Why is it So Hard to Win Social Security Disability Benefits?

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Clients often ask me why it is so hard for them to get Social Security benefits or SSI based on disability. The simple answer is that the system is strapped for cash. Since 2003, there has been a 29% increase in Americans with little or no work experience getting disability payments. By 2016, the Social Security-administered program that pays disability will probably have no money left.

Other factors that contribute to the rise in Social Security claims based on disability are: the Great Recession; aging baby boomers; and medical advances for our military veterans (according to the VA, soldiers are ten times as likely to survive today’s wars, but they frequently return with severe injuries and PTSD). Also, the many welfare reforms of the 1990s have resulted in pushing more people into the Social Security system with little work history.

Given the rise in Social Security claims for disability, and the dwindling trust fund, the system is therefore designed to make it very difficult for an individual to quickly receive benefits. At the initial application level, about 70% of claims are denied. Some of these claims are meritless. However, it is not uncommon for a person with a long work history and a truly disabling medical condition to get wrongly denied at the initial level. Unfortunately, that individual has even less of a chance of winning benefits on their first appeal, which is called a Request for Reconsideration. On average, about 80% of all Requests for Reconsideration are denied by Social Security.

At this point, the typical Social Security claimant is downright discouraged. About six to eight months have passed, and their situation has gone from bad to worse. The medical bills are piling up, and their health coverage may have ceased altogether. He or she may have to file bankruptcy, face foreclosure or eviction, drain a retirement savings account, and/or move in with a family member. The claimant is between a rock and a hard place: either continue to lose everything while awaiting a Social Security hearing, or attempt to work once again even though they know that they cannot sustain regular employment.

At this point many claimants give up the fight and don’t pursue a second appeal, known as a Request for Hearing. Don’t make that mistake. In fact, it is at the hearing level that a person has the best chance at winning their Social Security benefits. It usually takes between 12 to 18 months to get a hearing before a Social Security judge. In Hartford, Connecticut, the wait is currently about 12 months. Nationwide, a person has about a 46% shot at winning benefits at the hearing level. In Connecticut, the average grant rate is 51%. At the Office of Disability Adjudication and Review in Hartford, CT, the grant rate is currently 47%.

Unfortunately, not all Social Security Administrative Law Judges are cut from the same cloth. For example, in the same hearing office, one judge may have a mere 18% grant rate, while another judge will have an 80% grant rate. Once you find out the name of the judge assigned to your case, you can visit www.disabilityjudges.com to find out his or her grant rate. Most Social Security judges attempt to fairly assess the medical evidence, and therefore grant rates usually fall in the 40% to 60% range.

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