What are the chances of winning disability benefits through an appeal?
There are no statistics to reveal exactly what the chances of winning disability through an appeal actually are. However, as you appeal your claim through the Social Security Disability and SSI process your chance of winning disability benefits may improve.
The first appeal level is a reconsideration appeal. Basically, the reconsideration appeal involves a review of the initial disability determination. The only difference between this level and the disability application is that the reconsideration is sent to a different disability examiner for a decision. All of the same guidelines are used for the decision and there is very little flexibility.
If the first disability examiner made no errors according to Social Security Disability guidelines, there is very little chance that the reconsideration appeal will result in winning your disability benefits. In fact, the reconsideration appeal has an approval rate of only ten to fifteen percent.
At this point it is important not be become discouraged. Your reconsideration appeal denial clears the way for an administrative law judge disability hearing appeal. Unlike the reconsideration appeal, the hearing appeal offers you the best chance of winning your disability benefits.
The national disability hearing approval rate is about sixty-five percent, which is very high considering that about ten percent of administrative law judge hearing appeals are dismissed for reasons other than denial.
The reason so many disability applicants win their disability benefits at a hearing is there is more flexibility with regard to the criteria used to establish disability. Administrative law judges are not bound by the same rigid disability determination criteria that disability examiners have to use for their disability determinations.
An administrative law judge can take many other things into consideration when making their decision. And, while they basically adhere to disability guidelines established in the Social Security Disability handbook and vocational guidelines, they use their own judgment and interpretation to make their disability determination. Because of this flexibility in their decision making process, many disability applicants win their disability benefits at this appeal level.
There are two other levels of appeal after an administrative law judge disability hearing. If your disability hearing is denied, you can appeal their decision with an Appeal Council Review request.
In the past, you were allowed to file an Appeals Council Review appeal and file a new disability claim at the same time. The reason for this was that most often Appeal Council Reviews do not lead to an approval for disability. However, Social Security has recently changed their regulations making disability applicants chose one or the other. At this juncture, you or your representative will have to determine which of these options offers you the best chance of winning your disability benefits.
Overall, the chances of winning your disability benefits through an appeal are fairly good. The trick to winning disability through an appeal is to make sure you appeal all denials and that you file your appeals timely.
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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