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Old 03-24-2012, 12:19 PM #1
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I found this at an SSA lawyer blog web site and tried to get the link to the original data, but was not yet successful. The title of the post is 2011 Workload Data and included a chart that was created by an SSA attorney professional organization based on numbers provided by SSA. Again, I don't have links to the original source material.

http://socsecnews.blogspot.com/

The data shows that on a percentage of cases pending basis, a higher percentage of claims are approved at the hearing level (58%) than at the initial level (34%). However, I did a different analysis.

For 2011, there were approvals at all levels, the initial level and all appeals, totalling 1,605,813 claims.

69% of those claims approved were approved at the initial level. 69%! Nearly 7 out of 10 of claimants who are approved, are approved at the inital level. The vast number of approvals are done at the initial level. How can anyone say that the system it totally broken when 1,120,5074 out of 1,605,813 total approved claimants get benefits on the initial application in the year 2011?

I suppose it could still be argued that of all the denied claimants, that most of them should have one been part of that initial approval crowd and those are the people who participate in forums such as this, as a general rule. However, I believe (and think that everyone would agree with this statement) that there are many many claims for disability for people who are not truly disabled. Especially in a downturned economy when jobs are harder for everyone to get, the people with marginal skills or who live in towns with no sustaining industry might have a hard time and are looking for whatever they can get. And then, of course, are the scammers and then the people who want something for nothing.

I don't try to determine in this forum if anyone should or should not be entitled to benefits. I let the system we have figure it out. It may be flawed, but 1,120,574 people in 2011 would not agree that is broken since they were approved on the initial level. SSA could use additional staff at all levels. That might not increase approvals, but it would speed up the process and possibly more thorough analysis done earlier because there would be more people looking at the large number of claims.
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Old 03-24-2012, 02:26 PM #2
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im not getting where you are are arriving at that 69% at the initial level.
i get 34% at initial level and 12% at reconsideration stage, which are the two stages before alj. i wouldnt consider the alj to be part of the initial decision and i dont think that most applicants would either. its an appeal that takes years to get heard.
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Old 03-24-2012, 09:14 PM #3
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http://www.ssdfacts.com/national

Janke, I think you maybe reversing the percentages? The link you provide state's 34% approval.
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Old 03-24-2012, 11:45 PM #4
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Quote:
Originally Posted by LIT LOVE View Post
http://www.ssdfacts.com/national

Janke, I think you maybe reversing the percentages? The link you provide state's 34% approval.
I think the chart is misleading because it just considers percentages approved, not total numbers. The majority of claims that are approved are done so at the initial level, so rather that take the percentages in the chart, I did my own math. Here it is.

Initial claims 3,295,806 claims cleared; 34% approved. Total approved 1,120,574.

Reconsideration 819,710 cleared; 12% approved. Total approved 98,365.

Hearing 662,765 cleared; 58% approved. Total approved 384,403.

Appeals Council 103,271 cleared; 2% approved. Total approved 2,073.

Court 13,271 cleared; 3% approved. Total approved 398.

Add up total approvals at all levels 1,605,813. 1,120,574 of the total clearances were at the initial level. 69% of all claims approved in 2011 were done so at the initial level.

I did not add up the total of denials and it is true that there are many more of them than approvals. The point is that SSA approves initial applications for SSI and SSDI every day, average over 3000 a day, if you include federal holidays and Saturdays and Sundays.

Not a system that is totally broken by any standard.
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Old 03-25-2012, 11:13 AM #5
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Ok, I'm a "math person" -- and quite accustomed to seeing statistics used to prove a person's point of view (all you have to do is look at the news -- a Dem-leaning station will use numbers to PROVE one thing, a Rep-leaning station will use the SAME numbers to PROVE the opposite thing).

I really don't think that is what Janke is trying to do here. The POINT is that your BEST shot for getting approved IS on your FIRST try. Janke is saying, IMHO, that the system isn't "broken" because it DOES "usually" make the "right" decision on the first try (at least from what the statistics show).

Initial claims 3,295,806 claims cleared; 34% approved. Total approved 1,120,574 = 69.78%

Reconsideration 819,710 cleared; 12% approved. Total approved 98,365 = 6.12%

Hearing 662,765 cleared; 58% approved. Total approved 384,403 = 23.94%

Appeals Council 103,271 cleared; 2% approved. Total approved 2,073 = 0.12%

Court 13,271 cleared; 3% approved. Total approved 398 = 0.02%

HOWEVER, I would RESPECTFULLY disagree -- in that at the hearing level, 23.94% seems like an AWFULLY high number of people to have "fallen through the cracks" from the reconsideration level of 6.12%. I think that THIS is what has so many bewildered, upset, and dismayed.
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Old 03-25-2012, 01:27 PM #6
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Thanks. My main point in this analysis is that disability claims ARE approved at the initial level.

