Annual Statistical Report on the Social Security Disability Insurance Program, 2004

 

Outcomes of Applications for Disability Benefits

Notes

The tables in this section provide data on the outcomes of applications for disability benefits. The data on applications are derived from the Social Security Administration's (SSA's) Disability Research File maintained by the Office of Disability Programs. Each year this file is updated with information about applications for disability benefits that is then used to determine the outcome of those applications. The outcome data in these tables are reported by year of filing and include decisions made through the administrative appeals process.

Table 53 shows the total number of applications filed in a year, the number denied for nonmedical reasons before a medical decision is made (technical denials), the number that are pending a final decision, the outcome of applications for which a medical allowance or denial was made, and award and allowance rates. Applications for which a medical allowance or denial decision was made but which were subsequently denied for nonmedical reasons are shown under the medical decision header as subsequent denials. The most common nonmedical reason for denying a claim is insufficient number of recent work credits.

The allowance rate is calculated by dividing the number of medical allowances (including subsequent technical denials) by the total number of medical decisions made for a 1-year cohort. The award rate is a broader program measure that is calculated as the number of allowances minus subsequent denials divided by total applications (minus pending claims) filed for a given year.

Claims that remain pending after 6 years are probably the result of imperfect data rather than excessive delays in the decisionmaking process. It is highly probable that decisions have been rendered on most of the older claims. For more recent years, the award and allowance rates will change as decisions are made on pending claims.

Tables 54–56 show the allowance rate for Social Security only and the Social Security portion of concurrent applications (which are claims for both Social Security and Supplemental Security Income disability benefits). Each table shows a different level in the administrative decisionmaking process, that is, initial adjudicative, reconsideration, and hearing or higher level.

Beginning with 2000, the proportion of claims awarded at each level of the process changed as a result of the Prototype Process being tested in 10 states. Under this test, the reconsideration step of the appeals process was eliminated for applications filed October 1, 1999, or later. Elimination of the reconsideration level in these states results in a decrease in the aggregate proportion of claims awarded at this step.

The next section includes one table that shows the reason for medical allowance and one that shows the reason for medical denial (Tables 57 and 58). The reasons are derived from the sequential evaluation process used by decisionmakers. SSA maintains a list of impairments that are considered disabling under its regulations. An applicant can be found to be disabled if he or she

An applicant can be denied benefits if he or she

Chart 10. Final outcome of disabled-worker applications, 1994–2003

The final award rate for disabled-worker applicants has varied over time, averaging more than 49 percent for claims filed from 1994 through 2003. The percentage of applicants awarded benefits at the initial claims level averaged 31 percent over the same period and ranged from a high of about 35 percent to a low of 28 percent. The percentage of applicants awarded at the reconsideration and hearing levels are relatively constant, averaging 4 percent and 14 percent, respectively. Denied disability claims have averaged about 48 percent.

