Annual Statistical Report on the Social Security Disability Insurance Program, 2002

Outcomes of Applications for Disabled-Worker Benefits

Notes

The tables in this section provide data on the outcomes of disabled-worker applications. The data on applications are derived from the Social Security Administration's (SSA's) Disability Research File (DRF) maintained by the Office of Disability Programs. Each year the DRF 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 50 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 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 51-53 show the allowance rate for Social Security only and the Social Security portion of concurrent (a claim for both Social Security and SSI disability benefits) applications, one for each level in the administrative decisionmaking process, that is, initial, 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.

This section includes one table that shows the reason for medical allowance and one that shows reason for medical denial (Tables 54 and 55). 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:

  • Has a listed impairment,
  • Has a severe impairment that is equal to a listed impairment,
  • Has a severe impairment when medical and vocational factors are considered, or
  • Had previously established entitlement to a disability benefit.

An applicant can be denied benefits if he or she:

  • Has an impairment that is not expected to last 12 months,
  • Has an impairment that is not considered severe,
  • Is able to perform his or her usual type of work,
  • Is able to perform another type of work, or
  • Has an impairment resulting from drug addiction or alcoholism, provides insufficient medical evidence, fails to cooperate, fails to follow prescribed treatment, does not want to continue development of the claim, or returns to substantial work before disability can be established.
Table 50. Outcomes at all adjudicative levels, by year of application, 1992-2001
Year Total Pending
final
decision		 Technical
denials a		 Medical decisions Award
rate b
(percent)		 Allowance
rate c
(percent)
Denials Allowances
Medical Subsequent
nonmedical d		 Awards Subsequent
denials e
1992 1,310,004 0 130,885 481,439 5,725 689,111 2,844 52.6 58.8
1993 1,384,501 0 140,314 540,998 5,626 694,915 2,648 50.2 56.2
1994 1,383,092 0 130,246 573,402 5,507 671,540 2,397 48.6 53.9
1995 1,301,472 6,156 123,651 536,589 5,052 627,788 2,236 48.5 53.9
1996 1,313,818 7,586 116,932 531,269 5,014 650,901 2,116 49.8 55.0
1997 1,164,680 8,321 106,807 443,910 4,219 599,564 1,859 51.8 57.4
1998 1,138,101 10,420 96,627 415,648 4,220 609,141 2,045 54.0 59.4
1999 1,167,664 21,287 102,203 407,277 4,040 631,067 1,790 55.0 60.7
2000 1,257,160 73,927 133,821 405,907 3,930 637,677 1,898 53.9 61.1
2001 1,388,090 239,575 167,075 415,530 3,836 560,094 1,980 48.8 57.4
SOURCE: Social Security Administration, Disability Research file, 100 percent data.
NOTES: Data for the initial and reconsideration levels are current through June 2002. Data for the hearing level or above are current through July 2002.
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.
Includes decisions for Social Security-only applications and applications for both Social Security and SSI. Does not include SSI-only applications.
a. Applications denied for nonmedical reasons so no decision was made on severity of impairment.
b. Rate determined by dividing awards by all applications minus pending claims for that year.
c. Rate determined by dividing medical allowances by all medical decisions for that year.
d. Applications denied for nonmedical reasons after a decision was made that applicant did not meet the medical severity criteria for disability benefits.
e. Applications denied for nonmedical reasons after a decision was made that applicant met the medical severity criteria for disability benefits.
CONTACT: Clark Pickett (410) 965-9016 or di.asr@ssa.gov for further information.
Table 51. Medical decisions at the initial adjudicative level, by year of application and program, 1992-2001
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
(percent)
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 1,252,846 390,785 31.2 591,402 233,059 39.4 661,444 157,726 23.8
1995 1,177,754 367,293 31.2 569,956 223,457 39.2 607,798 143,836 23.7
1996 1,196,824 384,167 32.1 593,986 237,474 40.0 602,838 146,693 24.3
1997 1,057,779 357,880 33.8 551,876 228,793 41.5 505,903 129,087 25.5
1998 1,041,340 374,376 36.0 550,751 238,989 43.4 490,589 135,387 27.6
1999 1,065,234 397,335 37.3 578,691 259,910 44.9 486,543 137,425 28.2
2000 1,122,536 433,188 38.6 609,243 281,585 46.2 513,293 151,603 29.5
2001 1,218,623 479,779 39.4 652,076 312,640 47.9 566,547 167,139 29.5
SOURCE: Social Security Administration, Disability Research file, 100 percent data.
NOTES: Data are current through June 2002.
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 subsequently denied for nonmedical reasons.
a. Rate determined by dividing medical allowances by all medical decisions for that year.
