NCPA - National Center for Policy Analysis

Reforming the Social Security Appeals Process

February 3, 2017

In 2015, about 12 million workers and their dependents received Social Security Disability Insurance (SSDI) benefits. While this is slightly fewer than the 12.1 million beneficiaries in 2014, beneficiary growth has averaged about 4 percent a year since 1990.

Most claims are processed within three to five months. If the initial claim is denied, an applicant can appeal the decision. Once an appeal is filed, a reconsideration decision is made within about four months. Reconsideration involves review by another disability examiner and medical adviser team.

Some 900,000 claims were still awaiting final decisions in 2015:

  • About 441,000 applications filed in 2014 were awaiting final decisions.
  • Another 405,000 applications filed as far back as 2012 were still awaiting final disposition.
  • A smaller number of claims filed earlier, from 2008 to 2011, had still not been finalized in 2015.

If a claim is denied on reconsideration, the claimant can request a hearing before an administrative law judge (ALJ). The ALJ has the option of granting or denying a hearing based on the evidence in the record. The average wait time for a hearing varies by location of the hearing office. For example, as of September 2016:

  • In Fort Smith, Arkansas, the average wait for a hearing was 8 months.
  • In Houston, Texas, the average wait was one year.
  • In Buffalo, New York, Columbia, South Carolina, and Ponce, Puerto Rico, the average wait was over two years!

Factors Influencing Award Rates. Since 2000, award rates at all adjudicative levels for all claimants have trended downward, but the number of beneficiaries has grown, most likely as a result of the aging population. The majority of beneficiaries each year are 50 to 59 years of age; once awarded benefits, few claimants ever return to work.

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