Area chart linked to data in table format.
SOURCE: Tables 53–58.
NOTES: Awards are calculated as medical allowances minus subsequent technical denials. Technical denials include both nonmedical decision technical denials and medical decisions that were subsequently denied for technical reasons.
The proportion of claims awarded at each level of the process is likely to change as a result of the Prototype Process being tested in 10 states. Under this test, the reconsideration step of the appeals process was eliminated for applications filed October 1, 1999, or later. Elimination of the reconsideration level in these states is likely to result in a decrease in the overall proportion of claims awarded at this step.
Table 53. Outcomes at all adjudicative levels, by year of application, 1992–2003
Year Total Pending
final
decision
Technical
denials a
Medical
decisions
Award
rate d
(percent)
Allowance
rate e
(percent)
Denials Allowances
Medical Subsequent
nonmedical b
Awards Subsequent
denials c
All disabled beneficiaries
1999 1,265,055 4,786 104,330 442,841 4,071 707,169 1,858 56.1 61.4
2000 1,364,396 10,251 136,072 452,851 3,842 759,440 1,940 56.1 62.6
2001 1,513,536 30,426 170,380 483,392 3,618 823,786 1,934 55.5 63.0
2002 1,706,759 132,080 230,895 537,073 4,239 800,338 2,134 50.8 59.8
2003 1,903,272 300,410 374,430 570,274 4,892 651,002 2,264 40.6 53.3
Workers
1992 1,310,004 0 130,885 481,439 5,725 689,111 2,844 52.6 58.8
1993 1,384,501 0 140,314 540,906 5,626 695,007 2,648 50.2 56.2
1994 1,383,092 0 130,240 573,158 5,506 671,791 2,397 48.6 53.9
1995 1,301,472 0 123,712 542,183 5,049 628,292 2,236 48.3 53.6
1996 1,313,818 0 116,990 537,721 5,012 651,979 2,116 49.6 54.7
1997 1,164,680 4,621 106,822 445,664 4,216 601,498 1,859 51.9 57.4
1998 1,138,101 3,210 96,677 419,503 4,214 612,452 2,045 54.0 59.3
1999 1,167,664 4,675 102,306 416,422 4,023 638,452 1,786 54.9 60.5
2000 1,265,214 10,074 133,967 427,066 3,807 688,427 1,873 54.8 61.7
2001 1,414,598 29,973 168,094 457,809 3,575 753,268 1,879 54.4 62.2
2002 1,602,789 130,257 228,297 507,742 4,180 730,230 2,083 49.6 59.0
2003 1,802,488 296,376 371,475 538,366 4,835 589,254 2,182 39.1 52.2
Widow(er)s
1999 40,055 69 1,173 9,660 17 29,099 37 72.8 75.1
2000 39,996 99 1,257 8,967 11 29,633 29 74.3 76.8
2001 40,238 240 1,344 8,611 13 30,011 19 75.0 77.7
2002 40,580 1,036 1,535 9,068 20 28,902 19 73.1 76.1
2003 38,536 2,302 1,647 9,818 29 24,691 49 68.1 71.6
Adult children
1999 57,336 42 851 16,759 31 39,618 35 69.1 70.3
2000 59,186 78 848 16,818 24 41,380 38 70.0 71.1
2001 58,700 213 942 16,972 30 40,507 36 69.3 70.5
2002 63,390 787 1,063 20,263 39 41,206 32 65.8 67.0
2003 62,248 1,732 1,308 22,090 28 37,057 33 61.2 62.7
SOURCE: Social Security Administration, Disability Research file, 100 percent data.
NOTES: Data for the initial and reconsideration levels are current through June 2004. Data for the hearing level or above are current through August 2004.
Because a number of applications remain pending for more recent years, the award and allowance rates will change over time. Cases can be pending at the initial or appellate levels and can include either medical or technical issues.
Data include decisions for Social Security–only applications and applications for both Social Security and Supplemental Security Income (SSI); they do not include SSI-only applications.
Data from 1992 to 1998 are available for disabled workers only.
a. Applications were denied for nonmedical reasons; therefore no decision was made on severity of impairment.
