The procedure for Social Security disability appeals is broken at all levels of the appellate process. Be prepared for a frustrating experience.
The 1st Disability Appeal.
If your disability claim is denied, you can appeal to the Disability Determination Services known as DDS.
1. 20% of my clients have been obviously disabled at the time I first met with them. In 34 years I have never lost one of these very strong cases. Yet, DDS denied 100% of these cases.
2. I have had a few cases in which it is simple to determine the individual is disabled. In these cases I presented to DDS all the necessary medical documentation and legal analysis to prove disability. DDS denied 100% of these simple cases. Disability benefits were later awarded in 100% of these simple cases by the Administrative Law Judge (ALJ).
3. The time it takes DDS to deny a case keeps getting longer. It often takes 4 – 8 months for DDS to deny an appeal.
4. It is not unusual for an appeal at DDS to get lost. It is not unusual for DDS to deny a case and fail to tell the claimant and the attorney.
5. More than 50% of the time when I call DDS, my phone call is not returned.
The 2nd Disability Appeal.
If DDS denies the case you can appeal to the Office of Hearings Operations known as OHO. North Carolina has four (4) OHOs in Raleigh, Greensboro, Fayetteville and Charlotte.
6. The time it takes for a hearing to be held is unpredictable. It can take anywhere between six and twenty-four months to get a hearing before a Judge.
7. Many of the Judges I present cases to are unfamiliar with the file (i.e. the ALJ had not read the file before the hearing).
8. I submit a legal brief in every case that contains a detailed analysis of the medical records and discusses the applicable legal regulations that indicate the client is entitled to disability benefits. The brief is the most important service I provide my clients. In many cases the ALJ does not read my brief.
9. The Judge usually does not make a decision on the day of the Hearing. The decision is mailed to the client. It normally takes 2 – 5 months to get the decision after the hearing.
The OHOs are the most effective component of the disability appeal process. The vast majority of ALJs are professional, knowledgeable and fair. Most of the problems at OHO are due to inadequate resources. The ALJs are doing a good job under difficult circumstances.
The 3rd Disability Appeal.
If the ALJ denies the case you can appeal to the Appeals Council known as the AC.
10. The time it takes the AC to decide an appeal keeps getting longer. It currently takes 15 months to get a decision from the AC.
11. Years ago I found the AC to conduct a fair review and more than 50% of my appeals were remanded for another hearing. In recent years the AC’s denial rate has increased to an astronomical 85%.
The 4th Disability Appeal.
A denial by the AC can be appealed to the United States District Court. North Carolina has three (3) District Courts.
12. The Judges in the Western District deny 84% of the disability appeals they review.
13. In the Eastern and Middle Districts the denial rate on disability appeals ranges from 26% to 87% indicating a wide difference in attitudes among the Judges. Hence, the prospect for success in the Eastern and Middle Districts usually boils down to which Judge the case gets assigned to.
If your disability claim is denied, it is best to find an experienced disability attorney to represent you on appeal. To obtain a free analysis of your disability appeal, click on the Contact Us button.
This article was updated on July 17, 2019.