disabled man with attorney

Disability Decisions: Understanding the Levels of Review and the Likelihood of Getting Approved

By Michelle Shvarts
Principal Attorney

As you wade through the initial Social Security disability benefits application, the last thing you probably want to hear is that the road ahead may very well be a long one. The 2022 statistics on Social Security disability benefits dial and approval ratings tell the story of just how difficult it can be to get your claim approved. In this article, we’ll use the figures as the basis for a conversation about the claims process and why an attorney can make all the difference.

Levels of Review and the Likelihood of Getting Approved

In 2022, 38% of initial benefit applications were allowed and 62% were denied. Yes, the vast majority of claims at the initial application level were unsuccessful. After an initial denial, you have the right to file a request for reconsideration, which is a complete review of your claim. The reconsiderations are conducted by a medical consultant and claims examiner at Disability Determination Services (DDS) who were not involved in the initial decision made on your application.

During reconsideration, evidence submitted in your application as well as any new evidence submitted or obtained by DDS will be taken into consideration. It is, therefore, unlikely that your claims decision will change at all and even less likely if no new evidence has been taken into consideration. It will come as no surprise then, that approval rates at the reconsideration level are pretty bleak. In 2022, only 15% of reconsidered applications were allowed and 85% were denied.

However, do not despair! The second level of appealing a Social Security disability benefits claim denial, which is the Administrative Law Judge (ALJ) hearing level, has a much greater success rate. In 2022, 51% of claims were allowed at this level, 11% were dismissed and 39% were denied. ALJ hearings are conducted by attorneys working for the Social Security Administration’s Office of Hearings Operations and it is a wonderful opportunity to present your case right before a real, live human being. Preparation and dedicated legal counsel can make all the difference at this integral level of appeal.

If you are unsuccessful at the ALJ hearing level, you may be able to proceed to the next level of appeal which is the Appeals Council level. The council randomly selects cases for review and can even dismiss a case without review unless it finds something like an abuse of discretion or error of law by the ALJ. You must file a request with the Appeals Council in order to officially exhaust all of your appeal avenues if you wish to bring your claim to the final appeal level by bringing a lawsuit in federal court. To be realistic, only 1% of applications were allowed at the appeals council and federal court appeals level. The vast majority of claim applications were dismissed, denied, or remanded.

If you file a lawsuit in federal court, it will be heard in the U.S. District Court before a federal judge. Disability cases take place without juries and the judge is supposed to review your case only for legal errors. Many judges, however, end up ruling on factual issues as well.

Los Angeles Social Security Disability Attorney

Success in your disability application is possible although the road may be longer than you initially hoped for or anticipated. Know that having dedicated legal counsel by your side at every stage of appeal can greatly increase your chances of success as they know what the claims reviewers are looking for and what your application needs to be successful. Talk to the team at Disability Advocates about what needs to be done to increase your chances of successfully getting access to benefits. Contact us today.

About the Author
Ms. Shvarts is the managing attorney for Disability Advocates Group. She opened Disability Advocates Group to assist individuals who became disabled and unable to work to obtain the benefits they need and deserve.  Ms. Shvarts and the rest of the team at Disability Advocates Group are dedicated to assisting individuals obtain Social Security Disability Benefits (SSDI) and Supplemental Security Income (SSI) benefits.