Chances of Winning a Social Security Claim

UPDATE: September 16, 2016 -- Social Security Administration Cuts Hurt Every State The Center on Budget Policy Priorities (CBPP) published a report this week detailing the negative impact of budget cuts on the Social Security Administration (SSA). Since 2010, SSA’s operating budget has been cut by 10 percent, affecting Americans in all 50 states. Budget cuts have led to a steep decrease in the number of SSA employees, field office closures, and a record-high disability backlog. Nationwide, 6 percent of SSA staff have been cut, but some states like West Virginia have lost over 15 percent since 2010. There have also been over 600 field and mobile office closures. Staff cuts have led to declines in service in every state. This is most apparent in the backlog of disability hearing. Disability Determination Service (DDS) staff has shrunk 14 percent nationwide and a struggle to meet the growing demand for services. In 2011 the average wait for a decision was 360 days; this year the wait has stretched to 540 days. Prolonged delays for benefits have had a tremendous human cost, forcing some applicants to foreclose on their homes or declare bankruptcy. “It’s clear that SSA’s diminished operating budget has hurt communities throughout the country,” said Joseph Peters, Jr., Secretary-Treasurer of the Alliance. “Millions of Americans suffer dramatically from case backlogs and falling customer service.” The advocacy group Social Security Works, which is an Alliance partner, also reported on the effects of SSA's administrative budget cuts by state.

Updated May 13, 2015 (I just learned about this today): Google "Padro v. Astrue" -- A class action lawsuit complaining of generalized bias by five Administrative Law Judges (ALJs) in SSA’s Queens, New York hearing office. The court’s approval clears the way for new hearings to be provided to about 4,000 claimants who received unfavorable (or only partially favorable) decisions by these ALJs from January 1, 2008, through October 18, 2013. The settlement provides for the creation of a new, special unit in the Appeals Council that will automatically review all unfavorable and all appealed partial favorable decisions by the five ALJs for a 30-month monitoring period that begins on October 19, 2013. Claimants denied during this period will have their claims assigned to ALJs other than the five if their claims are remanded. More here...

http://www.empirejustice.org/assets/pdf/publications/dap-news/disability-law-news-1.pdf

http://www.socialsecurity.gov/padrosettlement/

http://www.ssa.gov/OP_Home/hallex/I-05/I-5-4-71.html

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Update April 12, 2015 - It appears that all the Republican hyperbole about "easy claims" and "bogus awards" has been having a big affect. Because terminations for disability benefits cancel out "awards" in any given year, and because only 1/3 of all claims were awarded last year, there was only a net gain of 11,934 disabled workers in payment status for disability benefits in 2014 — and that's out of  over 2.5 million claims. Deaths and conversions to regular Social Security retirement benefits account for most of the terminations that occur, because disabled and older people tend to apply for these benefits (not young healthy people who are lying and cheating to get on the government dole.) It's shame that so many people, who probably deserve the benefits, are now being denied. And no — it has nothing at all to do with reducing "fraud". Two studies show there was only 0.4 percent — far less than most other government programs. -- Source: Disabled Workers and Awards in Payment Status

Year	Applications (claims)	Approval Rate	Awards	In Current Payment Status	Terminations
2013	2,640,100	33.51%	884,894	8,942,584	767,738
2014	2,521,459	32.16%	810,973	8,954,518	793,646
YTD Change	-102,641	-1.35%	-73,921	11,934	25,908

* Cut Defense Spending to Save Social Security, or Raise Taxes

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PAST UPDATE: This page gets a lot of views, so I've added my most recent articles on this subject, which are posted at the Economic Populist:

• Republicans want 75 Years of Funding for Social Security
• Is there Fraud in Disability — or in the GOP?
• Why do Republicans Hate Social Security?
• Should Billionaires be Taxed for Social Security?
• The Last Word on Social Security Disability
• Report: Disability Claims and Awards Declined

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UPDATE: AARP FINALLY mentioned the Republican's rule change to defund disability in their newsletter today (1/29/2015) ... BUT ... they didn’t use that as their headline story in their newsletter ...AND.... they used the words “Congress” and “House”, but they never mentioned “Republicans” or “GOP”.

Also notice: Their newsletter first mentions this today, but the ARRP story they link to (buried on their website and was never on their front page) was dated Jan. 7 --- so why did AARP wait so long to mention this in their newsletter? Also notice: In the “old AARP story” that the AARP newsletter links to, there’s also just the mention of “Congress” and the “House”, but no blame was laid on the “Republicans” or the “GOP” – so how would AARP members (and especially Republican voters) know who is undermining their disability?

