Win Rates For Unrepresented Claimants Vs. Attorney Represented Claimants

Applicants and claimants for Social Security disability claims often ask me whether they “really” need an attorney to represent them through the application and approval process for benefits. I would never state that you need to hire an attorney because a claimant may go through the entire appeals process without an attorney or other representative. That being said, I’d like to provide you with some statistics as to the relative success rates of those who go unrepresented before the Social Security Administration.

Statistical Analysis of Your Chance of Winning

I am constantly asked by my own clients, “What are my chances of winning my claim for disability?” I’m a big fan of statistics, so I thought I would run a statistical analysis of a claimant’s chance of winning their claim in our area.

After an unfavorable initial decision and unfavorable first appeal, the second appeal is at the hearing level with an Administrative Law Judge. The greater Pensacola, Florida area is covered at this level of appeal by the Mobile, Alabama Office of Adjudication and Review (ODAR) for the Social Security Administration (SSA). Even though this ODAR is in Alabama, it properly covers the Northwest Florida area because Social Security is a federal program of benefits and not a state-specific one.

In any event, in 2010 and 2011 I filed several Freedom Of Information Act (FOIA) requests with the federal government. I asked for numerous categories of information, including the following:

• the total number of decisions issued by each Mobile ODAR Judge;
• the total number of fully favorable and partially favorable decisions (approvals) issued by each Judge;
• the total number of unfavorable decisions (denials) issued by each Judge;
• the number of approvals issued by each Judge in claims where the claimant did not have a representative or attorney;
• the number of denials issued by each Judge in claims where the claimant did not have a representative or attorney;
• the number of approvals issued by each Judge in claims where the claimant had a representative or attorney; and
• the number of denials issued by each Judge in claims where the claimant had a representative or attorney.

The results were very interesting. The following will address claims that went decision. The numbers do not include dismissals, which include claims that were dropped by the claimant or dismissed by the Judge for non-medical reasons (such as the claimant’s failure to appear at the hearing).

First I’ll address the findings where the claimant was unrepresented, or did not have an attorney or other representative. There were 267 fully favorable decisions, 39 partially favorable decisions, and 519 unfavorable decisions. This computes to a 37.1% win rate for those that represented themselves and did not have anyone to represent them at the hearing.[Note: A decision is categorized as a win here when the it is either fully favorable or partially favorable.]

Next are the findings for claimants represented by attorneys. There were 2,771 fully favorable decisions, 224 partially favorable decisions, and 1,169 unfavorable decisions. This computes to a 71.9% win rate for those that were represented by an attorney.