b. Applications were denied for nonmedical reasons after a decision was made that the applicant did not meet the medical severity criteria for disability benefits.
c. Applications were denied for nonmedical reasons after a decision was made that the applicant met the medical severity criteria for disability benefits.
d. Rate determined by dividing awards by all applications minus pending claims for that year.
e. Rate determined by dividing medical allowances by all medical decisions for that year.
CONTACT: Clark Pickett (410) 965-9016 or di.asr@ssa.gov.
Table 54. Medical decisions at the initial adjudicative level, by year of application and program, 1992–2003
Year All decisions Decisions on applications
for Social Security only
Decisions on applications
for both Social Security and SSI
Total Allowances Allowance
rate a
(percent)
Total Allowances Allowance
rate a
(percent)
Total Allowances Allowance
rate a,b
(percent)
All disabled beneficiaries
1999 1,160,649 459,999 39.6 649,840 313,676 48.3 510,809 146,323 28.6
2000 1,228,182 501,946 40.9 688,167 340,331 49.5 540,015 161,615 29.9
2001 1,342,817 560,106 41.7 742,775 379,872 51.1 600,042 180,234 30.0
2002 1,474,682 570,428 38.7 786,584 380,849 48.4 688,098 189,579 27.6
2003 1,525,515 561,375 36.8 775,685 364,875 47.0 749,830 196,500 26.2
Workers
1992 1,179,119 436,715 37.0 558,741 248,385 44.5 620,378 188,330 30.4
1993 1,244,187 421,560 33.9 571,464 240,839 42.1 672,723 180,721 26.9
1994 1,252,852 390,785 31.2 591,408 233,059 39.4 661,444 157,726 23.8
1995 1,177,760 367,293 31.2 569,962 223,457 39.2 607,798 143,836 23.7
1996 1,196,828 384,167 32.1 593,990 237,474 40.0 602,838 146,693 24.3
1997 1,057,794 357,880 33.8 551,891 228,793 41.5 505,903 129,087 25.5
1998 1,041,362 374,376 36.0 550,773 238,989 43.4 490,589 135,387 27.6
1999 1,065,286 397,335 37.3 578,743 259,910 44.9 486,543 137,425 28.2
2000 1,131,108 436,605 38.6 615,346 284,388 46.2 515,762 152,217 29.5
2001 1,246,173 494,907 39.7 670,481 324,189 48.4 575,692 170,718 29.7
2002 1,373,343 504,712 36.8 712,627 324,909 45.6 660,716 179,803 27.2
2003 1,427,746 501,570 35.1 708,132 314,903 44.5 719,614 186,667 25.9
Widow(er)s
1999 38,881 24,933 64.1 29,601 8,310 28.1 9,280 3,642 39.2
2000 38,737 25,781 66.6 29,879 7,882 26.4 8,858 3,784 42.7
2001 38,894 26,242 67.5 30,284 7,826 25.8 8,610 3,784 43.9
2002 39,039 25,886 66.3 30,356 8,164 26.9 8,687 3,696 42.5
2003 36,878 23,449 63.6 27,702 7,779 28.1 9,184 3,530 38.4
Adult children
1999 56,482 37,731 66.8 41,496 32,475 78.3 14,986 5,256 35.1
2000 58,337 39,560 67.8 42,942 33,946 79.1 15,395 5,614 36.5
2001 57,750 38,957 67.5 42,010 33,225 79.1 15,740 5,732 36.4
2002 62,300 39,830 63.9 43,605 33,750 77.4 18,695 6,080 32.5
2003 60,891 36,356 59.7 39,859 30,053 75.4 21,032 6,303 30.0
SOURCE: Social Security Administration, Disability Research file, 100 percent data.
NOTES: Data are current through June 2004.
Because a number of applications remain pending for more recent years, the allowance rate will change over time.
Applications with a medical decision may be pending a final nonmedical decision or be subsequently denied for nonmedical reasons.
Data from 1992 to 1998 are available for disabled workers only.
SSI = Supplemental Security Income.
a. Rate determined by dividing medical allowances by all medical decisions for that year.
b. Rate for the Social Security portion only.
CONTACT: Clark Pickett (410) 965-9016 or di.asr@ssa.gov.
Table 55. Medical decisions at the reconsideration level, by year of application and program, 1992–2003
Year All decisions Decisions on applications
