If you've applied for Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) benefits—or you know someone who has—it's likely Social Security will deny your initial application, and you'll have to file an appeal. Initial denials happen often enough that you might have the impression that you can only get disability benefits on appeal.
But that's not really true. While it's true that Social Security initially denies most disability claims, it's a myth that Social Security disability is automatically denied to everyone the first time around. But when you look at the statistics, it's easy to see how so many people get that impression.
Nationwide, about 65% of all disability claims are denied on the first application filed with the Social Security Administration (SSA). And your odds of getting Social Security to approve your claim won't improve if you continue to make new applications instead of filing an appeal.
Generally, your goal is to eventually get your case heard by an administrative law judge (ALJ) at an appeal hearing, because that's where you'll have the best chance of winning. The rate of denials is much lower after a hearing.
ALJs deny about 40% of the claims they see and dismiss another 10%—meaning about 50% of claims are approved after a hearing.
(For more information, see our survey results on denials at the initial application stage and on denials at the hearing stage.)
These approval statistics vary greatly by state as well. Some hearing offices award benefits in cases at a rate of around 60% or more, and other offices award benefits in less than 40% of cases. Learn about the chances of approval in your state.
The higher rate of approval after a hearing isn't by design or a matter of policy. There are a number of reasons you're more likely to get approved for SSDI or SSI after a hearing.
Time can make your claim stronger. It's not uncommon for an applicant's medical conditions to deteriorate while waiting for a hearing—which can take a year or more. By the time the hearing is held, an applicant's condition could have changed enough to qualify as disabled.
Similarly, applicants get older waiting for their hearing dates. It's possible to move into a higher age category while waiting for your hearing. Because of Social Security's grid rules, you're more likely to be awarded benefits when you're over the age of 50. Your chances improve even more when you reach 55.
You're more likely to have legal help. Many denials are overturned at the hearing stage because the applicant hired a lawyer after getting a denial letter. Over two-thirds of those appealing a disability claim hire an attorney for the hearing. If you have a lawyer, you're more than twice as likely to be approved for benefits than if you don't. (See our survey results on having a disability lawyer at the hearing.)
Disability lawyers are trained experts who know how to:
By contrast, when your initial application is being evaluated by a claims examiner at the state disability determination agency (DDS), there's no one to advocate for you or argue your case.
Different doctors evaluate your condition at the hearing. The doctors who work at the state DDS offices are called medical consultants, or MCs. And MCs are sometimes more conservative than the doctors (called medical experts, or MEs) who sometimes testify (usually by phone) at appeal hearings.
DDS medical consultants are often full-time staff employees at the DDS office, while the medical experts called for a hearing are often retired doctors who are paid on a consulting basis for each hearing. An ME is hired to provide independent testimony at your hearing about the physical or mental conditions you claim are disabling.
Having a busy DDS medical consultant weigh in on your case—maybe the twentieth case the MC has seen that week—makes it more likely your Social Security disability claim will get denied the first time you apply. On the other hand, having an independent medical expert at your hearing can greatly improve your chances for approval.
Judges are human. When an administrative law judge meets you in person, the judge can connect your medical file to your face. At the hearing, the judge gets to hear in your own words why you can't work. Because of that connection, an ALJ might be more likely to be convinced of your disability.
While many applicants for Social Security disability are denied on their first try, those with very severe impairments can often get benefits on the first try. Approval is automatic if your medical condition meets the requirements of one of Social Security's medical listings.
Even if your condition doesn't meet a listing, to significantly improve your chances of winning your disability case the first time around, you should:
Some people believe that Social Security denies SSDI claims to delay cases, hoping applicants' eligibility for disability will run out before they can file another claim. This isn't true—but it does sometimes happen.
When Social Security denies a disability claim, an applicant might file a new claim at a later date, only to find that their insured status for Social Security disability benefits has expired. When this happens, the applicant's only options are to:
How can an applicant's insured status for Social Security disability run out? SSDI is like an insurance policy, and every SSDI applicant has something called a "date last insured" (DLI). Think of your DLI as an expiration date for Social Security disability insurance benefits.
Your DLI is based on your work history. To be eligible for SSDI benefits, you must have worked for 5 of the last 10 years, paying taxes into the system. Your DLI is the last day you meet that qualification.
For more information, see our article on the date last insured (DLI).
Although Social Security doesn't automatically deny every disability application the agency receives, most are denied the first time. But an initial denial isn't usually the last word on your claim. You have options.
First, you need to understand why your claim was denied. Were you denied benefits on technical grounds or was it because you didn't meet Social Security's medical requirements?
Once you know why your Social Security disability claim was denied, you can decide if you need to hire a lawyer or if you can move forward with your appeal on your own. Hint: Statistics show that applicants with attorneys have more successful appeals than those who go it alone.
Learn more about what to do if your Social Security disability claim is denied.
Updated April 20, 2023
|Take our disability quiz to help you determine whether you qualify for benefits.|
Need a lawyer? Start here.