CONTACT: Clark Pickett (410) 965-9016 or di.asr@ssa.gov for further information.
Table 52. Medical decisions at the reconsideration level, by year of application and program, 1992-2001
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 (percent)
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 489,725 62,757 12.8 226,007 31,468 13.9 263,718 31,289 11.9
1995 458,029 60,584 13.2 218,943 31,563 14.4 239,086 29,021 12.1
1996 464,576 65,466 14.1 226,327 33,596 14.8 238,249 31,870 13.4
1997 403,192 59,978 14.9 206,115 33,373 16.2 197,077 26,605 13.5
1998 384,954 61,742 16.0 199,249 34,043 17.1 185,705 27,699 14.9
1999 385,349 57,808 15.0 203,636 33,192 16.3 181,713 24,616 13.5
2000 388,345 54,356 14.0 204,118 31,327 15.3 184,227 23,029 12.5
2001 347,863 41,015 11.8 177,859 23,677 13.3 170,004 17,338 10.2
SOURCE: Social Security Administration, Disability Research file, 100 percent data.
NOTES: Data are current through June 2002.
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 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.
a. Rate determined by dividing medical allowances by all medical decisions for that year.
CONTACT: Clark Pickett (410) 965-9016 or di.asr@ssa.gov for further information.
Table 53. Medical decisions at the hearing level or above, by year of application and program, 1992-2001
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
(percent)
1992 275,863 201,359 73.0 131,624 105,371 80.1 144,239 95,988 66.5
1993 310,655 217,724 70.1 143,997 112,561 78.2 166,658 105,163 63.1
1994 323,601 220,394 68.1 156,452 119,251 76.2 167,149 101,143 60.5
1995 295,811 202,147 68.3 148,614 113,512 76.4 147,197 88,635 60.2
1996 298,700 203,384 68.1 154,758 115,671 74.7 143,942 87,713 60.9
1997 259,010 183,565 70.9 137,317 106,259 77.4 121,693 77,306 63.5
1998 241,121 175,068 72.6 130,092 102,764 79.0 111,029 72,304 65.1
1999 238,480 177,714 74.5 131,091 105,509 80.5 107,389 72,205 67.2
2000 202,880 152,031 74.9 113,620 91,817 80.8 89,260 60,214 67.5
2001 53,555 41,280 77.1 31,333 25,817 82.4 22,222 15,463 69.6
SOURCE: Social Security Administration, Disability Research file, 100 percent data.
NOTES: Data are current through July 2002.
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 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.
a. Rate determined by dividing medical allowances by all medical decisions for that year.
CONTACT: Clark Pickett (410) 965-9016 or di.asr@ssa.gov for further information.
Table 54. Percentage distribution of final medical allowances, by year of application and reason for allowance, 1992-2001
Year Total Meets level
of severity
of listings		 Equals level
of severity
of listings		 Medical and
vocational
factors
considered		 Other a
Number Percent
1992 689,111 100.0 34.3 11.1 24.3 30.3
1993 694,915 100.0 34.3 8.7 23.6 33.4
1994 671,540 100.0 34.5 6.9 25.6 32.9
1995 627,788 100.0 34.5 6.8 26.9 31.9
1996 650,901 100.0 34.2 7.0 27.5 31.3
1997 599,564 100.0 35.1 7.6 26.5 30.8
1998 609,141 100.0 35.7 6.6 27.1 30.5
1999 631,067 100.0 34.1 6.3 28.7 30.9
2000 637,677 100.0 34.4 7.1 33.2 25.3
2001 560,094 100.0 40.4 8.4 40.9 10.3
SOURCE: Social Security Administration, Disability Research file, 100 percent data.
NOTES: Data for the initial and reconsideration levels are current through June 2002. Data for the hearing level or above are current through July 2002.
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 subsequently denied for nonmedical reasons.
Includes decisions for Social Security-only applications and applications for both Social Security and SSI. Does not include SSI-only claims.
a. Includes applications for which the disability was previously established and those for which the basis for the determination is not available.
CONTACT: Clark Pickett (410) 965-9016 or di.asr@ssa.gov for further information.
Table 55. Percentage distribution of final medical denials, by year of application and reason for denial, 1992-2001
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
1992 487,164 100.0 10.7 22.9 28.4 29.6 8.4
1993 546,624 100.0 10.4 22.7 27.6 29.8 9.5
1994 578,909 100.0 10.2 21.5 25.9 28.8 13.6
1995 541,641 100.0 10.7 20.9 25.5 29.6 13.4
1996 536,283 100.0 10.3 19.8 24.9 30.8 14.2
1997 448,129 100.0 10.7 18.6 25.8 30.6 14.2
1998 419,868 100.0 10.9 18.3 27.7 30.7 12.4
1999 411,317 100.0 10.8 17.4 29.2 29.8 12.8
2000 409,837 100.0 10.8 16.7 29.1 29.1 14.3
2001 419,366 100.0 10.3 15.9 28.9 29.4 15.6
SOURCE: Social Security Administration, Disability Research file, 100 percent data.
NOTES: Data for the initial and reconsideration levels are current through June 2002. Data for the hearing level or above are current through July 2002.
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 subsequently denied for nonmedical reasons.
Includes decisions for Social Security-only applications and applications for both Social Security and SSI. Does not include SSI-only claims.
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.
CONTACT: Clark Pickett (410) 965-9016 or di.asr@ssa.gov for further information.