description of your limitations and an opinion as to your ability to work, your chance of being approved for disability may dramatically improve. This statement is not equivalent to a short hand-written note from the treating physician and is often referred to as an RFC form or medical source statement.

Social Security guidelines require disability examiners to give heavy weight to the opinions of treating physicians if their opinion is substantiated by objective medical evidence. However, having said this, and speaking as a former disability examiner, I should point out that disability examiners often disregard the opinion of a claimant’s treating physician. Which is unfortunate, but often the case. At a social security hearing, on the other hand, a disability judge, or ALJ (administrative law judge) will be much more likely to take the doctor’s qualified opinion into account and let it influence the outcome of the case. This is provided, of course, that the doctor is a “treating physician”, meaning a doctor who has a history of providing treatment to a patient versus a doctor that a patient has only seen once or twice (such as would be the case involving a quick visit to an urgent care).

When your disability file is lacking in information

If the disability examiner does not have enough current information in the file after gathering records from all the treatment sources listed on the disability application, the disability claim may be decided on the basis of a consultative examination.

Consultative examinations are status examinations performed by doctors or medical professionals (psychologists would be included when the CE, or consultative exam, involves mental testing) paid for by Social Security. Generally, these short examinations do not lead to an approval for disability except in disability cases that involve the most severe conditions.

The importance of describing your work history properly

You should also describe your past jobs thoroughly. Through my experience as a Social Security disability examiner, I found that most disability applicants understate the demands of their employment. Social Security uses a sequential evaluation process based on functional ability rather than specific conditions. In order to be approved for disability you must have a severe impairment (it can be a physical or mental impairment) that prevents you from doing your past work.

This is the reason it is important for you to give a thorough description of your past work as your performed it. If the disability examiner finds that you cannot perform any of your past work they can move to last step of their sequential evaluation process. The last step is an evaluation to determine if you are able to perform other kinds of work with your residual functional capacity (what you are able to do in spite of the limitations of your disabling conditions), education, age, and the transferability of your job skills. If you are found unable to do your past work or any other kind of work, your disability claim may be approved through a medical vocational allowance.

Return to:  Social Security Disability Resource Center, or read answers to Questions

Related pages:

Will a Social Security Judge give You an Immediate Decision at the Disability Hearing?
Basic Facts about the Administrative Law Judge Social Security Disability Hearing
Are the Chances of Winning Disability Benefits Higher at a Social Security Hearing with a Judge?
Winning at a Social Security Disability Hearing
Social Security Disability Hearings - what to expect
What happens when you go to a Social Security disability hearing?
Preparing for a Disability Hearing to Win Social Security or SSI Benefits
Presenting evidence at a social security disability or SSI hearing
How Long Does It Take To Get The Results Of A Disability Hearing?
Do Most People Have To Go To A Disability Hearing in order to Get Approved For Disability?
Can you be approved for disability without having to go to a hearing?
Waiting for a Hearing to be Scheduled before an ALJ, Administrative Law Judge
Vocational expert at a disability hearing - what is this?
Social Security Disability Hearings - What is the ALJ
Denied at disability hearing and filed appeal with appeals council

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