When discussing approval rates within the context of Social Security Disability law, attorneys and disability advocates often focus on ODAR hearing approval rates. Indeed, hearing approval rates provide great insight to third-party representatives into the attractiveness of cases in certain ODARs. However, recognizing the fluctuation in approval data at the initial adjudication level may prove vital in constructing an effective business model for your disability practice.
Previously, my understanding of initial application approval data consisted of knowing that roughly two-thirds of disability applications are denied, and I had assumed that this figure remained constant across the country. It was only when a customer asked me whether we had compiled statistics on initial application approvals by state that I began to investigate.
In an ideal world where cash flow was not an issue, it would be best to have all cases at the hearing level in ODARs with long waiting periods and high approval rates. This would maximize the chances of receiving favorable decisions at the maximum allowable fee.
However, as this customer explained to me, firms rely on a certain percentage of initial application approvals to pay overhead and staffing costs, while they await decisions and payments from hearing stage cases. Further, swift initial application approvals offer great financial benefit to claimants.
Below is the 2015 data that the Social Security Administration has published on its website.*
2015 Initial Application Approval Data
|State||Region Code||All Determinations||Favorable||Favorable %|
States with Largest Increase in Initial Approval Rate
|State||2014 Approval %||2015 Approval %||Change|
The 2015 national approval rate at the initial level was almost exactly 33%. But, the favorable determination rate ranged from 25.8% (Mississippi) to 50.7% (Alaska). Further, 10 states had favorable determination rates of 40% or higher.
Using this data in conjunction with the ODAR approval rates can help firms project and manage cash flow effectively when expanding to new geographic areas. Further, the statistics can assist in providing realistic expectations to claimants about wait times and chances of approval.
* Statistics provided by https://www.ssa.gov/disability/data/SSA-SA-FYWL.csv. "Approval %" calculated by dividing "All Favorable Determinations" by "All Determinations" within original dataset.