Jun 10, 2017

They Call This The Waterfall Chart

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anonymous said...

To all the attorneys - please note that a significant majority [75% give or take] of those granted are done so at the con and recon levels. I hear people say that 'everyone is turned down twice' - the truth is that everyone the rep. sees has been turned down twice, but most people are granted before ODAR.

So it might help the claimant to get all the evidence in early so the DDS can review it. Bringing it to the hearing is very bad for the system as a few do.

Anonymous said...

Isn't that a rather large increase at reconsideration? As I recall, a few years back, recon was around 3% allowance.

Anonymous said...

9:32, you are incorrect.

Allowance rate at recon for all the years I could find waterfall charts:
2008 14%
2009 14%
2010 13%
2011 12%
2012 12%
2013 11%
2014 11%
2015 12%
2016 12%

I am concerned about the 20% hearing level dismissal rate in 2016, which is way higher than years past. Some of this is claimants dying before the hearing. A bit may be people recovering or going back to work. All those things are more likely as wait times increase. But I would guess a bunch of folks tried updating their addresses with SSA and it never made it into all the computer systems SSA patches together. Within that pool of nearly 100,000 dismissals are undoubtedly a lot of people who had they made it to their hearings would have been found disabled--but their disabilities made it really hard for them to navigate the process over such a long period of time.

Anonymous said...

The thing that stuck out for me was the 49% remand rate by Federal Courts. What a joke the AC is!

Athena said...

11:40, that's about 6.5% of AC denials. A joke, really?

Anonymous said...

at 11:40, yes, it is a joke. your 6.5% is utilizing the roughly 9000 remands by federal compared to the 113,000 decisions by the A/C. that comment would actually make sense IF ALL of the A/C denials appealed to federal court, which they clearly do not. we can't assume that the ones not taken to federal would have been denied. some reps don't do federal cases and the clients simply file a new claim. I'd be willing to bet the unrepresented claimants at the HRG level VERY rarely file a civil suit.

what is more telling is the fact that almost 20% of denials at the HRG level are remanded at either the A/C or by the federal court.

Anonymous said...


49% of claims appealed to federal court are reversed. They fact that a small portion of claimants are able to obtain representation, or proceed pro se, at federal court does not excuse the Appeals Council's abject failure to remand claims prior to court intervention.

Anonymous said...

See the SSAB website for allowance data:


Anonymous said...

@9:23PM: "49% of claims appealed to federal court are reversed. They fact that a small portion of claimants are able to obtain representation, or proceed pro se, at federal court does not excuse the Appeals Council's abject failure to remand claims prior to court intervention."

This is inaccurate. 2% of AC denials are actually reversed on the merits, meaning the federal court found the claimant disabled despite the Agency's finding of not disabled. The 49% remands mostly represent omissions or articulation errors where the ALJ didn't address a medical opinion, didn't articulate credibility factors, didn't articulate an adequate basis for RFC, etc., and AC let it go, most probably because they ultimately agreed claimant is not disabled. Does not necessarily mean the claimants are disabled or will be found disabled on remand, although certainly some ALJs may be more inclined to pay once they've received a federal court remand, to easily dispose of the case. Could the AC do better and do they sometimes deny cases wrongfully? Yes, because in a volume, production line-type adjudication environment with varying quality in staff, errors will occur, and this chart shows that ultimately, such errors occur in a fraction of the total claims adjudicated. By design, the Agency's final decision is subject to federal court review (and a claimant can go all the way to the Supreme Court on a claim for benefits). At each step, more people are allowed/found disabled, and some claims drop off. For those who go to federal court and are able to convince the court that the Agency's error wasn't harmless, the claims come back and the Agency has an opportunity to fix it. Whether good or bad, this is the system working as it was designed to work.

Anonymous said...

Year ALJ Decisions
2016. 476,135
2015. 507,883
2014. 530,574
2013. 629,337
2012. 668,061
2011. 662,765
2010. 619,887

Hard to reconcile these numbers with the supposed desire to increase the number of ALJ's and significantly reduce the backlog of over $1,100,000 plus cases.

Anonymous said...

Dismissals are increasing in part because SSI children's cases are being pulled in for review and parents are opting to not appear.

Anonymous said...

10:28, I don't think so. According to the footnote, the cases here are initial applications and their appeals, so not CDRs, non-disability cases (like retirement or survivors' claims), and not SSI re-dets. The number of determinations at the ALJ level only counts those appealed from recon (or initial decisions in prototype states) not federal court remands.