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Disability benefits - What are my chances of winning?

Every week on our disability forum we get the question, “What are my chances of winning disability benefits?” This question is always a bit difficult to answer. If the claimant is asking what is the probability in statistical terms assuming they have just submitted their disability application, they have a 30-35% of a chance of winning disability benefits. The chance of winning disability benefits at the reconsideration level drops to 20%.
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But this answer is not really beneficial to most claimants because many claimants, who do not meet the nonmedical requirements for SSI or SSDI actually have a 100% chance of getting denied, regardless of the severity of their mental or physical health condition. Other claimants, whose condition either meets a listing on the SSA Listing of Impairments or is part of the Compassionate Allowance Program have a 100% chance of getting approved at the application level (assuming they meet the nonmedical requirements of the SSDI or SSI programs and have medical evidence to prove their claim).

Improving your chance of winning SSDI or SSI benefits

When claimants ask, “What are my chances of winning disability benefits?” it seems that they should actually be asking different questions. For instance, “How does the SSA determine whether a claimant is disabled?” or “What can I do to improve my chances of winning SSDI or SSI the first time I apply?”

Unfortunately, many SSDI and SSI claimants do not even take the simplest steps to improve their chances of winning SSDI or SSI benefits. Some claimants apply without knowing how the SSA makes their disability determination or what the basic requirements are for SSI or SSDI. Not understanding these two issues will significantly lower your chances of ever winning benefits and waste your time.

So instead of asking what are the chances that your application will be approved let’s discuss what you need to do to help your claim get approved.

  1. Review the requirements of SSDI and SSI.

  2. Make sure your condition will last for at least 12 continuous months. The SSA does not award short-term disability benefits. If your condition will not last at least one year you will be automatically denied, regardless of the severity of your current condition.

  3. If you are applying for SSDI make sure you have enough work credits and you are considered insured. If you do not have enough work credits you will be automatically denied for SSDI.

  4. Make sure your condition is severe.

  5. Make sure you understand what it means to perform substantial gainful activity. If you are working too much or making too much money you will be automatically denied, regardless of the severity of your condition.

  6. Seek medical treatment. The SSA does not provide medical care for applicants. If you have not seen a doctor and you do not have medical evidence to support your claims that you are disabled you will most likely be denied. The SSA may send you to a consultative examiner for a cursory review of your conditions, but this exam should not be considered medical care and is generally not helpful to claimants.

  7. Talk to a disability lawyer or advocate if you have questions about how to win SSI or SSDI benefits.

Regardless of the questions you are asking, taking the right steps – before applying- can increase your chances of winning SSI or SSDI.
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