Social Security Disability Insurance (SSDI) is a government program that is supposed to provide financial support to anyone who is unable to work because they have become permanently disabled due to an illness or injury. To qualify for SSDI benefits you have to file a disability claim with the Social Security Administration (SSA) and your claim must be approved.
Each year the SSA received over 2 million claims for disability benefits. The odds of getting a claim approved are not very good. Only about 35% of all SSDI claims are ultimately approved and only 30% of disability applications are approved at the initial stage. In some cases, disability claims are properly denied because the applicant is not truly disabled and simply does not meet the eligibility requirements. In many other cases, however, claims are denied for technical reasons which usually involves an incomplete application or insufficient medical documentation.
Chances of Disability Claim Success at Each Level
Below we will look at the chances of getting a claim for disability benefits approved at the 3 levels or stages of the SSDI application process.
LEVEL 1: Initial Application Level
The first level or stage in the SSA disability claim process is the initial application level. Getting approved at the initial application level means that you submit a disability claim form to the SSA and that claim is approved without any further appeal. Unfortunately, the chances of getting a disability claim approved at this initial application stage are very low.
Only about 30 percent of all SSDI claims are approved at the initial application level. This means that 7 out of every 10 disability claims are initially denied by the SSA. The 30% of claims that do get approval at the initial application stage are usually those claims that fall into one of the SSA’s list of presumptive impairments. These are usually claimants who have clear and obvious disabilities where there is no question about their ability to work.
LEVEL 2: Reconsideration Stage
The second level in the SSA disability claim application process is called the reconsideration stage. When a claim is denied after the initial application, the claimant can request a reconsideration of the denial. Reconsideration simply involves having a different individual claims examiner at SSA take another look at your application and the original denial. The new claims examiner can then see if anything should be change and issue a new decision.
The chances of success at the claim reconsideration level are extremely low. Only 13% of SSDI claim denials are reversed on reconsideration. So if you have a 1 out of 10 chance of getting approved on reconsideration. What can be even more frustrating is that the reconsideration stage often takes months and there is no clear time frame or deadline for when the decision will be made.
LEVEL 3: Hearing Stage
The third level of appeal in a disability claim (after an unsuccessful reconsideration stage) is known as the hearing stage. In the hearing stage, the SSDI claim is fully reviewed by an Administrative Law Judge (ALJ) who makes an independent determination as to whether the claimant qualifies for benefits.
The hearing stage offers the highest changes of success for disability claims. Around 47% of all claims are successful at the hearing level. The chances of success at this stage are even higher for claimants who are represented by an attorney.
Improve Your Chances of Getting Approved at All Levels
There are several things that you can do to improve your chances of winning your Social Security disability claim. Moreover, following these steps may also help to expedite your application.
- Make Sure You Application is Complete
The first and most important thing you can do to ensure that your SSDI claim has a good chance of success (and gets processed quickly) is to make absolutely sure that every part of the SSA application form is fully complete. This includes not just providing all of the information required in the claim form, but also ensuring that all of the required medical documentation is provided.
The SSA website provides guidance and a very helpful application checklist that can be printed out. Make sure you do everything on this list and leave nothing blank or incomplete. Single mistake or omission on the form will usually result in a preliminary denial.
Be prepared to provide detailed information about your medical conditions, treatments that you have received, hospitals or clinics that you have visited, and the names of your healthcare providers. You will also need to give information about your educational background and training, as well as your employment history.
- Follow Up on the Status of Your Claim
It is not enough to simply submit a complete disability claim form to the SSA and simply wait for a response. One of the keys to a successful claim is being proactive. The SSA deals with literally millions of disability claims each year so if you want your claim to get moved along and increase the chances of it being approved, you will need to get SSA to pay attention to it.
After you submit your claim, you should make a habit of regularly contacting the SSA to inquire about the status. You should also keep a log of all your claims including the date, time, person you talked to and the content of the conversation. Keeping in touch with SSA will not only help your claim move along, but it will help to ensure that you are aware of any deadlines and don’t miss anything.
- Follow up on all Treatment Recommendations
You need to make sure that you follow all treatment recommendations made by your doctor, including taking medications as prescribed, attending all medical appointments, and following any other advice. Going to all of your scheduled appointments is the most important thing. Attending appointments will strengthen your disability claim by increasing the volume of medical records and evidence in the file.
The Social Security Administration wants to see that you are doing everything you can to improve your condition. If you stray from your prescribed treatment, your disability claim could be denied.
- Appeal All Denials of Your Claim
One of the most important things you can do to increase your chances of getting your disability claim approved is to always file and pursue an appeal if your claim is denied. There are 2 levels of appeal for SSDI claims.