Social Security Disability Resource Center
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Why is Almost Every Person Automatically Denied the First Time They File for Disability?
In actuality, this is not the case. However, when you consider the fact that more than 70 percent of all new disability claims are denied, and the fact that more than 80 percent of all first appeals are denied (this is the reconsideration appeal), then it becomes easy enough to understand why people believe this to be the case.
It becomes particularly difficult for people to understand the high rates of denial for SSD (social security disability) and SSI (supplemental security income disability) cases when either their cases involve:
A) limitation of reflexes, strength, or movement,
C) a cognitive issue (such as memory loss),
D) a condition that involves exacerbation and remission--meaning it gets worse, then better, then worse again--such as fibromyalgia or lupus,
E) when they have a longstanding problem with an an affective disorder illness (e.g. bipolar disorder) or an anxiety-related disorder.
For the individual who has a condition that has either prevented them from working and earning a livable wage, or a condition that has worsened to this point, receiving a denial on a claim probably seems nonsensical.
Is every person automatically denied the first time they file for disability? No, but the odds are against you when you file a claim. And if you need to file your first appeal, the request for reconsideration, the rate of denial is so high that it might as well be automatic.
The actual question to ask is probably, "Why is it that the social security administration denies so many claims in the first place?". Some might think this question to be a relative waste of time. After all, not everyone can be approved for disability benefits, just as not everyone can be satisfactorily treated for a medical condition.
However, the question has merit because of this one fact: for those who are denied disability benefits and then choose to appeal all the way to the level of a disability hearing before an administrative law judge, the chances of approval are good. In fact, roughly 60 percent of these individuals, if they have able representation, will be approved by a judge despite the fact that they were previously denied at the initial claim and reconsideration levels.
So, why is it that a claim can be approved by a judge, but denied by a disability claims examiner at the lower levels of the system? There really isn't a single answer. However, let's point out how the levels are different from each other.
At the disability application and reconsideration appeal levels, claims are decided by disability examiners. These individuals are conceptually similar to insurance adjusters for insurance companies. They work in bureaucratic settings and follow the lead of their supervisors and agency managers. They make decisions on claims but have to answer to enough individuals that, truly, their decisions are not really independent in any sense. They also make decisions in a way that does not involve the significant participation of the claimant or even the claimant's disability representative.
At the disability hearing level, the administrative law judge is the single decision maker and, effectively, answers to no one. True, there is an appeal level, the appeals council, that reviews the decisions of disability judges, but it is debatable as to whether or not this body has any real effect on the adjudicative behavior of judges who work in the field.
Basically, judges, unlike disability examiners, make their own decisions without the influence of supervisors, managers, and without the bureaucratic leanings of an entire agency (such as the north carolina DDS, or disability determination services).
Furthermore, judges operate on a level that allows for far greater participation by both the claimant and the claimant's disability lawyer or non attorney representative. In fact, the judge's ability to reach a more developed opinion of a claimant's case is enhanced by the work that is done by a disability representative who may gather additional medical evidence from treatment sources, opinions from doctors, and additional information regarding a claimant's work history.
Added to that is the fact that at the hearing level the attorney will actually appear with the claimant before the decision-maker (the judge) and make a presentation of the case that includes advocacy for a favorable outcome which is supported by evidence in the claimant's file.
Social Security Disability and SSI Resource Center
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Social Security Disability list of impairments
Social Security Disability Application
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The Most Basic questions about Getting Disability Benefits
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Common Mistakes to avoid after being denied for Disability
Social Security Disability SSI Questions and Answers
More Social Security Disability SSI Questions and Answers
Common Questions about Social Security Disability and SSI
Winning Social Security Disability or SSI Benefits
The SSI Disability Benefits Program
Medical exams for disability claims
Applying for Disability in various states
Social Security Disability SSI and Doctors - Yours and Theirs
Social Security Disability and SSI Claim Reviews
Social Security Disability SSI System and Benefits for Children
Denials, Appeals, and Getting a Disability Lawyer or Representative
What you should know about Social Security Disability and SSI Denials
Questions about Disability Lawyers and Hiring a Disability Attorney
Frequently asked questions about getting Denied for Disability Benefits
FAQ on Disability Claim Representation
Disability hearings before Judges
Selecting and hiring Disability Lawyers
Various Types of Benefits including SSI, Mental, and Child benefits
Social Security and SSI based on Mental Disability
Social Security Disability or SSI Benefits for Children
Disability Benefits through Social Security
Filing for Social Security Disability or SSI Benefits
Social Security Disability SSI: Medical Evidence and Records
Filing your claim for disability benefits
Eligibility for receiving disability benefits
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
Resources on this site
Social Security Disability, SSI Terms and Definitions
Previously answered questions regarding SSD and SSI
About the Author of SSDRC, Tim Moore
For Individuals living in North Carolina
Applying for Disability in North Carolina
North Carolina Disability Lawyer
Do You Get Disability Benefits From The First Time You Applied?
Does Social Security turn down every disability case the first time?
How Often Does Social Security Approve Disability The First Time You Apply?
How Many Times Will Social Security Deny You before You Get Approved for disability?
Can a disability attorney speed up my case?
Tips for Social Security Disability Psychological and mental testing
How Long does a Social Security Disability Determination take After Seeing the Psychologist?
Social Security Disability Mental Psychological Exam and Questions that get Asked
Does social security deny strong disability claims?
Social Security Disability is different from VA disability
Why are you denied the first time you are denied for disability?
What Happens To Social Security Disability Benefits After Divorce?
Can I do What I want with my Social Security Back Pay?
How much information should you put on a disability application?
What disability claimants get angry about - Part I
Social Security and not getting the medical records
Social Security Disability will sometimes order X-rays but never an MRI
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