What We Discern from the Case Disposition Data in the 2020 SSA Waterfall Chart

 As part of the budget request to Congress every year, SSA presents its justification for that request.  In that justification is the "waterfall" chart.  The 2020 data for the 2022 budget request looks like this:

Treating all the data as from one application pool (which is wrong but nonetheless useful), the chart tells us that SSA granted 1,042,170 claims initially, on reconsideration, by an ALJ, by the Appeals Council, or by order of the federal courts.  While the initial level grants 39% of the claims made, 767,424 allowances represent 74% of the favorable determinations or decisions made on the chart.  Reconsideration accounts for 7% of favorable dispositions, ALJs account for 15% of those favorable dispositions.  The AC and the federal court combined amount to 0.15% of the awards of benefits (not counting remands).  When the claimants' bar complains about the low allowance rate of the state agencies handling initial claims, the bar must concede that initial claims account for the overwhelming majority of allowed claims on this chart and historically.  The 2020 data is not that different from prior years.  

The data allows consideration of attrition as a phenomenon.  Of the 1.5 million claims filed, 660,000 do not seek reconsideration after the initial determination that the person does not meet the definition of disability.  Another 61,000 do not request a hearing after the reconsideration denial.  Claimants denied benefits by an ALJ do not seek AC review in 22,000 cases.  The second-place finisher for attrition is the 87,000 claimants that receive a denial of review by the AC and fail to seek review by the federal courts.  

Since the Conn-Daugherty debacle of 2010, the bar knows that allowance rates at the ALJ level dropped precipitously.  Along with that free fall of allowance rates, the AC grant of review dropped from a historical 25% to 30% to the 12% reported on this chart.  Despite the halving of the review rate by the AC, the claimants' representatives have not sought review in more cases in federal court.  The rate of federal court filings has slid from the historical 14% to just over 13%.  That might not represent a statistically relevant change in the federal filing rate.  But when compared to the drop in the AC review rate, the relatively stable filing rate screams that the government has tightened the screws and the bar flinched.  The bar has not responded with more federal court filings of meritorious claims.  

There are explanations for this observation.  ALJ decisions are better organized than they were 15 to 30 years ago.  The Findings Integrated Template eliminated most of the decisions that failed to address subjective symptom and limitation testimony.  The evolution from the free style consideration of medical opinion evidence to the weight standard and to the persuasive value standard has made decisions vaguer about why the ALJ made findings and more cumbersome to challenge.  The courts' embrace and expansion of the harmless error standard in the past 20 years has made the court litigation more difficult.  The ingestion of the poison pill that vocational witnesses have some unstated statistical expertise has placed further obstacles in the court review process.  The claimants' bar can and should do more and do better at the hearings and pursue more claims in federal court.  

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Suggested Citation:

Lawrence Rohlfing, What We Discern from the Case Disposition Data in the 2020 SSA Waterfall Chart, California Social Security Attorney (July 25, 2022) https://californiasocialsecurityattorney.blogspot.com

The author is AV rated for 23 years and listed in Super Lawyers for 14 years.