Odds of disability approval in Illinois are better at a hearing vs reconsideration
Statistically, it is a sobering fact that if your claim for Social Security Disability or SSI was denied at the disability application level (also known as the initial claim level), it will probably be denied at the reconsideration level.
In fact, national statistics indicate that about 85 percent of all reconsideration appeals are denied.
Why is this the case? It's a good question, particularly when it is true that claimants who appear at a disability hearing, and are represented by a disability lawyer, have about a sixty percent chance of being approved for benefits---this, despite the fact that they were previously denied at the first two levels of the system.
Obviously, there is a disconnect between the reconsideration appeal in Illinois and the disability hearing appeal. And that disconnect probably has a lot to do with this fact: administrative law judges who conduct disability hearings are removed from the DDS system.
For those who aren't aware, DDS stands for disability determination services.
DDS is the state level agency that decides SSDI (Social Security Disability insurance) and SSI (supplemental security income) claims for the social security adminisration. It is at DDS that examiners (I used to be one of them) work on disability claims, by gathering, reading, and evaluating medical evidence, consulting with doctors, and then approving or denying claims.
Each state has a DDS, but in some states the agency is known by a different name such bureau of disability determination or disability determination division or disability determination unit. No matter what the agency is called, however, it performs the same functions in every state.
One of those functions is to conduct the first appeal open to disability claimants. This is known as the request for reconsideration. Who works on a reconsideration appeal? Just as with disability applications, examiners work on them. And this is part of the problem. The same agency that delivers the decision on an initial claim also works on making the determination for the claimant's first appeal.
Even a blind man could see this reality: if a large number of cases were approved by DDS at the reconsideration level, then it would essentially equate to the agency admitting the denial that was issued on the disability application was, in fact, a mistake.
The simple fact is, disability reconsiderations are overwhelmingly denied because the same agency is involved on both disability applications and reconsiderations. And, thus, it is not surprising at all that judges, who are not connected to DDS, make significantly more approvals on SSD and SSI cases.
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11. After a disability hearing, what happens?
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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