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Recent Questions

SSDRC Disability Blog

How does SSA determine if a claim will be a denial or an approval?




 
Someone recently submitted the following question which is paraphrased here: How does SSA determine a denial or an approval? If you have a condition that is on their list of medical conditions, why does it still have to be decided on? Why is there a 90% denial rate?

There are two ways of getting approved. One is by satisfying a listing. This means that a person would have a condition in the listings manual and also that their medical records would satisfy the approval requirements of the listing. So,its not enough to just have a condition that is in the listings. You have to meet the criteria as well.

The other way of getting approved is a medical vocational allowance. This is where a disability examiner or a judge will review the medical records and the work history of an adult claimant to see what their past work demands were, what their skills are, and what kinds of mental and/or physical limitations they might have as a result of their condition or conditions.

To get approved this way, it would have to be shown that the person cannot go back to their past work and cannot also switch to some type of other work. This is usually how a person gets approved for disability benefits.

As for disability applications, currently the national average for denials is about 77 percent. Very high. However, it has been at least 70 percent for at least the last 20 years. Meaning the system has always been hard.

A high percentage of people who are denied and decide to file appeals, at least as far as to the level of a hearing, will be approved. So, that basically shows that there are large flaws in the system if so many individuals are initially denied but are later approved after having to endure very long waits and appeals.

It also means that anyone filing for disability should prepare to file appeals and not give up on their claim because the long-range chances of winning are actually not bad.








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








Related pages:

How long does it take to be approved for disability?
How does a person get approved for disability benefits
How Often Does Social Security Approve Disability The First Time You Apply?
What is the process for approving a Social Security disability claim?
How does SSA determine if a claim will be a denial or an approval?
Do you have to quit your job before filing for disability?
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Disability at age 50 or older
Social Security Disability SSI and proving you can't work
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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 provide answers to basic questions about pursuing disability benefits

How to file for disability, filing tips
What to Prove to Qualify for Disability Benefits
Applying for disability benefits, SSI and SSDI
What Disabilities Qualify for SSI and Social Security Disability?
Will you get disability back pay?
Social Security Disability And SSI Qualifications
Permanent Disability Qualifications for SSD and SSI
Social Security Disability SSI status
Disability lawyer representation, finding lawyers
Who will qualify for disability and what qualifying is based on
Qualifications for Disability Benefits
Important points about filing for disability
How long does it take to get disability after applying?
Am I Eligible For Social Security Disability?
Who is eligible for SSI disability?
How to get disability in Florida