Every year the Social Security Administration (SSA) releases its statistics regarding approvals and denials of disability claims. They recently released the 2014 disability statistics. Some of the percentages show almost a rubber stamp denial of claims. But these numbers are not much different from 2013. The chart shows the average allowance, denial, or dismissal percentage for each stage in the Social Security disability (SSD) claims process. It simply confirms how difficult it is to be approved for disability benefits.
There are five potential stages in the SSD claims process. The first stage is filing an initial application. This can be done in three ways, either online, over the phone, or in person. I generally suggest filing your application online. This way you have time to think about your answers, you can step away from the computer if needed, and you will have a time-stamped copy of when your application was submitted. The average time frame for a decision to be made at the initial application stage is 3-5 months. As you can tell from the chart above, the approval rating is a mere 32%. Two-thirds of claims are denied at this initial stage.
There are several reasons why the approval rate is so low at the initial application stage. In 2014 there were almost three million applications for disability. Of those three million how many were actual legitimate claims? Without speaking to an experienced Social Security disability attorney prior to filing an application most people have no idea whether their situation actually qualifies them for SSD or not. People generally apply because they have lost their job, they’ve heard a friend or neighbor has applied for SSD and they figure why not, it’s worth a shot right? Other people may have a legitimate claim for SSD benefits but they have not met the 12-month durational requirement yet. Meaning, their condition hasn’t prevented them from working for 12 months or it is not expected to last for 12 months. Whatever the reason, the approval rate at the initial stage is fairly low.
If you receive a denial the next step in the process is to file a reconsideration application. This simply means you are appealing to SSA’s denial of your initial application. Just because you received a denial letter does not mean that you are not disabled. Many people become discouraged and give up after the first denial.
The approval rate at the second stage is even lower…at a measly 11%. This percentage is down significantly from prior years when it was around 18%. At the reconsideration stage, you are simply asking SSA to take another look at your case. They will continue to develop your case for medical evidence and consider whether they made a mistake with their first decision. With such a low approval percentage you can practically expect you will need to go to the next stage and attend a hearing.
Request a Hearing:
The third stage in the process is requesting a hearing in front of an administrative law judge. Hearings are generally reserved for cases that aren’t quite so cut and dry. Meaning, an approval isn’t obviously explained based on the medical records alone. At the hearing, the individual must explain his situation, and usually, a judge requires additional expert testimony from a vocational expert and/or medical expert to assist in determining your ability to work. In 2014, at the hearing stage, the approval rating was 45%. You generally have a slightly less than 50-50 chance of winning your disability claim at this stage. If you don’t already have an attorney helping you with your case you should hire one before the hearing. Choosing the right attorney can significantly increase your chances of winning at this stage. You’ve already waited so long for a favorable decision, don’t you want to put forward the best case possible?
Of course, hiring an attorney doesn’t guarantee approval. If you are part of the 36% of claims that are denied at the third stage, you have the option to appeal the judge’s decision to the Appeals Council. The Appeals Council (AC) is an agency of Social Security that will review a judge’s decision for legal errors. The AC will not review every single case. They will simply review a case if there has been some type of legal error. If you are appealing for a factual reason or based on the judge’s interpretation, the AC will most likely refuse to hear the appeal. I recommend you follow the advice of your attorney at this point. The AC is akin to a black hole. It takes approximately 18 months before your case is even reached and chances are the AC will deny review of your case. In 2014 the Appeals Council declined review of 81% of appeals. However, all hope is not lost at this point.
Federal District Court:
If you continue to fight for your claim the next step would be filing a civil action in Federal District Court. You are allowed to appear pro se in District Court but I strongly recommend against it. Once in District Court, you can continue to appeal the case all the way up to the Supreme Court. As you can imagine the time frames for this process are extremely lengthy. Approximately 43% of claims filed in District Court were remanded for new hearings. This is more favorable than the Appeals Council numbers. Unfortunately, to get past the AC level and into District Court you are looking at approximately three years post administrative hearing. Most people aren’t able to hold on for that length of time.
In sum, applying for Social Security disability benefits is no easy task. If you are not one of the lucky 32 percenters approved at the initial stage, your claim will require a considerable length of time. My best advice when filing for Social Security disability benefits is to find an attorney who is experienced in this area of law, someone who you trust. This way you are placing yourself in the best possible “fighting” position from the very beginning. Don’t waste time trying to figure out this complicated process on your own. Save yourself the stress and seek out someone who knows how to navigate this process.