I also think there are multiple reasons that 23% of approvals are done at the hearings level.
1. Poorly prepared claims have missing information and the claims rep w ho takes the claim has limited time to spend assisting the claimant and the DDS analyst has limited time to search for information that is not provided. Some claimants believe that the medical records speak for themselves and that is simply not true when it comes to disability decisions.

2. Time has gone by. A marginal medical condition has gotten worse; an expected improvement in functioning has not happened; the claimant has had more medical tests and exams and there is more evidence.

3. ALJ's see claimants. DDS analysts do not. The visual and verbal interaction is one more piece of evidence that the ALJ has that the DDS analyst does not have.

4. ALJ's have greater discretion in applying the rules than DDS analysts. They are expected to and allowed to interpret law. DDS analysts do not have law degrees and have more tight control on the decisions they make. But this judicial discretion also creates what SSA calls 'outlier' ALJ's. Some (one in West Virginia comes to mind) approved virtually every claim that came before him and cherry picked the claimants belonging to one attorney. Everyone can see how that smacks of collusion to defraud, not what is correct for an ALJ. But then there are also the 80 year old ALJ who thinks that if he can still work, so can just about everyone else and denies almost all claims. So, there are many claims that are approved by an ALJ that just cannot be approved by the DDS analyst.

5. When a lawyer takes a case to an ALJ, the hearing is really a lawyer to lawyer conversation. And lawyers like to talk law. They like to talk to lawyers and make arguments. I think there will always be a bit of the good ol' boy (or girl) club between reps and ALJ's. And I think that can factor in to decisions as well.
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Old 03-25-2012, 03:28 PM #7
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Janke, I think your points are WELL made. Still, I wish that the system could be "tweaked". Much like the unjustly incarcerated individual who is given a monetary settlement -- it just does NOT make up for the time lost. IMHO, with the ridiculous amount of time that it takes for cases in some states to come before an ALJ, lives are already virtually ruined -- even a LARGE backpay award doesn't always help get a house, car, good credit, etc. back.

Sadly, it seems like the more educated as to the process the applicant is, the more likely they will prevail. It saddens me for those who do not have GOOD "help" and/or computer access.
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Old 03-25-2012, 10:39 PM #8
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Quote:
Originally Posted by Janke View Post
Thanks. My main point in this analysis is that disability claims ARE approved at the initial level.

I also think there are multiple reasons that 23% of approvals are done at the hearings level.
1. Poorly prepared claims have missing information and the claims rep w ho takes the claim has limited time to spend assisting the claimant and the DDS analyst has limited time to search for information that is not provided. Some claimants believe that the medical records speak for themselves and that is simply not true when it comes to disability decisions.

2. Time has gone by. A marginal medical condition has gotten worse; an expected improvement in functioning has not happened; the claimant has had more medical tests and exams and there is more evidence.

3. ALJ's see claimants. DDS analysts do not. The visual and verbal interaction is one more piece of evidence that the ALJ has that the DDS analyst does not have.

4. ALJ's have greater discretion in applying the rules than DDS analysts. They are expected to and allowed to interpret law. DDS analysts do not have law degrees and have more tight control on the decisions they make. But this judicial discretion also creates what SSA calls 'outlier' ALJ's. Some (one in West Virginia comes to mind) approved virtually every claim that came before him and cherry picked the claimants belonging to one attorney. Everyone can see how that smacks of collusion to defraud, not what is correct for an ALJ. But then there are also the 80 year old ALJ who thinks that if he can still work, so can just about everyone else and denies almost all claims. So, there are many claims that are approved by an ALJ that just cannot be approved by the DDS analyst.

5. When a lawyer takes a case to an ALJ, the hearing is really a lawyer to lawyer conversation. And lawyers like to talk law. They like to talk to lawyers and make arguments. I think there will always be a bit of the good ol' boy (or girl) club between reps and ALJ's. And I think that can factor in to decisions as well.
Are YOU on SSD and did YOU win on your first try?? If so, give us some details about that please.
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Old 03-26-2012, 08:19 AM #9
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Quote:
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Are YOU on SSD and did YOU win on your first try?? If so, give us some details about that please.
No I am not.
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Old 03-26-2012, 09:21 AM #10
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OLDCARP, we do a LOT of speculating about Janke!! I suspect a current/retired SSA employee or a FREAKING GENIUS!! Whatever -- just glad to have the knowledge and advice!

I dunno -- there might be a FEW people in here who won on the first try -- but, WHY would you join a group IF you didn't have any problems getting approved?? The whole point of seeking a forum, IMHO, is to find out WHAT, if anything, you might be able to do DIFFERENTLY. So, I think that most of the people here "probably" are gonna be RECONSIDERATION (like me) or HEARING (ALJ) "winners".
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