Why are so many Social Security Disability claims wrongly denied?

On Behalf of | May 10, 2019 | Social Security Disability Insurance |

It’s no secret that a large number of Social Security Disability (SSD) applicants have to go through at least one appeal or even a hearing in front of an administrative law judge to get their claims for benefits approved.

The question is, “Why?” If so many more people are gaining approvals on appeal, that means that there are a lot of unjust denials taking place. Somebody, somewhere, is making an awful lot of bad decisions on claims.

Some people think they may have an idea of how it’s happening, thanks to a request by reporters for public information they could use to examine the performance of the doctors each state uses to review disability claims and make decisions. The investigative reporters were curious to know exactly how fast those doctors were working through claims and how heavy their workloads really are.

They didn’t get the information. In order to obtain it, they needed to cough up $2.3 million to cover the cost of compiling the information because Social Security has no centralized system for tracking the data. Each state Disability Determination Services (DDS) would have to compile its own information and Social Security estimated that it would take 72,100 man-hours for the job. (Oddly enough, estimates from each state varied immensely. Iowa officials said they would need 9,063 hours to put the data together. Maine officials said they could have the information in just eight.)

However, the request did spark some interesting revelations that still give insight into what’s become a deeply flawed process. Information has come to light that some doctors are “reviewing” files that have hundreds — or thousands — of pages and test results in just minutes. One doctor in Tennessee, for example, was cranking out decisions (mostly denials) every 12 minutes, on average.

As one administrative law judge said when flatly rejecting the idea of basing his decision on that doctor’s assessment of a claimant’s disability, “I’m not going to be a party to any kind of fraud that the state DDS is sponsoring…”

Is it any wonder that an average of 65% of initial disability applications are denied (with some states having even worse rates of approval)? If you’re filing for Social Security Disability benefits, having an attorney to protect your legal rights may be the smartest decision you can make.

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