Social Security Disability, SSI Decisions. What Is the Rate of Approval?
The approval rate for Social Security Disability and SSI decisions varies from state to state as well as between the levels of the Social Security Disability process. The average national rate of approval for initial disability claims is 36 percent. This means about sixty four percent of all initial disability claims are denied.
Disability claimants are allowed to appeal their denial through a reconsideration appeal, or, more formally, a "request for reconsideration". The reconsideration appeal level has the lowest approval rate of all Social Security Disability case levels with a national average of only 13.8 percent.
This is mostly due to the fact that reconsideration appeals are sent back to the same state disability agency for a decision (the social security act specified that states would establish separate agenices to handle the act of disability determination for the social security administration and these agencies are known as DDS, or disability determination services).
The only difference between a "recon" and a disability application is that the reconsideration appeal is sent to a different disability examiner for review. If the initial disability examiner did not make an error according to the rules and Social Security SSI guidelines there is very little likelihood that another disability examiner will overturn their decision.
Whatever the reason, reconsideration appeals are most often looked upon as a step to the next (and, statistically, most winnable) level of the Social Security Disability process. If a disability claimant's reconsideration appeal is denied, they can appeal that decision to an ALJ, or administrative law judge.
The ALJ is the decision-maker for all cases that proceed to the social security hearing level. Hearings are conducted at federal hearing offices that were formally (and more logically) known as OHA, or the office of hearings and appeals. Currently, the hearings office goes by the title of ODAR, the office of disability adjudication and review.
The disability hearing level has the highest approval rate with a national average approval rate of 62 percent. This is an extremely high approval rate considering that 13 percent of the remaining hearing appeals were dismissed for other reasons other than a denial. That makes the disability hearing appeal denial rate about 25 percent.
If a disability claimant is denied at an administrative law judge hearing, they can appeal their denial to the Appeals Council, however the approval rate for Appeals Council review appeals is only about 13 percent.
Finally, if a disability claimant's disability case is denied through the Appeals Council, they can still appeal their decision to federal court. National statistics indicate that approximately 40 percent of disability cases taken to federal court are approved.
National statistics also indicate that the rate of approval for Social Security Disability decisions can vary greatly between states. While Social Security has a uniform disability process throughout the nation, individuals who make disability decisions are still "interpreting" medical, vocational, and disability guidelines and this interpretation is often subject to viewpoints that varies from state to state, or even from case processing unit to case processing unit within a state's DDS agency.
For example, Hawaii has the highest approval rate of about 52 percent for initial disability claim decisions, while Mississippi has the lowest initial disability claim approval rate of about 24 percent.
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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