Hmmm...So, what happens to those denied by ALJ, AC...Federal Court, District Court... Then, reapply (Concurrent to Federal Court)... Is a 2nd application tracked as "Initial," or is it tracked separately? Is there another chart for that? In my case, it basically took six years to get approved, by 2nd ALJ. How common is this? How common are 3rd and 4th applications?
30% at initial level? Since when? By my tracking it has fallen to 10%. The 15% at reconsideration seems appropriate. The allowance rate at the hearing level seems too high, more like 45%.
Your situation is common. Many people are genuinely unable to work, but they lose anyway. There are a number of reasons. Examples: Your health care providers did a poor job of documenting the severity of your condition in their medical records. Your circumstances prevent you from getting much treatment, resulting in poor documentation. Some outlier adjudicators only approve a very small percentage of claims and they face little if any accountability for denying legitimate claims. If you are unlucky enough to draw one of them, then you will likely lose even if your disability is well documented.
Choose better claims 10:00 sounds like taking 50/50 claims and seeing if it sticks when you throw it against the wall. The old combo platter of some of this has to reach a listing somewhere.
Not 10:00, but we don't discriminate against difficult claims. We don't do this to on the basis of "seeing if it sticks," we do it because we believe effective representation can overcome such difficulties and take pride in assisting the disabled.
...that said, our OHO are awful, but they are in the upper 20% on average. What OHO is tracking at 10%?
So the Reconsideration level continues to be a totally waste of time on initial applications but definitely make sense on the disability review cases since there is about a 50/50 reverse affirm rate at this level.
Speaking of which, by my calculations, when all is set and done, approximately 94% of the continuing disability reviews end up continuing getting benefits. Is this really a good use of the time.
Nope it's not a good use of time, and I expect simply relying on CDI and public reports of fraud would catch the vast majority of the 6% of recipients whose benefits are being terminated. As to recon, all it does is provide a revenue source for the state agencies. I suspect that's enough to allow it to remain for decades to come.
So while one third getting approved at the initial level may seem high, understand that the vast majority of people that apply are not represented at that point and that the large majority of those approved at the initial level suffer from impairments the meet the Listings. If they don't see the Listings and are under 50, the chances of success at the initial level are minimal.
But also note that they could as approval cases with later onsets which are also a goodly number of the initial allowances, not shown on the chart.
Yes, recon is largely a wast of time except to SS it means some number of people will simply give up, probably not as many as they think if you work through the numbers, but that is why they still want recon and went back to it in the places that it was not being done for a number of years as an experiment.
Hearing level is a little misleading because the favorable figure also does not count later onsets but overall, these are the numbers, slightly more approvals over all including dismissals. but down substantially form years ago.
And, the AC has become as bad as recon. Largely just a mechanism to disuade going further.
As to the CDR, the most interesting is that of the cases selected for CDR, themselves supposedly only those likely to have improved, over 90$ are found to still be disabled. A lot of effort for very little effect.
8,000 people die between filing their application and exhausting their appeals, and it’s a national tragedy and an indictment of SSA on this blog and in the comments.
65,000 people get awarded benefits at recon, likely a year earlier than they otherwise would have if the step was completely eliminated like the prototype states of yore, and it’s a waste of time.
So if SSA had awarded all 8,000 they’d still be alive? What’s your point?
Is the system flawed…yes. No system will ever be perfect. This one definitely needs an overhaul for sure. But the system isn’t causing them to die. Heck, they don’t even get medical coverage for 2 years even after approval except in certain special cases.
I am all for the reconsideration stage! My doctor didn't get... ok, let me re-do this. Social Security did not wait for my doctor, they almost immediately denied me (got a lawyer), 30 days later I was approved on the reconsideration step. Why they waited less than 2 weeks for my records before denying me, I will never know. The documentation was there, they just wouldn't wait for it all to be compiled. Paid a lawyer for hardly nothing. They KNEW I'd get SSDI, and because of the way lawyer's get paid (I agree it's not enough, even 20 years ago), they took the money, rightfully so! SSA (or DDS) could have waited another day or two and had them. So, as for reconsideration, yes... I do agree that it is set up in hopes people will just give up. My law firm and myself filed a complaint 20 years ago... never heard or received anything about why it occurred that way. *shocker!*. Even my lawyer was confused. It was an open and shut case. I do see why people think it's a waste of time tho. I see both sides. In this instance, it was a god-send.
