Even if you know you have a serious disability that prevents you from working, your claim for Social Security Disability benefits may still be denied. There are many reasons for the disapproval of disability claims, such as insufficient information or supporting documents with your application, or that the Social Security Administration (SSA) believes your disability is not one that qualifies for benefits. Many find this process frustrating and difficult on their own and ultimately decide to hire a Social Security disability lawyer on a contingency fee basis.
No matter what the reason for your disability denial, the good news is that the initial denial is far from a final decision. There are many opportunities to appeal a denial, and many appeals are successful. This is especially true if you seek help from a highly experienced Social Security disability lawyer as soon as you receive a denial.
A lawyer can help you with the four different levels of appeals, which include:
- Filing a Request for Reconsideration
- Requesting a hearing in front of an Administrative Law Judge (ALJ)
- Request a review by the Appeals Council
- Filing a lawsuit in federal court
The Success of Disability Appeals
In 2016, about 35.4 percent of all Social Security disability benefits claims were approved at the initial application stage, also called the initial adjudicative stage. This means that just about 65 percent of applicants did not receive awards right out of the gate. Not everyone appeals their initial denial, as some people may realize their claim was a long shot, while others are unsure of their right to appeal or the appeals process. This is only one of many reasons why you should always consult with a disability appeals law firm.
Those that do wish to appeal will request a reconsideration of their application. At the reconsideration stage in 2016, 41,139 awards resulted from 445,260 requests, meaning only 9.2 percent of reconsiderations were successful. The success rate is often low at this stage of the appeals process because your claim is being reviewed by the same agency that denied your claim in the first place. Even though a different examiner will handle the reconsideration, the likelihood is low that they will overturn the denial unless the initial examiner made an obvious error.
One of the most successful stages of the appeals process is the ALJ hearing. The same year as above, 12,535 decisions were made at ALJ disability hearings, with 5,826 approvals, which comes out to an approval rate of 46.5 percent. While the number of hearings is not as high as reconsiderations, a higher percentage of appellants are successful.
Fewer people still decide to continue pursuing disability benefits after an ALJ hearing and with varying success. Statistics indicate that the Appeals Council approves only 13 percent of cases reviewed, while those who file lawsuits in federal district court may have up to a 40 percent chance of prevailing.
At the end of 2016, there were 578,780 final approvals and 575,381 final denials after exhausting all appeals. Even with four different levels of appeals, just over 50 percent of applicants ended up with benefits. The average percentage of approvals can also vary widely from state to state, especially at each stage of appeals. For example, Hawaii and Utah have the highest approval rates at ALJ hearings, while Alaska and Kansas have – by far – the lowest hearing approval rates. Many factors go into the success of a disability appeal.
Most Common Reasons for Denials
Even though we can look at statistics and percentages to get an idea of approval rates, you are never guaranteed an approval just because a certain number of others received benefits. For this reason, you always want to put your strongest case forward, and this can happen with the assistance of a skilled SSDI lawyer.
It is always important to recognize the common reasons for a denial to help you avoid a denial for that very same reason. Of the 575,381 final denials in 2016, the following reasons were given:
- 41.1 percent because the applicant was found to be able to do other types of work
- 24.1 percent because they determined that the impairment was not severe
- 10.6 percent because the applicant was found to be able to continue their past usual work
- 4.8 percent because the impairment was not expected to or did not last for at least 12 months
- 19.5 percent for other undisclosed reasons
An experienced attorney can help you through the Social Security disability appeals process and present the strongest possible case, so you have the best chance at overturning an initial denial.