In this article, you will learn:
- How long you may have to wait for benefits
- The likelihood of a claim getting approved or denied
When an initial application for disability benefits when it gets filed the bulk of the work in deciding whether you meet the rules for disability is done by your state Disability Determination Services (or DDS). An average claim is going to take somewhere in the range of about six months. If someone who has a very clearly defined condition, a terminal condition, or things like that, it can happen much more quickly. Some conditions can take longer, which I can touch on here in a moment, but in general, the initial claim will be about six months.
If it’s been denied, the first step on appeal is to file a Request for Reconsideration. That goes back to the same DDS office that made the initial determination. It is assigned to a different person to make that decision, but it follows much of the same workflow. If there are medical updates, then the reconsideration process is probably going to follow much the same timeframe as the initial application and may take around 6 months.
If there was no new medical information, DDS may make a quick determination and it could take as little as a month or two for the appeal to be processed. When there is no new medical information to review these reconsideration claims are often denials.
If the claim is denied twice, we get an opportunity to go in front of an actual living human being and talk to them about this disability claim. That person is an Administrative Law Judge. When we file our request for hearing after those first two denials, with most offices it is going to take anywhere from 12 to 18 months to get a hearing date. There are some exceptions that can get things moving a little bit more quickly. When the hearing is scheduled, we get an opportunity to go in and speak with the judge about the merits of the claim, to answer some questions about what’s seen in the medical records, and to have some dialogue about why our client is disabled.
How Often Social Security Disability Claims Are Denied
About a third of the claims are approved initially. In 2019, it was about 37% of cases approved at the initial application. These include cases of terminal illness and very serious medical conditions that are obviously disabling. That means that two-thirds of the claims that are filed are denied initially.
On appeal, at the reconsideration, the allowance rate is much lower. In fact, more than 80% of cases are denied on reconsideration. A lot of that has to do with having paired out all of those cases that we know are terminal cases or case in which the claimant has very serious health conditions that are clearly disabling. This brings us around to the people who are obviously dealing with significant health issues, but still, the question ultimately is how limiting those conditions are, and how to establish these limitations.
When those cases are denied at reconsideration, and we go in front of a judge, this brings in a human element, so there is some variance based on the judge that is involved. But usually, 46% of cases are approved by judges at that point.
If a claim is denied by a judge, we do have an opportunity to appeal once more within Social Security to a panel that reviews judges’ decisions called the Appeals Council. We found in 2021 through 2022, that the appeals council has been relatively quick to issue decisions, taking four to six months for most folks, but their rate of return or remand on these cases is also quite low. Less than 1% of cases appealed to the Appeals Council actually get reversed at this point. About 10% of the appeals get sent back for a new hearing.
For more information on Getting Social Security Disability Benefits, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling (704) 412-4773 today.
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