for Social Security only
Decisions on applications
for both Social Security and SSI
Total Allowances Allowance
rate a
(percent)
Total Allowances Allowance
rate a
(percent)
Total Allowances Allowance
rate a,b
(percent)
All disabled beneficiaries
1999 398,176 61,143 15.4 210,349 34,724 16.5 187,827 26,419 14.1
2000 408,499 58,590 14.3 215,416 33,233 15.4 193,083 25,357 13.1
2001 435,072 58,417 13.4 222,192 32,590 14.7 212,880 25,827 12.1
2002 495,402 59,551 12.0 245,647 32,742 13.3 249,755 26,809 10.7
2003 454,458 45,945 10.1 218,012 25,115 11.5 236,446 20,830 8.8
Workers
1992 419,798 53,881 12.8 190,594 25,352 13.3 229,204 28,529 12.4
1993 469,151 58,275 12.4 206,606 27,306 13.2 262,545 30,969 11.8
1994 489,731 62,757 12.8 226,013 31,468 13.9 263,718 31,289 11.9
1995 458,035 60,584 13.2 218,949 31,563 14.4 239,086 29,021 12.1
1996 464,580 65,466 14.1 226,331 33,596 14.8 238,249 31,870 13.4
1997 403,207 59,978 14.9 206,130 33,373 16.2 197,077 26,605 13.5
1998 384,976 61,742 16.0 199,271 34,043 17.1 185,705 27,699 14.9
1999 385,401 57,808 15.0 203,688 33,192 16.3 181,713 24,616 13.5
2000 397,004 55,762 14.0 209,119 31,946 15.3 187,885 23,816 12.7
2001 423,898 55,822 13.2 216,096 31,420 14.5 207,802 24,402 11.7
2002 483,286 57,351 11.9 239,310 31,746 13.3 243,976 25,605 10.5
2003 444,380 44,534 10.0 213,302 24,460 11.5 231,078 20,074 8.7
Widow(er)s
1999 7,108 1,983 27.9 4,108 917 22.3 3,000 1,066 35.5
2000 6,353 1,574 24.8 3,854 738 19.1 2,499 836 33.5
2001 6,192 1,599 25.8 3,859 741 19.2 2,333 858 36.8
2002 6,248 1,250 20.0 3,883 613 15.8 2,365 637 26.9
2003 5,219 770 14.8 2,982 420 14.1 2,237 350 15.6
Adult children
1999 5,667 1,352 23.9 2,553 615 24.1 3,114 737 23.7
2000 5,142 1,254 24.4 2,443 549 22.5 2,699 705 26.1
2001 4,982 996 20.0 2,237 429 19.2 2,745 567 20.7
2002 5,868 950 16.2 2,454 383 15.6 3,414 567 16.6
2003 4,859 641 13.2 1,728 235 13.6 3,131 406 13.0
SOURCE: Social Security Administration, Disability Research file, 100 percent data.
NOTES: Data are current through June 2004.
Because a number of applications remain pending for more recent years, the allowance rate will change over time.
Applications with a medical decision may be pending a final nonmedical decision or be subsequently denied for nonmedical reasons.
A revised process was introduced on October 1, 1999, in 10 states, under which initial denials could be appealed directly to the hearing level without a reconsideration.
Data from 1992 to 1998 are available for disabled workers only.
SSI = Supplemental Security Income.
a. Rate determined by dividing medical allowances by all medical decisions for that year.
b. Rate for the Social Security portion only.
CONTACT: Clark Pickett (410) 965-9016 or di.asr@ssa.gov.
Table 56. Medical decisions at the hearing level or above, by year of application and program, 1992–2003
Year All decisions Decisions on applications
for Social Security only
Decisions on applications for
both Social Security and SSI
Total Allowances Allowance
rate a
(percent)
Total Allowances Allowance
rate a
(percent)
Total Allowances Allowance
rate a,b
(percent)
All disabled beneficiaries
1999 259,057 187,885 72.5 141,940 111,443 78.5 117,117 76,442 65.3
2000 277,685 200,843 72.3 151,007 118,345 78.4 126,678 82,498 65.1
2001 281,835 207,197 73.5 150,307 120,145 79.9 131,528 87,052 66.2
2002 228,652 172,493 75.4 123,185 100,985 82.0 105,467 71,508 67.8
2003 58,130 45,946 79.0 33,836 28,878 85.3 24,294 17,068 70.3
Workers
1992 275,863 201,359 73.0 131,624 105,371 80.1 144,239 95,988 66.5
1993 310,655 217,816 70.1 143,997 112,593 78.2 166,658 105,223 63.1
