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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

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,

B) pain,

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,

or

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.








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

Qualifications for disability benefits

How to Prove you are disabled and Win your Disability Benefits

Qualifying for Disability - The Process

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Getting disability for fibromyalgia

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What is the Application Process for Social Security Disability and SSI?

Common Mistakes to avoid after being denied for Disability

Social Security Disability SSI Exam tips

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Related pages:

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?
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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








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.