Social Security Disability Resource Center
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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.
Social Security Disability and SSI Resource Center
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Social Security Disability Requirements
Social Security Disability list of impairments
Social Security Disability Application
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How much income can you earn on Social Security disability?
If you get denied at a disability hearing, can you win later?
How much can an attorney charge for Social Security disability?
Can you get approved for disability based on Ulcerative Colitis?
The Most Basic questions about Getting Disability Benefits
Social Security Disability SSI and whether or not you can work
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
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.
How to file for disability, SSD or SSI
How to file for Disability and what medical conditions qualify
How long will it take to get disability?
What if your disability gets denied?
How to Prove you are disabled and qualify to win disability benefits
How to get disability with a mental condition
How long for Social Security Disability Back pay
Social Security Disability SSI eligibility