1994 323,607 220,645 68.2 156,458 119,338 76.3 167,149 101,307 60.6
1995 301,916 202,651 67.1 150,881 113,746 75.4 151,035 88,905 58.9
1996 306,243 204,462 66.8 157,788 116,190 73.6 148,455 88,272 59.5
1997 262,704 185,499 70.6 139,052 107,191 77.1 123,652 78,308 63.3
1998 248,298 178,379 71.8 133,420 104,389 78.2 114,878 73,990 64.4
1999 255,032 185,095 72.6 138,883 109,266 78.7 116,149 75,829 65.3
2000 273,463 197,932 72.4 147,801 116,072 78.5 125,662 81,860 65.1
2001 277,899 204,418 73.6 147,270 117,944 80.1 130,629 86,474 66.2
2002 225,526 170,250 75.5 120,747 99,181 82.1 104,779 71,069 67.8
2003 57,348 45,332 79.0 33,234 28,400 85.5 24,114 16,932 70.2
Widow(er)s
1999 2,909 2,220 76.3 2,244 1,736 77.4 665 484 72.8
2000 3,007 2,307 76.7 2,321 1,805 77.8 686 502 73.2
2001 2,762 2,189 79.3 2,195 1,756 80.0 567 433 76.4
2002 2,217 1,785 80.5 1,788 1,457 81.5 429 328 76.5
2003 610 521 85.4 477 407 85.3 133 114 85.7
Adult children
1999 1,116 570 51.1 813 441 54.2 303 129 42.6
2000 1,215 604 49.7 885 468 52.9 330 136 41.2
2001 1,174 590 50.3 842 445 52.9 332 145 43.7
2002 909 458 50.4 650 347 53.4 259 111 42.9
2003 172 93 54.1 125 71 56.8 47 22 46.8
SOURCE: Social Security Administration, Disability Research file, 100 percent data.
NOTES: Data are current through August 2004.
Because a number of applications remain pending for more recent years, the allowance rate will change over time.
Applications with a medical decision may be pending a final nonmedical decision or be subsequently denied for nonmedical reasons.
A revised process was introduced on October 1, 1999, in 10 states, under which initial denials could be appealed directly to the hearing level without a reconsideration.
Data from 1992 to 1998 are available for disabled workers only.
SSI = Supplemental Security Income.
a. Rate determined by dividing medical allowances by all medical decisions for that year.
b. Rate for the Social Security portion only.
CONTACT: Clark Pickett (410) 965-9016 or di.asr@ssa.gov.
Table 57. Percentage distribution of final medical allowances, by year of application and reason for allowance, 1992–2003
Year Total Meets level
of severity
of listings
Equals level
of severity
of listings
Medical and
vocational
factors
considered
Other a
Number Percent
All disabled beneficiaries
1999 707,169 100.0 33.1 5.9 27.0 34.0
2000 759,440 100.0 31.4 6.2 29.5 32.9
2001 823,786 100.0 30.6 6.2 30.7 32.5
2002 800,338 100.0 31.8 6.0 33.7 28.5
2003 651,002 100.0 37.4 6.9 42.1 13.6
Workers
1992 689,111 100.0 34.3 11.1 24.3 30.3
1993 695,007 100.0 34.3 8.7 23.6 33.4
1994 671,791 100.0 34.5 6.9 25.6 32.9
1995 628,292 100.0 34.5 6.7 26.8 31.9
1996 651,979 100.0 34.2 7.0 27.4 31.4
1997 601,498 100.0 35.0 7.6 26.4 31.0
1998 612,452 100.0 35.5 6.6 27.0 30.9
1999 638,452 100.0 33.7 6.3 28.4 31.7
2000 688,427 100.0 32.0 6.6 30.9 30.5
2001 753,268 100.0 31.2 6.5 32.1 30.2
2002 730,230 100.0 32.5 6.3 35.3 25.9
2003 589,254 100.0 38.5 7.4 44.7 9.4
Widow(er)s
1999 29,099 100.0 14.9 2.5 24.6 58.0
2000 29,633 100.0 12.8 2.5 26.3 58.3
2001 30,011 100.0 12.3 2.6 27.1 57.9
2002 28,902 100.0 12.1 2.2 28.0 57.8
2003 24,691 100.0 12.5 2.5 30.1 54.8
Adult children
1999 39,618 100.0 35.9 3.2 7.4 53.5
2000 41,380 100.0 35.0 3.1 7.3 54.7
2001 40,507 100.0 33.0 3.0 8.0 55.9
2002 41,206 100.0 33.2 3.0 8.0 55.8
2003 37,057 100.0 35.8 3.1 9.1 52.0
SOURCE: Social Security Administration, Disability Research file, 100 percent data.
NOTES: Data for the initial and reconsideration levels are current through June 2004. Data for the hearing level or above are current through August 2004.