Other organizations, such as The Alliance for Retired Americans, Social Security Works (and others) came out about this HEADLINE STORY the very next day in their newsletters (and mentioned “REPUBLICANS” or “GOP”). Did AARP only belatedly and “casually” mention this in today’s newsletter because I emailed them last week to complain?

This makes me very suspicious of AARP – and it’s possibly because of AARP’s association with insurance companies that they REFUSE to squarely lay the blame on the GOP (or the Republicans.) Everybody should call AARP out on this --- BECAUSE --- disabled Republican voters should know the truth as to really watching their back (HINT: It's not the Republicans or AARP)

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This is what I found about the chances of winning a SSDI claim from 4 different sources.

Source One: 35% of initial applicants were awarded. Here's the path through the process:

• There's the initial claim (either online or at your local SSA office),
• and two subsequent written appeals if any other claim is denied,
• then there's a hearing before an administrative law judge (ALJ),
• then there's the Appeals Counsel if a claim is denied at the hearing level,
• and lastly, there's federal court.

The highest winning percentage is at the hearing level, which nationally has a winning percentage of 62%, with 25% losing, and the remaining 13% dismissed for one reason or another.

Many cases that are denied at the hearing level appeal to the Appeals Council. Most cases at the Appeals Council are denied at a 74% rate. Almost a quarter of the cases are remanded or approved. A remand is when the case is sent back to the administrative law judge (in most cases the same administrative law judge) and the Remand percentage rate for 2010 was 22%.

Only 2% of the cases at the Appeals Council were completely reversed and won. The last 2% were dismissed for one reason or another.

Of the 83,000 cases appealed to the Appeals Council 12,000 cases were taken to Federal Court. At the Federal Court level also called US District Court, there is a pretty even split. 40% of the cases taken to federal court were denied. 47% of the cases taken to Federal Court were remanded and 4% were approved out right. 9% of cases were dismissed. Keep in mind these are the national average for cases decided in 2010 and although it gives you a good picture these numbers may differ from year to year and depending upon where your case is being decided and by which particular decision maker or ALJ (the hearing judge).

Source Two: Forty-percent of claims were approved at the hearing level if a claimant went to the hearing without the benefit of social security representation, while sixty-two percent of represented claimants were awarded benefits.

Source Three: Very few Appeal Council Review appeals end in an outright approval for disability. Most appeals are denied with a few being remanded back--to the administrative law judge who made the original decision--for review. But even those disability cases that are remanded to the ALJ for review are often denied.

Age will play a role in determining decisions on disability claims but usually comes into play when a person is older, either fitting into the fifty and above age range, or the fifty-five and above age range. These are the points at which age becomes more of a consideration and age can provide a benefit for someone who has relatively more functional limitations and, correspondingly, less education and fewer job skills.

Your level of education does a play a role in the evaluation process used by both the social security disability and SSI disability programs. However, the effect of one's education level is not nearly as much as many people would assume. And there are many cases in which educational level does not even enter into the process.

These cases, of course, are those in which a claimant is approved on the basis of satisfying the requirements of a listing in the blue book (the social security disability list of impairments).

When cases are approved this way, it is because their medical records provide detailed enough information which conforms to the disability approval criteria of a specific listing, such as, for example, lupus or bipolar disorder, or degenerative disc disease.

Source Four: What are my chances of winning at the Appeals Council level? The Social Security Administration reports that on average, this is how Appeals Councils decisions end up:

• 72% of the Requests for Review are denied
• 22.5% of the cases are remanded to an ALJ
• 3% of the cases result in the Appeals Council issuing a new decision,
• and 2.5% of the cases result in a dismissal (because the request for review was not filed by the deadline).

If your case is remanded, you have a good chance of eventually getting awarded partial or full benefits. Keep in mind that more time will have passed since the original ALJ decision, during which your condition may have deteriorated, and you can submit additional evidence at the remand hearing showing how your disability has worsened over time.

In addition, even if your review is denied, you can then take your case to the federal district court level where there is a greater likelihood of getting awarded disability benefits or receiving a remand.

The Appeals Council can also independently decide to review a favorable ALJ decision and then issue a new decision that is partially or fully unfavorable.