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How to file for disability, Filing for SSI
Disability Requirements, Disability Status
How long is the wait?, Disability Application
The Social Security List of Impairments
Qualifying for Disability, Mental Disability
Disability Lawyer Info, Disability Back Pay

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.








Essential Questions

What is the Social Security Disability SSI list of impairments?

Can you work while getting or applying for Disability?

How Often Does Social Security Approve Disability The First Time You Apply?

Tips for getting Social Security Disability or SSI benefits approved

What medical conditions will get you approved for disability?

What kind of Mental Problems Qualify for Disability?

Receiving a Disability Award Letter

Conditions Social Security will recognize as a disability

Previously answered questions regarding SSD and SSI

Applying for disability in your state



Most popular topics on SSDRC.com

Social Security Disability SSI Questions

The listings, list of disabling impairments

Can a mental illness qualify you for disability?

Disability Lawyers prevent unnecessary denials

How much Social Security Disability SSI back pay?

How to apply for disability for a child or children

Filing a Social Security Disability SSI application

Filing for disability - when to file

How to apply for disability - where to apply

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How to Prove you are disabled and Win your Disability Benefits

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Related pages:

How long after court will I know anything about my disability?
How do you get your doctor to help your disability claim?
Can you get a quick disability decision?
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)
Getting a Disability Lawyer in Pennsylvania
If you apply for disability in Pennsylvania
Will I qualify for disability Benefits in Pennsylvania?


These pages answer some of the most basic questions for individuals who are considering filing a claim.

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

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?









For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.