The approval rate is much higher at the disability hearing level than at any other stage of the application or appeals process. That is according to an extensive analysis of disability claims filed between 1997 and 2004. That means your chances of winning disability benefits are higher at a Social Security hearing with a judge.
This study, published online by the Social Security Administration (SSA), revealed an approval rate of around 78 percent at the hearing level. Meanwhile, around 45 percent of applicants have their initial applications approved, and 14 percent receive benefits after a reconsideration appeal.
What Happens at Each Stage of the Application and Appeals Process?
The Initial Application
When you become disabled and believe you might qualify for benefits, you start by filling out an initial application. The application is extensive and asks for information like:
- Basic identifying information;
- Your medical history and current disabling condition;
- Your work history going back 15 years; and
- Your education and job skills.
Along with your application, you must submit supporting documents, such as your medical history, doctor’s notes, statements from managers and coworkers, and anything else that can strengthen your case.
The SSA reviews your application, judging it against the organization’s medical requirements and non-medical requirements. You must qualify on a medical basis, meaning the SSA believes you are totally disabled and your condition prevents you from working. You also must qualify on a non-medical basis, meaning your work history is sufficient, and you have paid enough into Social Security via payroll taxes.
A disability examiner from the SSA will review your initial application. How long it takes to get a decision for disability varies, but you will usually hear back within three to five months. The SSA makes no guarantees, and the process sometimes takes longer.
If the SSA denies your initial application, you receive a notification in the mail letting you know you were not approved and explaining what the denial was based on. At this point, you have the option to appeal the SSA’s decision through a request for reconsideration.
The Request for Reconsideration
Following a denial of your initial application, you file a formal appeal with the SSA. This request for reconsideration asks for a second review, this time by a different disability examiner. However, because the second disability examiner uses the same criteria as the first to review your application, chances are good that they will come to the same decision. This is likely why the approval rate at the request for reconsideration stage is so low.
If you receive a denial on a reconsideration appeal, you have the option to move on to the third stage of the application process: a hearing in front of an ALJ.
The ALJ Hearing
At this stage, you meet face to face with an ALJ with sole decision-making power on your application. You can have an attorney at all stages of the disability process, especially during the ALJ hearing.
When you arrive at the hearing, the ALJ will have reviewed your complete file but also will consider additional evidence and testimony. Your lawyer can argue on your behalf and explain why you should qualify for benefits.
Why Do Applicants Have More Success at an ALJ Hearing?
The SSA has not released specific information or reasoning as to why the approval rate is so much higher at ALJ hearings than at other stages in the process. However, there are several possible reasons why the odds of a judge giving you a disability denial are lower at this point in the process.
A Worsening Medical Condition
In many cases, several months or even a year or longer might pass between the initial application and the ALJ hearing. The applicant’s condition might have worsened during that time. It is possible that the applicant’s medical condition was not severe enough to qualify when they first filed a claim, but it does qualify by the time they get to the ALJ stage.
Better Access to Information
ALJs can be more holistic in their evaluation of your claim. They can ask specific questions and receive clarification in certain areas. Disability examiners, by contrast, must base their decision on a file instead of a face-to-face conversation. They may not fully understand your condition and how it affects you.
How Can I Talk to a Disability Lawyer About My Appeal?
The Social Security Disability attorneys at the Disability Advantage Group, want to help you win the benefits you deserve. To schedule a free consultation to have all your questions answered and your claim evaluated, call 865-566-0800 today.