In Florida, you will need to file two appeals in order to have your claim heard by a Judge.
The First Appeal: Reconsideration
Most states, including Florida, require you to file a Request for Reconsideration with your local Social Security District Office before you can file a Request for Hearing before an Administrative Law Judge. Your reconsideration request will then be reevaluated by someone new with Disability Determination Services.
Unfortunately, the chances of winning at the reconsideration stage are very low. In Florida, statistics show that only about 10% of Requests for Reconsideration are approved for benefits. That means nine out of ten claims continue to be denied. Thus, you can generally expect that if you are denied on your initial claim for disability benefits, you will probably be denied on your first appeal for reconsideration as well.
To summarize, SSDI and SSI claims that are denied at the initial application level will almost always need to be heard by an Administrative Law Judge (ALJ) at a hearing before they can be approved. So if your initial claim is denied, expect to file at least two appeals (except in those states that have eliminated the reconsideration stage of appeal).
The Second Appeal: Requests for Hearings Before an Administrative Law Judge
Reconsideration requests are rarely approved because they are handled by the very same agency that reviews initial claims. In Florida, the state agency is called Disability Determination Services (DDS). DDS is responsible for deciding which cases win and which cases lose.
If you think about it, it isn’t very likely for the same state agency to deny an application for benefits and then approve it just a few weeks later. Logically, for DDS to deny an initial claim and then, just weeks later, to review the paperwork and approve the claim upon a request for reconsideration would be admitting to decisional errors on the initial claim.
In other words, it is practically an admission that a denied claim should have won and been awarded benefits in the first place. For this reason, DDS very seldom approves a Social Security Disability or SSI case at the reconsideration level and the denial rate on reconsiderations is even higher than the denial rate for initial claims.
However, some reconsideration requests are approved. There are two primary reasons that some claims are approved at this level. First, the claim is reassigned to a new claims examiner at the reconsideration stage. So someone new is looking at the claim with a fresh set of eyes. The claim may be approved because of this new perspective. Second, some claims are approved because new and material evidence is submitted during the appeal that bolsters the strength of the claim.
For these reasons, you can expect a virtual automatic denial of the reconsideration because it happens roughly 90% of the time. Thus, the general “rule of thumb” regarding approvals and denials is that, unless you are approved on your initial application, you will likely need to have your case heard by a judge at a hearing before your case can be won and benefits can be approved.