Disability Approval Chances at the Social Security Reconsideration and Hearing Levels

In the federal disability system, administered by the social security administration, the first level of disability appeal is called a request for reconsideration. This appeal is sent to the same state disability determination services agency (DDS) that denied the claimant's first application, so it is not surprising that statistics show most people are not awarded benefits as a result of filing a reconsideration appeal.

Also, because reconsideration appeals are decided based on the exact same guidelines used to deny the initial disability application, it is unlikely that a claimant will get a different result unless he or she has new, persuasive medical information to add to the record. And generally this does not occur because the time distance between a decision on a disability application and a disability reconsideration tends to be fairly short (sometimes just a few weeks, and usually, at most, a handful of months).

Even though reconsideration appeals are decided by a different disability examiner than the one that reviewed the application, unless there is some significant medical evidence that documents a change or worsening in the claimant's medical condition, or gross error on the part of the first disability examiner, the chance of winning a reconsideration disability appeal is pretty slim. Currently about 81% of all reconsideration appeals are denied.

However, at the second level of appeal, a disability hearing, claimants stand a better chance of approval. Over 61% of all people who file second appeals and who are represented are approved for disability benefits.

This indicates three things: 1) DDS denies a lot of claims that are actually valid; 2) federal Administrative Law Judges (ALJs) are more likely to approve disability applications than the disability examiners employed by DDS; 3) having someone research the background of the case, gather additional evidence, and present an argument for the approval of the claim can make a substantial difference in the outcome.

Typically, most people who file for Social Security Disability (SSD) or SSI must appeal not once, but twice before they are approved. Most claimants do not bother to see their claim through to the end, though. According to one estimate, of the 2 million plus people who apply for disability, only 500,000 actually go through with a hearing.

Why is the number of appeals so low? Well, many claimants are not aware that being denied Social Security once is not the final word on collecting benefits. They do not realize that about 70% of all applicants are initially denied, or that so many reconsideration appeals are denied as well. And many probably just get worn down by the whole process'it can take years to appear before an ALJ (administrative law judge) because there are so many cases clogging the disability system at every level.

On the bright side, those who file a reconsideration appeal, get denied on this appeal, and then go on to pursue a Social Security Disability hearing have a very good chance of winning an SSA disability appeal. Statistically, the odds of approval are simply in favor of claimants who A) do not give up on their claims, and B) utilize the appeal system provided by socials security.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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