What are the odds of a judge giving you a disability denial?

The odds of being approved for disability or denied for disability by an administrative law judge will vary depending on several factors. One of those is the judge. Some ALJs have higher rates of approval than others and some ALJs are notorious when it comes to how many claims (including solid claims with substantial medical evidence) they turn down. Unfortunately, there is little a claimant, or a claimant's attorney can do about the judge that is assigned to their case.

However, what can be done is this: presenting a claim before the administrative law judge in a prepared and professional manner. This means having familiarity with the facts of the case (including records that were previously submitted and the basis for prior denials), having an acute understanding of how Social Security Disability and SSI claims are decided, and having provided whatever additional medical record documentation is required for the hearing.

Doubtless, some federal disability judges are apt to take a dim view of claimants who show up poorly prepared for their own disability hearings.

Another factor that will affect the outcome of a case will simply be the strength of the case itself. What determines how strong a case is? The medical records that constitute the evidence for the case. Unfortunately, in many cases, the records will be weak because they will fail to establish the claimant's physical or mental limitations (medical records tend to lack detail when it comes to delineating a person's functional capacity).

One way to get around this, of course, will be for the claimant (in actuality, usually the claimant's social security attorney) to obtain a supporting statement from their treating physician, i.e. a doctor who has some history of providing medical treatment to them and who is therefore qualified to comment on their prognosis and limitations.

What are the actual odds of receiving a disability denial from a judge at a disability hearing. Recent statistics indicate that, for all types of cases and all ages of claimants, more than sixty percent of hearings result in an approval of disability benefits.

However, children's cases tend to be denied more heavily than adult cases (children often have conditions, such as asthma and seizure disorder, which improve as they get older), so we can likely conclude that adults will have a better than sixty percent chance of winning benefits.

Furthermore, it is an established fact that claimants who go to hearings represented by counsel are more likely to win disability benefits as well. To some small extent, this may be because judges give more credence to cases in which the claimant has obtained representation.

However, the higher win rates for represented claims probably have much more to do with the simple fact that a claim involving an experienced social security attorney will be more likely to be properly prepared, meaning that the attorney will have spent time analyzing the case, the factors leading to the case being denied at earlier levels, and obtaining additional medical evidence, including medical source statements from the claimant's treating physician (or treating physicians if the claimant has multiple doctors).

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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