What Are My Chances of Winning a Disability Appeal?

If you are denied benefits at the initial review stage, it’s important to understand you can continue to fight to get approved. You’ll have to file an appeal and be prepared to wait for a decision, but it can be worth the additional effort. Appeal approval rates vary by state, but they tend to average higher than initial review approval rates.

Social Security Disability (SSD) is a federal program, but every state has its own Disability Determination Services (DDS) office(s) and Office of Disability Adjudication and Review (ODAR). ODAR is the appeals branch of state agency disability services.

Disability staff collects additional evidence from you, your doctors, and/or your attorney prior to an appeal hearing. A hearing is scheduled and you eventually appear before an administrative law judge (ALJ). That ALJ reviews the details of your claim and makes a decision on your eligibility for SSD benefits.

Review Process for Appeals

Some ALJs have higher approval rates than others, which can influence your chances of winning. The judges that serve in each state create the state’s average of ODAR approvals and the following chart shows state-by-state figures for SSD benefits awarded in the appeals stage of the review process.

Learn More: Appealing After A Denial

State Initial Approval Rate
Alabama 76.2%
Alaska 60.7%
Arizona 60.7%
Arkansas 72.2%
California 70.0%
Colorado 80.8%
Connecticut 76.4%
Delaware 61.2%
District of Columbia 74.6%
Florida 68.4%
Georgia 60.5%
Hawaii 70.9%
Idaho 81.7%
Illinois 69.3%
Indiana 71.0%
Iowa 83.9%
Kansas 77.9%
Kentucky 73.9%
Louisiana 64.5%
Maine 86.5%
Maryland 76.9%
Massachusetts 78.7%
Michigan 74.6%
Minnesota 81.9%
Mississippi 64.7%
Missouri 75.8%
Montana 74.1%
Nebraska 76.0%
Nevada 73.8%
New Hampshire 89.6%
New Jersey 74.3%
New Mexico 76.0%
New York 78.9%
North Carolina 75.9%
North Dakota 84.7%
Ohio 74.2%
Oklahoma 79.4%
Oregon 86.2%
Pennsylvania 76.3%
Rhode Island 79.5%
South Carolina 65.6%
South Dakota 77.6%
Tennessee 69.3%
Texas 65.1%
Utah 79.0%
Vermont 86.4%
Virginia 74.8%
Washington 80.0%
West Virginia 81.9%
Wisconsin 74.2%
Wyoming 94.1%

Other Impacts on an Appeal

The state in which you live is not the only thing that affects your chances of winning, of course. The thoroughness of your application, the details in your medical records, and the severity level of your disability all play a part in the outcome of your claim. Certain kinds of disabilities are also more or less likely to be approved for benefits.

Applicants with mental illnesses, chronic pain conditions, and disabilities that fluctuate in intensity or severity level over time all have a more difficult time winning their disability claims. To prove your disability case, you must have strong medical records, including a formal diagnosis.

An application without a definitive diagnosis is less likely to win, even in states that average a high approval rate at ODAR, so work closely with your doctor. If a definitive diagnosis is not achievable, be sure to build other parts of your medical evidence and work with your doctor and other healthcare providers to thoroughly document the full extent of your symptoms and limitations.

Tips To Help Increase Chances of Winning an Appeal

There are some things you can do that may help increase the chances of your appeal being approved. These include:

1. Submit On time: The first step to helping win your appeal is to submit the appeal on time. You have 60 days to file an appeal. Your denial letter should explain when the 60 days begins and when you should file an appeal by. If you do not submit an appeal on time, then you will need to start the process all over again.

2. Denial Letter: Use your denial letter as a guide for your disability benefits appeal. If your letter outlines a specific reason why your claim was denied, such as a lack of medical evidence, you will have a starting point on how to improve your appeal.

What Are My Chances of Winning a Disability Appeal?
6. Doctor’s Support: If you are able to, try to get a letter of support from one, if not more, of your doctor’s. A statement or letter from your doctor can help paint a picture of your condition and its impact on your ability to work for those review your claim.

3. Income Limits: If you earn above the substantial gainful activity (SGA), then you will not qualify for benefits. When filing your appeal, make sure you do not exceed the SGA.

What Are My Chances of Winning a Disability Appeal?

4. Blue Book Listing: Look over the Blue Book again to make sure you meet one of the listings. If you do not, then it may be difficult to win your appeal. Even if you were denied, you condition may still qualify for benefits.

5. New Medical Evidence: If you have any new medical evidence, or evidence that you did not include in your initial application, you should submit these with your appeal. If your initial claim was denied due to a lack of medical evidence, consider meeting with a doctor to find out if there are more tests that can be done or evidence a doctor can help you gather to submit.

7. Residual Functional Capacity (RFC): Consider having a doctor fill out an RFC form on your behalf, especially if you do not meet a Blue Book listing. An RFC will outline how the condition you are experiencing impacts your inability to work in the job(s) you’ve been trained to work in.

What Are My Chances of Winning a Disability Appeal?
8. Legal Assistance: A Social Security disability attorney may be able to help with your appeal. A lawyer can help you gather your evidence and properly submit an appeal. If your claim goes to the Court of Appeals, your disability lawyer will be able to help represent you. Most disability attorneys operate on contingency fees, so payment will not be required until you win your appeal. Fill out the Free Case Evaluation above to get in touch with an attorney that takes cases in your area today.