Because a number of applications remain pending for more recent years, the numbers and percentages will change over time.
Applications with a medical decision may be pending a final nonmedical decision or be subsequently denied for nonmedical reasons.
Data include decisions for Social Security–only applications and applications for both Social Security and Supplemental Security Income (SSI); they do not include SSI-only claims.
Data from 1992 to 1998 are available for disabled workers only.
a. Includes applications for which the disability was previously established and those for which the basis for the determination is not available. The majority of applications for which the basis of determination is not available are cases allowed at or above the hearing level.
CONTACT: Clark Pickett (410) 965-9016 or di.asr@ssa.gov.
Table 58. Percentage distribution of final medical denials, by year of application and reason for denial, 1992–2003
Year Total Impairment
did not
or is not
expected
to last
12 months
Impairment
is not
severe
Able to do
usual
past work
Able to do
other type
of work
Other a
Number Percent
All disabled beneficiaries
1999 446,912 100.0 10.3 17.8 28.3 30.8 12.8
2000 456,693 100.0 10.1 17.2 28.2 30.4 14.1
2001 487,010 100.0 9.4 16.8 27.9 30.8 15.1
2002 541,312 100.0 8.8 17.2 27.9 30.6 15.5
2003 575,166 100.0 8.0 17.0 28.4 31.1 15.5
Workers
1992 487,164 100.0 10.7 22.9 28.4 29.6 8.4
1993 546,532 100.0 10.4 22.7 27.6 29.8 9.5
1994 578,664 100.0 10.2 21.5 25.9 28.8 13.6
1995 547,232 100.0 10.6 20.8 25.4 29.4 13.8
1996 542,733 100.0 10.2 19.6 24.7 30.6 14.8
1997 449,880 100.0 10.7 18.6 25.8 30.6 14.2
1998 423,717 100.0 10.8 18.3 27.8 30.8 12.3
1999 420,445 100.0 10.7 17.4 29.3 30.1 12.6
2000 430,873 100.0 10.5 16.7 29.3 29.7 13.8
2001 461,384 100.0 9.7 16.4 28.9 30.2 14.9
2002 511,922 100.0 9.1 16.8 28.9 29.8 15.3
2003 543,201 100.0 8.3 16.7 29.4 30.4 15.3
Widow(er)s
1999 9,677 100.0 5.6 29.1 31.8 22.7 10.8
2000 8,978 100.0 5.3 29.0 31.4 22.4 12.1
2001 8,624 100.0 4.7 27.6 31.1 22.8 13.7
2002 9,088 100.0 4.8 25.7 32.4 24.0 13.0
2003 9,847 100.0 4.6 24.7 33.4 24.2 13.0
Adult children
1999 16,790 100.0 3.1 22.7 0.7 53.3 20.2
2000 16,842 100.0 2.9 22.9 0.7 51.9 21.7
2001 17,002 100.0 2.6 21.3 0.9 52.8 22.4
2002 20,302 100.0 2.3 21.4 0.8 53.6 21.8
2003 22,118 100.0 2.2 21.5 0.7 53.6 22.0
SOURCE: Social Security Administration, Disability Research file, 100 percent data.
NOTES: Data for the initial and reconsideration levels are current through June 2004. Data for the hearing level or above are current through August 2004.
Because a number of applications remain pending for more recent years, the numbers and percentages will change over time.
Applications with a medical decision may be pending a final nonmedical decision or be subsequently denied for nonmedical reasons.
Data include decisions for Social Security–only applications and applications for both Social Security and Supplemental Security Income (SSI); they do not include SSI-only claims.
Data from 1992 to 1998 are available for disabled workers only.
a. Applicant has an impairment resulting from drug addiction or alcoholism, provided insufficient medical evidence, failed to cooperate, failed to follow prescribed treatment, did not want to continue development of the claim, or returned to substantial work before disability could be established. Also includes cases denied at or above the hearing level for which the basis of determination is not available.
CONTACT: Clark Pickett (410) 965-9016 or di.asr@ssa.gov.