Quick Answers
The chances of getting approved for Social Security disability benefits on your initial application are around 35%. However, the chances increase significantly if you appeal an initial denial. About 70% of applicants are approved after going through all levels of appeal. Certain factors like your age, condition, and ability to provide thorough medical evidence impact your chances.
What are your chances of being approved for Social Security Disability on the first try?
According to statistics from the Social Security Administration (SSA), only around 35% of initial disability claims are approved. That means about 65% are denied at first. This does not necessarily mean you do not qualify for benefits, but rather that more medical evidence may be needed to prove your case.
Why are so many claims denied initially? There are a few key reasons:
- Incomplete medical records – If you do not submit enough detailed medical evidence from your doctors, SSA cannot get a full picture of your condition.
- Strict disability criteria – The SSA definition of disability is strict, meaning you must prove inability to work any full-time job, not just your own occupation.
- Inconsistent information – Any inconsistencies between your alleged limitations and daily activities raise red flags for SSA claims examiners.
Therefore, a high initial denial rate does not mean you should get discouraged if you are turned down on the first application. Be prepared to appeal and provide additional evidence to bolster your case.
How age impacts your chances
Your age plays a role in your chances of being approved for disability benefits. According to SSA data:
- For applicants under age 50, about 32% are approved initially.
- For applicants aged 50 to 54, around 36% are approved on initial claims.
- Once applicants reach their late 50s, approval rates exceed 50% for initial applications.
Why are approval chances better for older applicants? As you age, severe impairments like arthritis or heart disease make it harder for your body to handle physical job duties. SSA recognizes that older individuals face higher barriers to gainful employment.
How your medical condition impacts chances
Certain impairments are more likely to get approved for disability benefits with less difficulty. These include:
- Terminal illnesses – Conditions with high mortality rates within 12 months, like late-stage cancers, are often fast-tracked.
- Musculoskeletal disorders – Impairments like rheumatoid arthritis, joint replacements or spinal disorders have high approval rates.
- Cardiovascular disease – Heart conditions account for a large share of disability awards.
- Neurocognitive disorders – Conditions like dementia, Alzheimer’s and traumatic brain injury commonly meet approval.
On the other hand, more subjective conditions with less objective findings face longer odds. These include chronic pain, depression, anxiety, fibromyalgia, fatigue and headaches. Strong medical evidence is required to prove disability for these.
What happens if your disability claim gets denied?
If your initial disability claim gets denied, don’t panic. You have several options to appeal and get your case reconsidered. The appeal process has four levels:
- Reconsideration – Your first appeal, with a different claims examiner reviewing your case.
- Administrative hearing – You present your case before an administrative law judge.
- Review by Appeals Council – The Appeals Council looks for any errors in the judge’s decision.
- Federal court review – You can file a lawsuit in federal district court as a last resort.
Only about 15% of denials are overturned at reconsideration, but your chances increase significantly once you reach a hearing. Around half of cases are approved at the ALJ hearing level, and federal court yields a high approval rate as well.
Why appealing gives you better odds
There are a few key reasons why your chances improve through the appeal process:
- Additional medical evidence – You can submit new records, test results, doctor letters, etc. to better prove your case.
- Attorney representation – Disability lawyers win approval for 60-70% of their cases at the hearing level.
- New perspective – A different examiner reviews your entire case file from scratch.
- In-person testimony – The ALJ hears directly from you at the hearing about limitations.
In many cases, the appeal process allows you to correct any weaknesses in your original application and get your claim approved. Don’t give up if you are initially denied.
How can you boost your chances of being approved for disability?
While Social Security’s approval/denial decision is out of your hands, there are important steps you can take to maximize your chances of getting benefits:
Provide strong medical evidence
Work closely with your doctors to obtain complete medical records that paint a clear picture of your condition and resulting functional limitations. Key evidence to include:
- Diagnostic test results – X-rays, MRIs, nerve conduction studies, etc.
- Clinical exam notes showing abnormalities upon examination
- Medical opinions stating your limitations and inability to work
- Treatment notes indicating medications, therapy, etc. attempted
Follow doctor’s orders
Adhering to prescribed treatment plans shows SSA you are committed to improving your health. Failure to follow recommendations can hurt your credibility.
Avoid inconsistencies
Make sure your claimed limitations match your daily activities. Any major discrepancies will raise red flags and hurt your case.
Retain an attorney
Experienced disability lawyers are invaluable in collecting records, presenting persuasive arguments to judges, and navigating the complex process.
What medical conditions have the highest approval rates?
While every disability claim is unique, data from the SSA shows certain impairments have higher allowance rates. Here are the medical conditions with the highest approval odds:
| Impairment | Approval Rate |
|---|---|
| Amputation of two limbs | 89% |
| Congestive heart failure | 89% |
| Chronic kidney disease, stage 5 | 87% |
| Soft tissue injuries | 87% |
| Creutzfeldt-Jakob disease | 86% |
| Dementia | 86% |
| Severe traumatic brain injury | 84% |
| End stage liver disease | 83% |
| Amputation of one limb | 82% |
| Amyotrophic lateral sclerosis (ALS) | 82% |
As shown, terminal illnesses, advanced organ failure, neurocognitive disorders, and severe musculoskeletal impairments have approval rates over 80% in many cases. Other common conditions like back pain, arthritis and heart disease have slightly lower approval odds.
How long does it take to get approved for disability benefits?
Getting approved for Social Security disability benefits typically takes significant time – around 1 to 1.5 years on average from initial application through all appeals. Here are the average processing times for each step:
- Initial application: 3-6 months
- Reconsideration appeal: 1-3 months
- ALJ hearing: 12-18 months
- Appeals Council: 1-2 years
- Federal court: 1-3 years
Times can vary significantly however based on factors like your state, hearing office, type of condition, and whether you have representation. Getting approved sooner is possible with fast-tracked cases. Otherwise, expect around 1 to 2+ years total through appeals.
How to potentially get approved faster
There are a few options that may help speed up the approval process:
- Request expedited review – If you have a severe condition and dire financial need, you can request expedited handling of your claim.
- Electronic filing – Filing your initial application online can help avoid mail delays.
- Call SSA for updates – Calling regularly for status updates can help flag any issues.
- Get hearing waiver – Your attorney can request an on-the-record decision to skip the ALJ hearing.
- Send new evidence quickly – Submitting updated medical records promptly helps prevent delays.
However, even with these steps, expect that getting through the full process will take 12+ months in most disability cases.
Getting your Social Security claim approved
While securing disability benefits involves hurdles, carefully building your case and persevering through appeals gives you a strong chance at winning approval eventually. Focus on submitting comprehensive medical evidence that leaves no question about your inability to work. Retaining an attorney also provides invaluable help. With persistence through the process, you can maximize your odds of getting this critical assistance.