Should we start with the good news or the bad? The chances are that if you are coming across this post, you are in one of three situations. And you are curious about your chances of getting your Social Security Claim Approved. These three situations being…
You are considering a filing a claim for social security ( SSI or SSDI).
Or, you have filed and wanted to know your chances.
Or maybe, you have been denied and wondering if you should appeal.
The Bad News
Let’s start with the bad news. The Social Security appeal process is long, frustrating, and overly complicated at the best of times. Unfortunately, we are most certainly not in the best of times right now.
Part of the reason for the long wait is a record number of claims awaiting appeal hearings. One might argue this is because claims themselves are at an all-time high. Another might say the ~70% initial denial rate reflects a system that doesn’t work except for those willing AND able to stick through it to the end.
In fact, the list of reasons why this process doesn’t work is too long to discuss in this format. But we can discuss the best and clearest way to even the tables and ensure the best possible chance of getting a successfully granted claim or appeal.
The Good News
The good news is, the best thing you can do to set yourself up for a successful claim also helps you to answer question #3 above.
Question: “Should you appeal?”
Wayne Gretzky once said, “you miss 100% of the shots you don’t take.” You would be amazed at how true this is in Social Security, let me demonstrate.
You can see from the graph/data below; you have at best a 50/50 chance of getting your Social Security Claim Approved at any part of the claims process. In most cases, your chances are significantly smaller. But with each stage, some are approved, which means, the averages move too.
At this point, it appears that your chances at any place in the process of getting your Social Security Claim Approved are pretty small. But there is some light at the end of the tunnel. Let’s look at this data a slightly different way. Assume there are two pools. A red pool of denials and a blue pool of approvals.
At the initial application stage, approximately 70% are denied outright. So, 30% of applicants, getting what they sought are in the approval pool, and 70% are in the denial pool.
Denials vs. Approvals at the Initial Application Stage
Upon reconsideration, another 10% of the 70% that are still in denials is added to the Social Security Claim Approved pool.
Denials vs. Approvals at the Initial Reconsideration Stage
The pools are getting closer in size.
This next step is where things actually turn upside down. Depending on where you live, and the ALJ’s your approval rate at the appeal hearing will vary. For instance, in Spokane, the ALJ award rate is around 60%. In comparison, in Seattle, the award rate is about 44%. Let’s take the mean and say you have a 50/50 chance at this point. You see that for those who have stuck with their claim this far, the chances are better than not of being granted their claims.
Another Way to Look at It
Let’s consider a similar situation. You have a six-sided die, you roll a 6, and you are awarded, you roll a 1 through 5, and you are denied. You have three rolls to be awarded; we’ll call these rolls:
The Initial Claim roll, the Reconsideration roll, and the Appeal roll.
On the initial claim roll, you have a (1 in 6) 17% chance of getting a 6.
For the reconsideration roll, you have a 1 in 6 chance again, but your chances of having rolled a 6 in one of two rolls at this point come out to 31%.
And on the appeal roll, you have another 1 in 6 chance. However, you are rolling a 3rd time, so your chances of having rolled a six by the end of this roll are growing. You now have a 42% chance of having rolled a 6 by the end of this turn.
Conclusion: Stay in the Fight!
Do you see how it makes a difference to remain in the fight?! Staying in the claim through the appeals process is possibly the most significant aspect of your claim associated with a positive outcome.
Of course, the problem with numbers is they don’t do justice to the human story behind these decisions. Every denial is emotionally taxing and draining on those who have been denied. It’s not easy to fight Uncle Sam; it’s daunting and scary. It’s also, often difficult to pursue a claim that can take years to finish.
These reasons are all predicated on you bringing in the help that is experienced and successful. This help means retaining an excellent Social Security Disability law firm. Help that both drastically improves your chances of success at each stage and ensures your claim stays alive as long as possible.