12:53 PM. For the most part, Reconsideration is a device used to make you wait, that is excluded from the ALJ wait times... Meaning, SSA likes it because it disguises the real hearing wait times. In theory, it is a "relook" at your case. In practice, it is a rubber stamping of a flawed process that is designed to approve only the "totally obvious" cases. But, then, I think the listings are designed to provide a nearly impossible standard to meet, in order to have a "standard" for denial. They are typically nowhere near the actual points of disability, particularly with musculoskeletal afflictions. They do the Reconsiderations on the same "evaluation" done by "drive-by" "physicians." All this apears to be done to give great flexibility to the ALJ's decision making, which isn't required to be in agreement with the preponderance of the evidence. In short, I think they should allow you to opt out or opt in to Reconsideration. In your case, they couldn't be bothered to make an actual initial decision. Same thing happened to me on my 2nd application.
3:20 Even if you could "appeal endlessly" in theory... In practice, wait times severely limit the number from 2, to maybe 5(?) before Date of Last Insurance ends your chance for SSDI. I am curious, how many lose on a 2nd (or third) hearing, then have to apply for SSI only because of Date of Last Insured?
10:00 here. 4th stage testicular cancer and radiation damage client has to go for a fricking hearing. Client without a voice box due to cancer was denied at initial level. These are not throw it against the wall claims!
Hmmm...So, what happens to those denied by ALJ, AC...Federal Court, District Court... Then, reapply (Concurrent to Federal Court)... Is a 2nd application tracked as "Initial," or is it tracked separately? Is there another chart for that? In my case, it basically took six years to get approved, by 2nd ALJ. How common is this? How common are 3rd and 4th applications?
ReplyDelete30% at initial level? Since when? By my tracking it has fallen to 10%. The 15% at reconsideration seems appropriate. The allowance rate at the hearing level seems too high, more like 45%.
ReplyDelete@Tim
ReplyDeleteYour situation is common. Many people are genuinely unable to work, but they lose anyway. There are a number of reasons. Examples: Your health care providers did a poor job of documenting the severity of your condition in their medical records. Your circumstances prevent you from getting much treatment, resulting in poor documentation. Some outlier adjudicators only approve a very small percentage of claims and they face little if any accountability for denying legitimate claims. If you are unlucky enough to draw one of them, then you will likely lose even if your disability is well documented.
Choose better claims 10:00 sounds like taking 50/50 claims and seeing if it sticks when you throw it against the wall. The old combo platter of some of this has to reach a listing somewhere.
ReplyDelete@10:39
ReplyDeleteNot 10:00, but we don't discriminate against difficult claims. We don't do this to on the basis of "seeing if it sticks," we do it because we believe effective representation can overcome such difficulties and take pride in assisting the disabled.
...that said, our OHO are awful, but they are in the upper 20% on average. What OHO is tracking at 10%?
So the Reconsideration level continues to be a totally waste of time on initial applications but definitely make sense on the disability review cases since there is about a 50/50 reverse affirm rate at this level.
ReplyDeleteSpeaking of which, by my calculations, when all is set and done, approximately 94% of the continuing disability reviews end up continuing getting benefits. Is this really a good use of the time.
@2:29
ReplyDeleteNope it's not a good use of time, and I expect simply relying on CDI and public reports of fraud would catch the vast majority of the 6% of recipients whose benefits are being terminated. As to recon, all it does is provide a revenue source for the state agencies. I suspect that's enough to allow it to remain for decades to come.
