The chances of winning at the appeal level in a Social Security Disability or SSI claim vary according to the level the case is at, what occurred at any hearing before an Administrative Law Judge (“ALJ”), and whether the claimant is being represented by an attorney.
Often, claims considered at the initial and reconsideration stages of an application do not have a good chance of winning. In fact, most claims are denied at these stages. Once the claim is denied twice and goes to a hearing before an ALJ, many factors come into play. These factors include the level of development of the case, including the quality of the medical records submitted to the examiner or ALJ, updating the examiner or ALJ with current medical information, and attending any consultative exams the examiner or ALJ ordered.
If the ALJ denies the claim, the claimant or their representative should go over the unfavorable decision to point out any inconsistencies with the testimony during the hearing and in the medical records. It is helpful to have a lawyer from the beginning of a new claim, but it is especially important at the appeal level because an attorney will have the legal knowledge necessary to file a substantive appeal. The chances of winning an appeal go up significantly if the claimant has a lawyer.