Social Security Disability RC

How to file for disability, Filing for SSI
Disability Requirements, Disability Status
How long is the wait?, Disability Application
Social Security Disability list of impairments
How to Qualify for Disability, Mental Disability
Disability Lawyers FAQ, Disability Back Pay

Appealing a Social Security Disability or SSI Denial with a Disability Hearing Before an ALJ (Administrative Law Judge)



 
Though denial rates differ by state, on average about seventy percent of all applications for disability will be denied by SSA (the social security administration). An even higher percentage of first appeals (this is the request for reconsideration) will be denied as well: up to eighty-seven percent according to recent statistics.

Even so, most claimants who have been denied on their SSD or SSI case would be well-advised to file an appeal instead of simply giving up and letting their claim lapse. This is because at the second level of appeal, the disability hearing (where the decision-maker is not a disability examiner, but, instead, a federal administrative law judge who specializes in adjudicating disability claims), more than 60 percent of all cases will be approved for benefits.

Why are disability hearings more effective than the first two levels for allowing claimants to win their benefits? There are several reasons for this:

1. The disability hearing allows both the claimant and their chosen representative, such as a disability lawyer, to offer a presentation of facts of the case, the medical evidence involved, as well as a theory of the case (i.e. an argument as to why the facts merit an approval). At the lower levels of the system, there is no such involvement of the claimant or their attorney.



2. The hearing process is non-adversarial. The claimant may appear with their representative; however, the social security administration does not have opposing council and the judge does not represent the interests of SSA. This fact alone may go far in answering why it is that most cases that have been denied by disability examiners are later approved by administrative law judges who are not required to answer to any level of management at the social security administration.

3. Administrative law judges give proper consideration to the opinions of treating physicians. A treating physician is social security's term for a doctor who has a history of providing medical treatment to a claimant. As such, the doctor is expected to have some familiarity with the claimant's condition and response to treatment, thus making them capable of offering an opinion on the claimant's prognosis and current functional abilities as well as functional limitations.

As disability judges see things, the opinion of the treating physician holds enough weight that an approval can be made on the basis of it. And this is a logical position since a treating physician has actually provided medical treatment to the claimant. At the lower levels of the system, however, the opinion of the treating physician is not given the proper consideration.

And, in fact, even when claimants submit detailed letters from their doctors to a disability examiner working on a disability application or reconsideration appeal, it will very often be overlooked. This may be because the disability examiner works, in his or her processing unit, with a unit medical consultant (an M.D.) whose job is to review the disability examiner's assessment of the case and provide their own opinion of the claimant's functional limitations.

Administrative law judges at disability hearings, however, do not place the opinion of a doctor who has never treated or even seen the claimant (the disability examiner's unit medical consultant) above that of the doctor who does have a history of providing medical treatment to the claimant (the treating physician). And this fact, probably more than any other, is what sets the disability hearing appeal far apart from the earlier levels of the system where the great majority of claims are denied by disability examiners.








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



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Social Security Disability SSI Questions

The listings, list of disabling impairments

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Disability Lawyers prevent unnecessary denials

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How to apply for disability for a child or children

Filing a Social Security Disability SSI application

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Related pages:

How to Appeal a disability claim denial from Social Security
Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits
What is a Social Security Disability Denial based on?
Are there ways to avoid being denied for SSI or Social Security Disability?
What does a Disability Denial Letter from Social Security say?
Reconsideration of a Social Security Disability denial- what does it involve?
What to do if you receive notification of a Social Security Disability or SSI claim denial
If you receive a Social Security Disability Denial quickly does that mean the case is weak?
What happens if my SSI or Social Security Disability Application is denied?
Social Security Disability Denied The Reasons Why (medical denials)
Will I qualify for Social Security Disability SSI in California
Getting a Social Security Disability SSI Attorney in California
How long do disability claims take in California and why



These pages answer some of the most basic questions for individuals who are considering filing a claim.

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?

What happens if I file a disability application and it is denied by a disability examiner or Judge?









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.