So while one third getting approved at the initial level may seem high, understand that the vast majority of people that apply are not represented at that point and that the large majority of those approved at the initial level suffer from impairments the meet the Listings. If they don't see the Listings and are under 50, the chances of success at the initial level are minimal.
ReplyDeleteBut also note that they could as approval cases with later onsets which are also a goodly number of the initial allowances, not shown on the chart.
Yes, recon is largely a wast of time except to SS it means some number of people will simply give up, probably not as many as they think if you work through the numbers, but that is why they still want recon and went back to it in the places that it was not being done for a number of years as an experiment.
Hearing level is a little misleading because the favorable figure also does not count later onsets but overall, these are the numbers, slightly more approvals over all including dismissals. but down substantially form years ago.
And, the AC has become as bad as recon. Largely just a mechanism to disuade going further.
As to the CDR, the most interesting is that of the cases selected for CDR, themselves supposedly only those likely to have improved, over 90$ are found to still be disabled. A lot of effort for very little effect.
8,000 people die between filing their application and exhausting their appeals, and it’s a national tragedy and an indictment of SSA on this blog and in the comments.
ReplyDelete65,000 people get awarded benefits at recon, likely a year earlier than they otherwise would have if the step was completely eliminated like the prototype states of yore, and it’s a waste of time.
So if SSA had awarded all 8,000 they’d still be alive? What’s your point?
ReplyDeleteIs the system flawed…yes. No system will ever be perfect. This one definitely needs an overhaul for sure. But the system isn’t causing them to die. Heck, they don’t even get medical coverage for 2 years even after approval except in certain special cases.
I am all for the reconsideration stage! My doctor didn't get... ok, let me re-do this. Social Security did not wait for my doctor, they almost immediately denied me (got a lawyer), 30 days later I was approved on the reconsideration step. Why they waited less than 2 weeks for my records before denying me, I will never know. The documentation was there, they just wouldn't wait for it all to be compiled. Paid a lawyer for hardly nothing. They KNEW I'd get SSDI, and because of the way lawyer's get paid (I agree it's not enough, even 20 years ago), they took the money, rightfully so! SSA (or DDS) could have waited another day or two and had them. So, as for reconsideration, yes... I do agree that it is set up in hopes people will just give up. My law firm and myself filed a complaint 20 years ago... never heard or received anything about why it occurred that way. *shocker!*. Even my lawyer was confused. It was an open and shut case. I do see why people think it's a waste of time tho. I see both sides. In this instance, it was a god-send.
ReplyDelete12:53 PM. For the most part, Reconsideration is a device used to make you wait, that is excluded from the ALJ wait times... Meaning, SSA likes it because it disguises the real hearing wait times. In theory, it is a "relook" at your case. In practice, it is a rubber stamping of a flawed process that is designed to approve only the "totally obvious" cases. But, then, I think the listings are designed to provide a nearly impossible standard to meet, in order to have a "standard" for denial. They are typically nowhere near the actual points of disability, particularly with musculoskeletal afflictions. They do the Reconsiderations on the same "evaluation" done by "drive-by" "physicians." All this apears to be done to give great flexibility to the ALJ's decision making, which isn't required to be in agreement with the preponderance of the evidence. In short, I think they should allow you to opt out or opt in to Reconsideration. In your case, they couldn't be bothered to make an actual initial decision. Same thing happened to me on my 2nd application.
ReplyDeleteIf you can appeal endlessly, then why have any other steps? Just go straight to hearing.
ReplyDeleteYou can’t appeal endlessly
ReplyDelete3:20 Even if you could "appeal endlessly" in theory... In practice, wait times severely limit the number from 2, to maybe 5(?) before Date of Last Insurance ends your chance for SSDI. I am curious, how many lose on a 2nd (or third) hearing, then have to apply for SSI only because of Date of Last Insured?
ReplyDelete10:00 here. 4th stage testicular cancer and radiation damage client has to go for a fricking hearing. Client without a voice box due to cancer was denied at initial level. These are not throw it against the wall claims!
ReplyDelete