Wednesday, May 31, 2006

Are you automatically denied for Social Security Disability or SSI when you first apply with an initial application ?

I've probably heard a hundred variations of this granule of commonly accepted wisdom regarding social security disability and SSI. Generally, the comments go something like this:

"Well, I expected they would deny me since they always do the first time"

"I know they never approve you on your first application, that's why you have to keep filing over and over until you get it"

"Is there a rule where they have to turn you down first before they can approve you?"

Point of fact: there is no SSA rule that dictates that title II (social security disability) or title 16 (SSI, or supplemental security income) disability claims must be denied on the first application, or X number of times before a claim can eventually be approved.

Why has this become folklore? Because so many cases do get denied at the intial application level. According to federal statistics, in 2003 about 63 percent of all initial claims were turned down. That, of course, is a national statistic which is an average. In some states, denial rates were 70 percent and over for that year. In fact, in the state of Mississippi, in 2003, nearly 73 percent of initial claims were denied.

Accentuating this myth, certainly, is the fact that claimants who filed their first appeal (now called a reconsideration, in future years to be called a review) were denied at even higher rates (yes, denial rates on first appeals are generally higher across the country).

Nonetheless, it is not standard operational procedure for disability claims to be turned down at the initial application level, or at any level. It is simply a depressing reality of the SSA disability system.

The thing to keep in mind is this: if you are filing for social security disability or SSI, you stand, on average, about a 30 percent chance of being approved on your initial claim. If you are denied on your initial claim, you should definitely file an appeal. Your first appeal, however, will stand an 80-85 percent chance of being denied. But, if your pursue your claim to the point where you can have your case presented to an administrative law judge at a disability hearing, you will a much better chance of being approved for benefits.

1. Without representation, you will have a better than 40% chance of being approved.

2. With attorney or non attorney representation, you will have a better than 60% chance of being approved.

So, if your claim is denied, it does not mean that your claim is without merit and it does not mean that you will never receive disability benefits. What it will mean, though, is that you will be more likely to win your claim if you follow the appeals process and, at some point, obtain qualified representation.

Return to the Social Security Disability SSI Benefits Blog

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